Preview
FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022
NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023
Century Surety Company
550 POLARIS PARKWAY, SUITE 300
WESTERVILLE, OH 43082
A STOCK COMPANY
COMMERCIAL LINES POLICY
THIS POLICY JACKET WITH COMMON POLICY CONDITIONS, THE
DECLARATIONS PAGE, COVERAGE PART(S), COVERAGE FORM(S)
AND APPLICABLE FORMS AND ENDORSEMENTS COMPLETE THIS
POLICY.
CSCP 1000 0519
FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022
NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023
CENTURY
SURETY COMPANY
Century Surety Company
550 Polaris Parkway, Suite 300
Westerville, Ohio 43082
www.centurysurety.com
COMMERCIAL EXCESS LIABILITY COVERAGE DECLARATIONS
AMED INSURED AND ADDRESS: INSURED'S AGENT: Fairmont Ins Brokers Ltd
NYC Building Solutions Corp 1600 60th St
1202 Halsey St
Brooklyn NY 11204
Brooklyn NY 11207 Licensed Surplus Lines Producer: Northeast Coverages, Inc
910 Franklin Avenue
Suite 210
Garden City NY 11530
Same as Mailing Address Above
POLICY PERIOD: From: 12/24/2021 To: 12/24/2022 at 12:01 AM Standard nme at your mailing address shown above
Business Description: Contractor
O Individual □Joint Venture □ Partnership □ Limited Liability Company 181 Organization (Other than Partnership or Joint Venture)
ULTIMATE NET LOSS LIMITS OF LIABILITY PREMIUM
181 Flat D Adjustable
Rate: Per: Premium Basis:
Policy Fee (fully earned) s Deposit Premium: s
Each Occurrence Limit: s 4,000,000
Inspection Fee s Premium: $
Surplus Lines Tax s Minimum Premium: $
TRIA Premium:
Aggregate Limit: s-------
4,000,000
$
$
Rejected
$
$
Total Policy Premium: $
25 % of the Policy Premium is fully earned as of the effective date of this policy and is not subject to return or refund.
FORMS AND ENDORSEMENTS: Forms an Endorsements applying to t is Coverage an made part o this policy at time o issue:
See Attached Form CIL 1500B
Any person who, with intent to de raud or knowing that he is acilitating a aud against an Insurer, submits an application or 1les a claim containing
false or deceptive statement is guilty of insurance fraud.
COMPANY REPRESENTATIVE:
Northeast Coverages, Inc
910 Franklin Avenue
Suite 210 Countersigned By
Garden City NY 11530 Authorized Representative
Program Code: CXLH Licensed Surplus Lines Producer Signature
I , t Is ompany as execute un ess countersIgne
by the duly Authorized Agent of this Company at the Agency hereinbefore mentioned.
Secretary President
CXL 1100 0920
This is to certify that Excess Line Association of '1ew York received and reviewed the 01/31/2022
attached insurance document in accordance with Article 21 of the New York State ld:109650880
Insurance Law
THE INSURER(S) NAMED HEREIN IS (ARE) NOT LICENSED BY THE STATE OF NE\V YORK,
NOT SUBJECT TO ITS SUPER'11SION, AND 11\" THE EVENT OF THE INSOLVENCY OF THE
11\"SURER(S), NOT PROTECTED BY THE NEW YORK STATE SECURITY FUNDS. THE POLICY
MAY NOT BE SUBJECT TO ALL OF THE REGULATIONS OF THE DEPARTMENT OF
FINANCIAL SERVICES PERTAINING TO POLICY FORMS.
FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022
NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023
COMMERCIAL EXCESS LIABILITY POLICY
CONTROLLING UNDERLYING INSURANCE SCHEDULE
Policy No: CCP 1022802 Effective Date: 12/24/2021
12:01 A.M. Standard Time
NAMED INSURED: NYC Building Solutions Corp
CARRIER, POLICY NUMBER, POLICY PERIOD TYPE OF POLICY RETAINED LIMITS OF LIABILITY
NOT COVERED Employers
Liability
$ NOT COVERED Each Accident
$ NOT COVERED Disease Policy Limit
$ NOT COVERED Disease Each Employee
OR
$ NOT COVERED Each Accident per Occurrence
Western World Insurance Co Commercial
Policy number per as on file with General $ 2,000,000 General Aggregate Limit (other than Prods/Comp Ops)
company Liability
12/24/2021 to 12/24/2022 $ 2,000,000 Products/Completed Operations Aggregate Limit
$ 1,000,000 Personal and Advertising Injury Limit
$ 1,000,000 Each Occurrence Limit
NOT COVERED Automobile Bodily Injury Liability
Liability $ NOT COVERED Each Person
Limited to $ NOT COVERED Each Accident
Hired Auto
Liability Property Damage Liability
Limited to
Non-Owned $ NOT COVERED Each Accident
Auto Bodily Injury/Property Damage Liability Combined Single Limit
Liability
Limited to $ NOT COVERED Each Accident
Non-Owned
and Hired
Auto
CXL 1100a 07 12 Page 1 of 1
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Policy Number: CCP 1022802 CIL 15 00b 02 02
SCHEDULE OF FORMS AND ENDORSEMENTS
(other than applicable forms and endorsements shown elsewhere in the policy)
Forms and Endorsements applying to the Coverage Parts listed below and made a part of this policy at time of issue:
Form/ Edition
Endt. # Date Title Total # of Forms Selected: 37
Forms Applicable to this Coverage part - INTERLINE-ALL COVERAGE PARTS
CCP 2010 05 08 Service of Suit Clause
CIL 0003 02 20 Calculation of Premium
CIL 1500B 02 02 Schedule of Forms and Endorsements
CSCP 1000 05 19 Century Surety Company Commercial Lines Policy Jacket
U.S. Treasury Department's Office of Foreign Assets Control ("OFAC") Advisory Notice to
IL P001 01 04
Policyholders
PNCC 0001a 04 20 Policyholder Notice Claims Reporting
PRIV 0001 05 19 Privacy Statement
TRIA 0001 09 20 Policyholder Disclosure Notice of Terrorism Insurance Coverage
Notice To Policyholders Regarding Duties in the Event of an Occurrence, Offense, Claim or
XUPN 0001 02 13
Suit
9 Forms
Forms Applicable to this Coverage part - EXCESS
CX 0001 04 13 Commercial Excess Liability Coverage Form
CX 2101 09 08 Nuclear Energy Liability Exclusion Endorsement (broad Form)
CX 2119 04 13 Exclusion - Employment-Related Practices
Conditional Exclusion of Terrorism Involving Nuclear, Biological or Chemical Terrorism
CX 2132 01 15
(Relating to Disposition of Federal Terrorism Risk Insurance Act)
Exclusion of Certified Acts of Terrorism and Exclusion of Other Acts of Terrorism Committed
CX 2135 01 15
Outside The United States
CX 2136 01 15 Exclusion of Punitive Damages Related to a Certified Act of Terrorism
Exclusion of Certified Nuclear, Biological, Chemical or Radiological Acts of Terrorism; Cap
CX 2145 01 15
on Losses From Certified Acts of Terrorism
CX 2700 09 08 Underlying Claims-made Coverage
CXL 1100 09 20 Century Surety Company Commercial Excess Liability Coverage Declarations
CXL 1100a 07 12 Controlling Underlying Insurance Schedule
CXL 1102 09 17 Special Exclusions and Limitations Endorsement - Contracting and Service Risks
CXL 1103 08 13 Amendment of Retained Limit Definition
CXL 1113 10 10 Exclusion - Total Pollution
CXL 1115 02 21 Amendatory Endorsement - Coverage Territory
CXL 1118 07 15 Limitation - Hot Tar and Torch Roofing Operations
CXL 1136a 02 15 Exclusion - Bodily Injury to Independent Contractors - Designated States
CXL 1137 05 13 Exclusion - Electronic Data
CXL 1157 06 14 Limitation - Scaffolding Hazard
Exclusion - Condominium, Cooperative, Timeshare, Townhome, Row House or Tract Home
CXL 1162 12 17
Construction
CIL 15 00b 02 02 Page 1 of 2
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CXL 1168 07 15 Exclusion - Imported Drywall
CXL 1174CO 01 21 Limitation - State of Colorado
CXL 1174MOa 01 21 Exclusion - State of Missouri
CXL 1174WA 01 21 Limitation - State of Washington
CXL 1178 03 20 Exclusion - Automobile Liability
CXL 1185 02 14 Exclusion - Action Over
CXL 1196 10 13 Exclusion - Access or Disclosure of Confidential or Personal Information
CXL 1198 07 15 Exclusion - Critical Aircraft Products or Grounding
CXL 1213 12 19 Absolute Exclusion - Cyber Multi-Media or Internet
28 Forms
CIL 15 00b 02 02 Page 2 of 2
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NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023
CLAIMS REPORTING
We offer FOUR convenient ways to report a claim
1) Online - Visit: www.centurysurety.com We’ve made filing
Click on Report a Claim a claim quick and
convenient!
2) Email - Send claim information to:
newclaim@centurysurety.com Simply go to
www.centurysurety.com
3) Phone - Call our Service Center at: (800) 825-9489 and click on
Report A Claim
4) Fax - Fax claim information to: (614) 895-7040
Online reporting can
accelerate the claims
process leading to a faster
resolution for you.
31&&D
FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022
NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023
CCP 2010 0508
SERVICE OF SUIT CLAUSE
This endorsement modifies insurance provided by the policy to which this form is
attached.
It is agreed that in the event of the failure by us to pay any amount claimed to be due
hereunder, we will, at your request, submit to the jurisdiction of a court of competent
jurisdiction within the United States of America. Nothing in this clause constitutes or
should be understood to constitute a waiver of our rights to commence an action in a
court of competent jurisdiction in the United States of America, to remove an action to a
United States District Court, or to seek a transfer of a case to another court as
permitted by the laws of the United States of America or of any state in the United
States of America. In any such suit against us, we will abide by the final decision of
such court or of any Appellate Court in the event of an appeal.
It is further agreed that service of process in such suit may be made upon the person or
organization shown in the Policy Declarations or upon us at the address shown in the
policy jacket.
The above named are authorized and directed to accept service of process on behalf of
us in any such suit and/or upon your request to give a written undertaking to you that
we will enter a general appearance upon our behalf in the event such a suit shall be
instituted.
Further, pursuant to any statute of any state, territory, or district of the United States of
America, which makes provision therefore, we hereby designate the Superintendent,
Commissioner, or Directors of Insurance or other officer specified for that purpose in
the statute or his successor or successors in office, as their true and lawful attorney
upon whom may be served any lawful process in any action, suit, or proceeding
instituted by or on your behalf or any beneficiary hereunder arising out of this contract
of insurance, and hereby designates the above named as the person to whom the said
officer is authorized to mail such process or a true copy thereof.
CCP 20 10 0508 Page 1 of 1
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CIL 00 03 0220
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CALCULATION OF PREMIUM
This endorsement modifies insurance provided under the following:
CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART
COMMERCIAL AUTOMOBILE COVERAGE PART
COMMERCIAL EXCESS LIABILITY COVERAGE FORM
COMMERCIAL GENERAL LIABILITY COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL LIABILITY UMBRELLA COVERAGE FORM
COMMERCIAL PROPERTY COVERAGE PART
CONTRACTORS’ POLLUTION LIABILITY COVERAGE FORM
CRIME AND FIDELITY COVERAGE PART
EMPLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART
ENVIRONMENTAL SERVICES BUSINESSOWNERS COVERAGE FORM
ENVIRONMENTAL SERVICES LIABILITY COVERAGE FORM
EQUIPMENT BREAKDOWN COVERAGE PART
FARM COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
MEDICAL PROFESSIONAL LIABILITY COVERAGE PART
OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
The following is added:
The premium shown in the Declarations was computed
based on rates in effect at the time the policy was is-
sued. On each renewal, continuation, or anniversary of
the effective date of this policy, we will compute the
premium in accordance with our rates and rules then in
effect.
CIL 00 03 0220 © ISO Properties, Inc., 2007 Page 1 of 1 o
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NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023
IL P 001 0104
U.S. TREASURY DEPARTMENT'S OFFICE OF FOREIGN
ASSETS CONTROL ("OFAC")
ADVISORY NOTICE TO POLICYHOLDERS
No coverage is provided by this Policyholder Notice nor can it be construed to replace any provisions of your
policy. You should read your policy and review your Declarations page for complete information on the coverages
you are provided.
This Notice provides information concerning possible impact on your insurance coverage due to directives issued
by OFAC. Please read this Notice carefully.
The Office of Foreign Assets Control (OFAC) administers and enforces sanctions policy, based on Presidential
declarations of "national emergency". OFAC has identified and listed numerous:
l Foreign agents;
l Front organizations;
l Terrorists;
l Terrorist organizations; and
l Narcotics traffickers;
as "Specially Designated Nationals and Blocked Persons". This list can be located on the United States Treas-
ury's web site – http//www.treas.gov/ofac.
In accordance with OFAC regulations, if it is determined that you or any other insured, or any person or entity
claiming the benefits of this insurance has violated U.S. sanctions law or is a Specially Designated National and
Blocked Person, as identified by OFAC, this insurance will be considered a blocked or frozen contract and all
provisions of this insurance are immediately subject to OFAC. When an insurance policy is considered to be such
a blocked or frozen contract, no payments nor premium refunds may be made without authorization from OFAC.
Other limitations on the premiums and payments also apply.
IL P 001 0104 © ISO Properties, Inc., 2004 Page 1 of 1
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Privacy Statement
In applying for insurance products and services with AmeriTrust Group, Inc. subsidiaries, you may
have provided us with non-public personal information. Additionally, we may seek additional
information, such as your creditworthiness or credit history, from third party reporting agencies.
This information allows us to provide you with the best products and customer service. Keeping
your personal information private and secure, whether learned directly from you or a third-party
reporting agency, is our priority.
The categories of non-public personal and financial information that we collect may include your
name, address, social security or employer identification number, assets, income, date of birth,
motor vehicle driving information and other information that is appropriate or necessary to provide
you with the insurance products and services that you request.
We do not disclose any non-public personal or financial information about you, unless permitted
or required by law or with your consent.
We may have shared this information with affiliated parties as permitted by law. We refer to and
use that information to issue and service your insurance policies, provide insurance services or
administer claims. We restrict access to your non-public personal and financial information to
those employees who need the information to provide you with products or services.
We maintain physical, electronic and procedural safeguards to protect your non-public personal
and financial information. These safeguards comply with federal and state regulations.
If you contact us at our website, https://www.ameritrustgroup.com, we do not use “cookies”, which
many organizations use to track visitors’ actions on their websites. Cookies are a general
mechanism that can store and retrieve information on your computer.
We value the relationship that we have established with current and former customers. Should
you have any comments or questions regarding our Privacy Policy, please contact us at 800-482-
2726.
This Privacy Policy applies to the following companies: (1) AmeriTrust Group, Inc.’s insurance company
subsidiaries (Star Insurance Company, Ameritrust Insurance Corporation, Williamsburg National Insurance
Company, ProCentury Insurance Company, and Century Surety Company); (2) Crest Financial
Corporation’s subsidiaries; and (3) Meadowbrook, Inc.’s subsidiaries.
PRIV 0001 0519 PAGE 1 OF 1
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NOTE TO AGENT:
It is required by federal law that you provide this document to the insured.
POLICYHOLDER DISCLOSURE
NOTICE OF TERRORISM INSURANCE COVERAGE
Coverage for acts of terrorism is included in your policy. As defined in Section 102(1) of the Act: The term
“act of terrorism” means any act that is certified by the Secretary of the Treasury—in consultation with the
Secretary of Homeland Security, and the Attorney General of the United States—to be an act of terrorism; to
be a violent act or an act that is dangerous to human life, property, or infrastructure; to have resulted in
damage within the United States, or outside the United States in the case of certain air carriers or vessels or
the premises of a United States mission; and to have been committed by an individual or individuals as part
of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct
of the United States Government by coercion. Under your coverage, any losses resulting from certified acts
of terrorism may be partially reimbursed by the United States Government under a formula established by the
Terrorism Risk Insurance Act, as amended. However, your policy may contain other exclusions which might
affect your coverage, such as an exclusion for nuclear events. Under the formula, the United States
Government generally reimburses 80% beginning January 1, 2020 of covered terrorism losses exceeding the
statutorily established deductible paid by the insurance company providing the coverage.
However, if the aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk
Insurance exceed $100 billion in a calendar year, the Treasury shall not make any payment for any portion of
the amount of such losses that exceeds $100 billion.
If aggregate insured losses attributable to terrorism acts certified under the Terrorism Risk Insurance Act
exceed $100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk
Insurance Act, we shall not be liable for the payment of any portion of the amount of such losses that exceeds
$100 billion, and in such case insured losses up to that amount are subject to pro-rata allocation in accordance
with the procedures established by the Secretary of the Treasury.
The portion of your annual premium that is attributable to coverage for acts of terrorism is as shown below.
This premium does not include any charges for the portion of losses covered by the United States government
under the Act.
Property $
Inland Marine $
Crime $ Excluded
General Liability $
Garage/Auto Dealers $ Excluded
Excess $ Rejected
Total $ Rejected
Name of Insurer: Century Surety Company
Policy Number: CCP 1022802
TRIA 0001 0920
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NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023
XUPN 0001 0213
NOTICE TO POLICYHOLDERS REGARDING
DUTIES IN THE EVENT OF AN
OCCURRENCE, OFFENSE, CLAIM OR SUIT
This notice does not form a part of your insurance contract. No coverage is provided by this notice, nor
is this notice to be construed to replace any provisions of your policy, including the policy’s
endorsements. If there is any conflict between this notice and the policy’s endorsements, then the
provisions of the policy and the policy’s endorsements shall prevail.
Carefully read your entire policy and the policy’s endorsements that are attached.
This policy includes a condition requiring you to notify us of an occurrence, offense, or an event as soon
as practicable, when you notify your underlying insurer of an occurrence, offense, or an event. Failure
to provide us with this notice may result in an exclusion of your coverage. You may provide notice
of an occurrence, offense or event through your insurance agent named on the Declarations page of this
policy.
XUPN 0001 0213 Page 1 of 1
Includes copyrighted material of Insurance Services Office, Inc., used with its permission.
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COMMERCIAL EXCESS LIABILITY
CX 00 01 04 13
COMMERCIAL EXCESS LIABILITY COVERAGE FORM
Various provisions in this policy restrict coverage. When we have no duty to defend, we will have
Read the entire policy carefully to determine rights, the right to defend, or to participate in the
duties and what is and is not covered. defense of, the insured against any other suit
Throughout this policy the words "you" and "your" seeking damages for "injury or damage".
refer to the Named Insured shown in the Declarations, However, we will have no duty to defend the
and any other person or organization qualifying as a insured against any suit seeking damages for
Named Insured under this policy. The words "we", which insurance under this policy does not
"us" and "our" refer to the company providing this apply.
insurance. The word "insured" means any person or At our discretion, we may investigate any
organization qualifying as such under the "controlling "event" that may involve this insurance and
underlying insurance". settle any resultant claim or suit, for which we
Other words and phrases that appear in quotation have the duty to defend.
marks in this Coverage Part have special meaning. But:
Refer to Section IV – Definitions. Other words and
phrases that are not defined under this Coverage Part (1) The amount we will pay for "ultimate net
but defined in the "controlling underlying insurance" loss" is limited as described in Section II –
will have the meaning described in the policy of Limits Of Insurance; and
"controlling underlying insurance". (2) Our right and duty to defend ends when we
The insurance provided under this Coverage Part will have used up the applicable limit of
follow the same provisions, exclusions and limitations insurance in the payment of judgments or
that are contained in the applicable "controlling settlements under this Coverage Part.
underlying insurance", unless otherwise directed by However, if the policy of "controlling
this insurance. To the extent such provisions differ or underlying insurance" specifies that limits
conflict, the provisions of this Coverage Part will are reduced by defense expenses, our right
apply. However, the coverage provided under this and duty to defend ends when we have
Coverage Part will not be broader than that provided used up the applicable limit of insurance in
by the applicable "controlling underlying insurance". the payment of defense expenses,
judgments or settlements under this
There may be more than one "controlling underlying Coverage Part.
insurance" listed in the Declarations and provisions in
those policies conflict, and which are not superseded b. This insurance applies to "injury or damage"
by the provisions of this Coverage Part. In such a that is subject to an applicable "retained limit".
case, the provisions, exclusions and limitations of the If any other limit, such as, a sublimit, is
"controlling underlying insurance" applicable to the specified in the "controlling underlying
particular "event" for which a claim is made or suit is insurance", this insurance does not apply to
brought will apply. "injury or damage" arising out of that exposure
unless that limit is specified in the Declarations
SECTION I – COVERAGES under the Schedule of "controlling underlying
1. Insuring Agreement insurance".
a. We will pay on behalf of the insured the c. If the "controlling underlying insurance"
"ultimate net loss" in excess of the "retained requires, for a particular claim, that the "injury
limit" because of "injury or damage" to which or damage" occur during its policy period in
insurance provided under this Coverage Part order for that coverage to apply, then this
applies. insurance will only apply to that "injury or
We will have the right and duty to defend the damage" if it occurs during the policy period of
insured against any suit seeking damages for this Coverage Part. If the "controlling
such "injury or damage" when the applicable underlying insurance" requires that the "event"
limits of "controlling underlying insurance" have causing the particular "injury or damage" takes
been exhausted in accordance with the place during its policy period in order for that
provisions of such "controlling underlying coverage to apply, then this insurance will
insurance". apply to the claim only if the "event" causing
that "injury or damage" takes place during the
policy period of this Coverage Part.
CX 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 5
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d. Any additional insured under any policy of (b) Claim or suit by or on behalf of a
"controlling underlying insurance" will governmental authority for damages
automatically be an additional insured under because of testing for, monitoring,
this insurance. If coverage provided to the cleaning up, removing, containing,
additional insured is required by a contract or treating, detoxifying or neutralizing, or in
agreement, the most we will pay on behalf of any way responding to, or assessing the
the additional insured is the amount of effects of, pollutants.
insurance required by the contract, less any This exclusion does not apply to the extent that
amounts payable by any "controlling underlying valid "controlling underlying insurance" for the
insurance". pollution liability risks described above exists or
Additional insured coverage provided by this would have existed but for the exhaustion of
insurance will not be broader than coverage underlying limits for "injury or damage".
provided by the "controlling underlying d. Workers' Compensation And Similar Laws
insurance".
Any obligation of the insured under a workers'
2. Exclusions compensation, disability benefits or
The following exclusions, and any other exclusions unemployment compensation law or any
added by endorsement, apply to this Coverage similar law.
Part. In addition, the exclusions applicable to any SECTION II – LIMITS OF INSURANCE
"controlling underlying insurance" apply to this
insurance unless superseded by the following 1. The Limits of Insurance shown in the Declarations,
exclusions, or superseded by any other exclusions and the rules below fix the most we will pay
added by endorsement to this Coverage Part. regardless of the number of:
Insurance provided under this Coverage Part does a. Insureds;
not apply to: b. Claims made or suits brought, or number of
a. Medical Payments vehicles involved;
Medical payments coverage or expenses that c. Persons or organizations making claims or
are provided without regard to fault, whether or bringing suits; or
not provided by the applicable "controlling d. Limits available under any "controlling
underlying insurance". underlying insurance".
b. Auto 2. The Limits of Insurance of this Coverage Part will
Any loss, cost or expense payable under or apply as follows:
resulting from any of the following auto a. This insurance only applies in excess of the
coverages: "retained limit".
(1) First-party physical damage coverage; b. The Aggregate Limit is the most we will pay for
(2) No-fault coverage; the sum of all "ultimate net loss", for all "injury
or damage" covered under this Coverage Part.
(3) Personal injury protection or auto medical
payments coverage; or However, this Aggregate Limit only applies to
"injury or damage" that is subject to an
(4) Uninsured or underinsured motorists aggregate limit of insurance under the
coverage. "controlling underlying insurance".
c. Pollution c. Subject to Paragraph 2.b. above, the Each
(1) "Injury or damage" which would not have Occurrence Limit is the most we will pay for the
occurred, in whole or in part, but for the sum of all "ultimate net loss" under this
actual, alleged or threatened discharge, insurance because of all "injury or damage"
dispersal, seepage, migration, release or arising out of any one "event".
escape of pollutants at any time. d. If the Limits of Insurance of the "controlling
(2) Any loss, cost or expense arising out of underlying insurance" are reduced by defense
any: expenses by the terms of that policy, any
(a) Request, demand, order or statutory or payments for defense expenses we make will
regulatory requirement that any insured reduce our applicable Limits of Insurance in the
or others test for, monitor, clean up, same manner.
remove, contain, treat, detoxify or
neutralize, or in any way respond to, or
assess the effects of, pollutants; or
Page 2 of 5 © Insurance Services Office, Inc., 2012 CX 00 01 04 13
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NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023
3. If any "controlling underlying insurance" has a 3. Duties In The Event Of An Event, Claim Or Suit
policy period that is different from the policy period a. You must see to it that we are notified as soon
of this Coverage Part then, for the purposes of this as practicable of an "event", regardless of the
insurance, the "retained limit" will only be reduced amount, which may result in a claim under this
or exhausted by payments made for "injury or insurance. To the extent possible, notice
damage" covered under this insurance. should include:
The Aggregate Limit of this Coverage Part applies (1) How, when and where the "event" took
separately to each consecutive annual period of this place;
Coverage Part and to any remaining period of this
Coverage Part of less than 12 months, starting with (2) The names and addresses of any injured
the beginning of the policy period shown in the persons and witnesses; and
Declarations, unless the policy period is extended (3) The nature and location of any "injury or
after issuance for an additional period of less than 12 damage" arising out of the "event".
months. In that case, the additional period will be
b. If a claim is made or suit is brought against any
deemed part of the last preceding period for purposes insured, you must:
of determining the Limits of Insurance.
(1) Immediately record the specifics of the
SECTION III – CONDITIONS claim or suit and the date received; and
The following conditions apply. In addition, the
(2) Notify us as soon as practicable.
conditions applicable to any "controlling underlying
insurance" are also applicable to the coverage You must see to it that we receive written
provided under this insurance unless superseded by notice of the claim or suit as soon as
the following conditions. practicable.
1. Appeals c. You and any other insured involved must:
If the "controlling underlying insurer" or insured (1) Immediately send us copies of any
elects not to appeal a judgment in excess of the demands, notices, summonses or legal
amount of the "retained limit", we may do so at our papers received in connection with the
own expense. We will also pay for taxable court claim or suit;
costs, pre- and postjudgment interest and (2) Authorize us to obtain records and other
disbursements associated with such appeal. In no information;
event will this provision increase our liability
beyond the applicable Limits of Insurance (3) Cooperate with us in the investigation or
described in Section II – Limits Of Insurance. settlement of the claim or defense against
the suit; and
2. Bankruptcy
(4) Assist us, upon our request, in the
a. Bankruptcy Of Insured enforcement of any right against any
Bankruptcy or insolvency of the insured or of person or organization which may be liable
the insured's estate will not relieve us of our to the insured because of "injury or
obligations under this Coverage Part. damage" to which this insuranc
Preview
FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022 NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023 Century Surety Company 550 POLARIS PARKWAY, SUITE 300 WESTERVILLE, OH 43082 A STOCK COMPANY COMMERCIAL LINES POLICY THIS POLICY JACKET WITH COMMON POLICY CONDITIONS, THE DECLARATIONS PAGE, COVERAGE PART(S), COVERAGE FORM(S) AND APPLICABLE FORMS AND ENDORSEMENTS COMPLETE THIS POLICY. CSCP 1000 0519 FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022 NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023 CENTURY SURETY COMPANY Century Surety Company 550 Polaris Parkway, Suite 300 Westerville, Ohio 43082 www.centurysurety.com COMMERCIAL EXCESS LIABILITY COVERAGE DECLARATIONS AMED INSURED AND ADDRESS: INSURED'S AGENT: Fairmont Ins Brokers Ltd NYC Building Solutions Corp 1600 60th St 1202 Halsey St Brooklyn NY 11204 Brooklyn NY 11207 Licensed Surplus Lines Producer: Northeast Coverages, Inc 910 Franklin Avenue Suite 210 Garden City NY 11530 Same as Mailing Address Above POLICY PERIOD: From: 12/24/2021 To: 12/24/2022 at 12:01 AM Standard nme at your mailing address shown above Business Description: Contractor O Individual □Joint Venture □ Partnership □ Limited Liability Company 181 Organization (Other than Partnership or Joint Venture) ULTIMATE NET LOSS LIMITS OF LIABILITY PREMIUM 181 Flat D Adjustable Rate: Per: Premium Basis: Policy Fee (fully earned) s Deposit Premium: s Each Occurrence Limit: s 4,000,000 Inspection Fee s Premium: $ Surplus Lines Tax s Minimum Premium: $ TRIA Premium: Aggregate Limit: s------- 4,000,000 $ $ Rejected $ $ Total Policy Premium: $ 25 % of the Policy Premium is fully earned as of the effective date of this policy and is not subject to return or refund. FORMS AND ENDORSEMENTS: Forms an Endorsements applying to t is Coverage an made part o this policy at time o issue: See Attached Form CIL 1500B Any person who, with intent to de raud or knowing that he is acilitating a aud against an Insurer, submits an application or 1les a claim containing false or deceptive statement is guilty of insurance fraud. COMPANY REPRESENTATIVE: Northeast Coverages, Inc 910 Franklin Avenue Suite 210 Countersigned By Garden City NY 11530 Authorized Representative Program Code: CXLH Licensed Surplus Lines Producer Signature I , t Is ompany as execute un ess countersIgne by the duly Authorized Agent of this Company at the Agency hereinbefore mentioned. Secretary President CXL 1100 0920 This is to certify that Excess Line Association of '1ew York received and reviewed the 01/31/2022 attached insurance document in accordance with Article 21 of the New York State ld:109650880 Insurance Law THE INSURER(S) NAMED HEREIN IS (ARE) NOT LICENSED BY THE STATE OF NE\V YORK, NOT SUBJECT TO ITS SUPER'11SION, AND 11\" THE EVENT OF THE INSOLVENCY OF THE 11\"SURER(S), NOT PROTECTED BY THE NEW YORK STATE SECURITY FUNDS. THE POLICY MAY NOT BE SUBJECT TO ALL OF THE REGULATIONS OF THE DEPARTMENT OF FINANCIAL SERVICES PERTAINING TO POLICY FORMS. FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022 NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023 COMMERCIAL EXCESS LIABILITY POLICY CONTROLLING UNDERLYING INSURANCE SCHEDULE Policy No: CCP 1022802 Effective Date: 12/24/2021 12:01 A.M. Standard Time NAMED INSURED: NYC Building Solutions Corp CARRIER, POLICY NUMBER, POLICY PERIOD TYPE OF POLICY RETAINED LIMITS OF LIABILITY NOT COVERED Employers Liability $ NOT COVERED Each Accident $ NOT COVERED Disease Policy Limit $ NOT COVERED Disease Each Employee OR $ NOT COVERED Each Accident per Occurrence Western World Insurance Co Commercial Policy number per as on file with General $ 2,000,000 General Aggregate Limit (other than Prods/Comp Ops) company Liability 12/24/2021 to 12/24/2022 $ 2,000,000 Products/Completed Operations Aggregate Limit $ 1,000,000 Personal and Advertising Injury Limit $ 1,000,000 Each Occurrence Limit NOT COVERED Automobile Bodily Injury Liability Liability $ NOT COVERED Each Person Limited to $ NOT COVERED Each Accident Hired Auto Liability Property Damage Liability Limited to Non-Owned $ NOT COVERED Each Accident Auto Bodily Injury/Property Damage Liability Combined Single Limit Liability Limited to $ NOT COVERED Each Accident Non-Owned and Hired Auto CXL 1100a 07 12 Page 1 of 1 FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022 NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023 Policy Number: CCP 1022802 CIL 15 00b 02 02 SCHEDULE OF FORMS AND ENDORSEMENTS (other than applicable forms and endorsements shown elsewhere in the policy) Forms and Endorsements applying to the Coverage Parts listed below and made a part of this policy at time of issue: Form/ Edition Endt. # Date Title Total # of Forms Selected: 37 Forms Applicable to this Coverage part - INTERLINE-ALL COVERAGE PARTS CCP 2010 05 08 Service of Suit Clause CIL 0003 02 20 Calculation of Premium CIL 1500B 02 02 Schedule of Forms and Endorsements CSCP 1000 05 19 Century Surety Company Commercial Lines Policy Jacket U.S. Treasury Department's Office of Foreign Assets Control ("OFAC") Advisory Notice to IL P001 01 04 Policyholders PNCC 0001a 04 20 Policyholder Notice Claims Reporting PRIV 0001 05 19 Privacy Statement TRIA 0001 09 20 Policyholder Disclosure Notice of Terrorism Insurance Coverage Notice To Policyholders Regarding Duties in the Event of an Occurrence, Offense, Claim or XUPN 0001 02 13 Suit 9 Forms Forms Applicable to this Coverage part - EXCESS CX 0001 04 13 Commercial Excess Liability Coverage Form CX 2101 09 08 Nuclear Energy Liability Exclusion Endorsement (broad Form) CX 2119 04 13 Exclusion - Employment-Related Practices Conditional Exclusion of Terrorism Involving Nuclear, Biological or Chemical Terrorism CX 2132 01 15 (Relating to Disposition of Federal Terrorism Risk Insurance Act) Exclusion of Certified Acts of Terrorism and Exclusion of Other Acts of Terrorism Committed CX 2135 01 15 Outside The United States CX 2136 01 15 Exclusion of Punitive Damages Related to a Certified Act of Terrorism Exclusion of Certified Nuclear, Biological, Chemical or Radiological Acts of Terrorism; Cap CX 2145 01 15 on Losses From Certified Acts of Terrorism CX 2700 09 08 Underlying Claims-made Coverage CXL 1100 09 20 Century Surety Company Commercial Excess Liability Coverage Declarations CXL 1100a 07 12 Controlling Underlying Insurance Schedule CXL 1102 09 17 Special Exclusions and Limitations Endorsement - Contracting and Service Risks CXL 1103 08 13 Amendment of Retained Limit Definition CXL 1113 10 10 Exclusion - Total Pollution CXL 1115 02 21 Amendatory Endorsement - Coverage Territory CXL 1118 07 15 Limitation - Hot Tar and Torch Roofing Operations CXL 1136a 02 15 Exclusion - Bodily Injury to Independent Contractors - Designated States CXL 1137 05 13 Exclusion - Electronic Data CXL 1157 06 14 Limitation - Scaffolding Hazard Exclusion - Condominium, Cooperative, Timeshare, Townhome, Row House or Tract Home CXL 1162 12 17 Construction CIL 15 00b 02 02 Page 1 of 2 FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022 NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023 CXL 1168 07 15 Exclusion - Imported Drywall CXL 1174CO 01 21 Limitation - State of Colorado CXL 1174MOa 01 21 Exclusion - State of Missouri CXL 1174WA 01 21 Limitation - State of Washington CXL 1178 03 20 Exclusion - Automobile Liability CXL 1185 02 14 Exclusion - Action Over CXL 1196 10 13 Exclusion - Access or Disclosure of Confidential or Personal Information CXL 1198 07 15 Exclusion - Critical Aircraft Products or Grounding CXL 1213 12 19 Absolute Exclusion - Cyber Multi-Media or Internet 28 Forms CIL 15 00b 02 02 Page 2 of 2 FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022 NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023 CLAIMS REPORTING We offer FOUR convenient ways to report a claim 1) Online - Visit: www.centurysurety.com We’ve made filing Click on Report a Claim a claim quick and convenient! 2) Email - Send claim information to: newclaim@centurysurety.com Simply go to www.centurysurety.com 3) Phone - Call our Service Center at: (800) 825-9489 and click on Report A Claim 4) Fax - Fax claim information to: (614) 895-7040 Online reporting can accelerate the claims process leading to a faster resolution for you. 31&&D FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022 NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023 CCP 2010 0508 SERVICE OF SUIT CLAUSE This endorsement modifies insurance provided by the policy to which this form is attached. It is agreed that in the event of the failure by us to pay any amount claimed to be due hereunder, we will, at your request, submit to the jurisdiction of a court of competent jurisdiction within the United States of America. Nothing in this clause constitutes or should be understood to constitute a waiver of our rights to commence an action in a court of competent jurisdiction in the United States of America, to remove an action to a United States District Court, or to seek a transfer of a case to another court as permitted by the laws of the United States of America or of any state in the United States of America. In any such suit against us, we will abide by the final decision of such court or of any Appellate Court in the event of an appeal. It is further agreed that service of process in such suit may be made upon the person or organization shown in the Policy Declarations or upon us at the address shown in the policy jacket. The above named are authorized and directed to accept service of process on behalf of us in any such suit and/or upon your request to give a written undertaking to you that we will enter a general appearance upon our behalf in the event such a suit shall be instituted. Further, pursuant to any statute of any state, territory, or district of the United States of America, which makes provision therefore, we hereby designate the Superintendent, Commissioner, or Directors of Insurance or other officer specified for that purpose in the statute or his successor or successors in office, as their true and lawful attorney upon whom may be served any lawful process in any action, suit, or proceeding instituted by or on your behalf or any beneficiary hereunder arising out of this contract of insurance, and hereby designates the above named as the person to whom the said officer is authorized to mail such process or a true copy thereof. CCP 20 10 0508 Page 1 of 1 FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022 NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023 CIL 00 03 0220 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALCULATION OF PREMIUM This endorsement modifies insurance provided under the following: CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL EXCESS LIABILITY COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL LIABILITY UMBRELLA COVERAGE FORM COMMERCIAL PROPERTY COVERAGE PART CONTRACTORS’ POLLUTION LIABILITY COVERAGE FORM CRIME AND FIDELITY COVERAGE PART EMPLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART ENVIRONMENTAL SERVICES BUSINESSOWNERS COVERAGE FORM ENVIRONMENTAL SERVICES LIABILITY COVERAGE FORM EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART The following is added: The premium shown in the Declarations was computed based on rates in effect at the time the policy was is- sued. On each renewal, continuation, or anniversary of the effective date of this policy, we will compute the premium in accordance with our rates and rules then in effect. CIL 00 03 0220 © ISO Properties, Inc., 2007 Page 1 of 1 o FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022 NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023 IL P 001 0104 U.S. TREASURY DEPARTMENT'S OFFICE OF FOREIGN ASSETS CONTROL ("OFAC") ADVISORY NOTICE TO POLICYHOLDERS No coverage is provided by this Policyholder Notice nor can it be construed to replace any provisions of your policy. You should read your policy and review your Declarations page for complete information on the coverages you are provided. This Notice provides information concerning possible impact on your insurance coverage due to directives issued by OFAC. Please read this Notice carefully. The Office of Foreign Assets Control (OFAC) administers and enforces sanctions policy, based on Presidential declarations of "national emergency". OFAC has identified and listed numerous: l Foreign agents; l Front organizations; l Terrorists; l Terrorist organizations; and l Narcotics traffickers; as "Specially Designated Nationals and Blocked Persons". This list can be located on the United States Treas- ury's web site – http//www.treas.gov/ofac. In accordance with OFAC regulations, if it is determined that you or any other insured, or any person or entity claiming the benefits of this insurance has violated U.S. sanctions law or is a Specially Designated National and Blocked Person, as identified by OFAC, this insurance will be considered a blocked or frozen contract and all provisions of this insurance are immediately subject to OFAC. When an insurance policy is considered to be such a blocked or frozen contract, no payments nor premium refunds may be made without authorization from OFAC. Other limitations on the premiums and payments also apply. IL P 001 0104 © ISO Properties, Inc., 2004 Page 1 of 1 FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022 NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023 Privacy Statement In applying for insurance products and services with AmeriTrust Group, Inc. subsidiaries, you may have provided us with non-public personal information. Additionally, we may seek additional information, such as your creditworthiness or credit history, from third party reporting agencies. This information allows us to provide you with the best products and customer service. Keeping your personal information private and secure, whether learned directly from you or a third-party reporting agency, is our priority. The categories of non-public personal and financial information that we collect may include your name, address, social security or employer identification number, assets, income, date of birth, motor vehicle driving information and other information that is appropriate or necessary to provide you with the insurance products and services that you request. We do not disclose any non-public personal or financial information about you, unless permitted or required by law or with your consent. We may have shared this information with affiliated parties as permitted by law. We refer to and use that information to issue and service your insurance policies, provide insurance services or administer claims. We restrict access to your non-public personal and financial information to those employees who need the information to provide you with products or services. We maintain physical, electronic and procedural safeguards to protect your non-public personal and financial information. These safeguards comply with federal and state regulations. If you contact us at our website, https://www.ameritrustgroup.com, we do not use “cookies”, which many organizations use to track visitors’ actions on their websites. Cookies are a general mechanism that can store and retrieve information on your computer. We value the relationship that we have established with current and former customers. Should you have any comments or questions regarding our Privacy Policy, please contact us at 800-482- 2726. This Privacy Policy applies to the following companies: (1) AmeriTrust Group, Inc.’s insurance company subsidiaries (Star Insurance Company, Ameritrust Insurance Corporation, Williamsburg National Insurance Company, ProCentury Insurance Company, and Century Surety Company); (2) Crest Financial Corporation’s subsidiaries; and (3) Meadowbrook, Inc.’s subsidiaries. PRIV 0001 0519 PAGE 1 OF 1 FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022 NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023 NOTE TO AGENT: It is required by federal law that you provide this document to the insured. POLICYHOLDER DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE Coverage for acts of terrorism is included in your policy. As defined in Section 102(1) of the Act: The term “act of terrorism” means any act that is certified by the Secretary of the Treasury—in consultation with the Secretary of Homeland Security, and the Attorney General of the United States—to be an act of terrorism; to be a violent act or an act that is dangerous to human life, property, or infrastructure; to have resulted in damage within the United States, or outside the United States in the case of certain air carriers or vessels or the premises of a United States mission; and to have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. Under your coverage, any losses resulting from certified acts of terrorism may be partially reimbursed by the United States Government under a formula established by the Terrorism Risk Insurance Act, as amended. However, your policy may contain other exclusions which might affect your coverage, such as an exclusion for nuclear events. Under the formula, the United States Government generally reimburses 80% beginning January 1, 2020 of covered terrorism losses exceeding the statutorily established deductible paid by the insurance company providing the coverage. However, if the aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance exceed $100 billion in a calendar year, the Treasury shall not make any payment for any portion of the amount of such losses that exceeds $100 billion. If aggregate insured losses attributable to terrorism acts certified under the Terrorism Risk Insurance Act exceed $100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act, we shall not be liable for the payment of any portion of the amount of such losses that exceeds $100 billion, and in such case insured losses up to that amount are subject to pro-rata allocation in accordance with the procedures established by the Secretary of the Treasury. The portion of your annual premium that is attributable to coverage for acts of terrorism is as shown below. This premium does not include any charges for the portion of losses covered by the United States government under the Act. Property $ Inland Marine $ Crime $ Excluded General Liability $ Garage/Auto Dealers $ Excluded Excess $ Rejected Total $ Rejected Name of Insurer: Century Surety Company Policy Number: CCP 1022802 TRIA 0001 0920 FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022 NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023 XUPN 0001 0213 NOTICE TO POLICYHOLDERS REGARDING DUTIES IN THE EVENT OF AN OCCURRENCE, OFFENSE, CLAIM OR SUIT This notice does not form a part of your insurance contract. No coverage is provided by this notice, nor is this notice to be construed to replace any provisions of your policy, including the policy’s endorsements. If there is any conflict between this notice and the policy’s endorsements, then the provisions of the policy and the policy’s endorsements shall prevail. Carefully read your entire policy and the policy’s endorsements that are attached. This policy includes a condition requiring you to notify us of an occurrence, offense, or an event as soon as practicable, when you notify your underlying insurer of an occurrence, offense, or an event. Failure to provide us with this notice may result in an exclusion of your coverage. You may provide notice of an occurrence, offense or event through your insurance agent named on the Declarations page of this policy. XUPN 0001 0213 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022 NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023 COMMERCIAL EXCESS LIABILITY CX 00 01 04 13 COMMERCIAL EXCESS LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. When we have no duty to defend, we will have Read the entire policy carefully to determine rights, the right to defend, or to participate in the duties and what is and is not covered. defense of, the insured against any other suit Throughout this policy the words "you" and "your" seeking damages for "injury or damage". refer to the Named Insured shown in the Declarations, However, we will have no duty to defend the and any other person or organization qualifying as a insured against any suit seeking damages for Named Insured under this policy. The words "we", which insurance under this policy does not "us" and "our" refer to the company providing this apply. insurance. The word "insured" means any person or At our discretion, we may investigate any organization qualifying as such under the "controlling "event" that may involve this insurance and underlying insurance". settle any resultant claim or suit, for which we Other words and phrases that appear in quotation have the duty to defend. marks in this Coverage Part have special meaning. But: Refer to Section IV – Definitions. Other words and phrases that are not defined under this Coverage Part (1) The amount we will pay for "ultimate net but defined in the "controlling underlying insurance" loss" is limited as described in Section II – will have the meaning described in the policy of Limits Of Insurance; and "controlling underlying insurance". (2) Our right and duty to defend ends when we The insurance provided under this Coverage Part will have used up the applicable limit of follow the same provisions, exclusions and limitations insurance in the payment of judgments or that are contained in the applicable "controlling settlements under this Coverage Part. underlying insurance", unless otherwise directed by However, if the policy of "controlling this insurance. To the extent such provisions differ or underlying insurance" specifies that limits conflict, the provisions of this Coverage Part will are reduced by defense expenses, our right apply. However, the coverage provided under this and duty to defend ends when we have Coverage Part will not be broader than that provided used up the applicable limit of insurance in by the applicable "controlling underlying insurance". the payment of defense expenses, judgments or settlements under this There may be more than one "controlling underlying Coverage Part. insurance" listed in the Declarations and provisions in those policies conflict, and which are not superseded b. This insurance applies to "injury or damage" by the provisions of this Coverage Part. In such a that is subject to an applicable "retained limit". case, the provisions, exclusions and limitations of the If any other limit, such as, a sublimit, is "controlling underlying insurance" applicable to the specified in the "controlling underlying particular "event" for which a claim is made or suit is insurance", this insurance does not apply to brought will apply. "injury or damage" arising out of that exposure unless that limit is specified in the Declarations SECTION I – COVERAGES under the Schedule of "controlling underlying 1. Insuring Agreement insurance". a. We will pay on behalf of the insured the c. If the "controlling underlying insurance" "ultimate net loss" in excess of the "retained requires, for a particular claim, that the "injury limit" because of "injury or damage" to which or damage" occur during its policy period in insurance provided under this Coverage Part order for that coverage to apply, then this applies. insurance will only apply to that "injury or We will have the right and duty to defend the damage" if it occurs during the policy period of insured against any suit seeking damages for this Coverage Part. If the "controlling such "injury or damage" when the applicable underlying insurance" requires that the "event" limits of "controlling underlying insurance" have causing the particular "injury or damage" takes been exhausted in accordance with the place during its policy period in order for that provisions of such "controlling underlying coverage to apply, then this insurance will insurance". apply to the claim only if the "event" causing that "injury or damage" takes place during the policy period of this Coverage Part. CX 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 5 FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022 NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023 d. Any additional insured under any policy of (b) Claim or suit by or on behalf of a "controlling underlying insurance" will governmental authority for damages automatically be an additional insured under because of testing for, monitoring, this insurance. If coverage provided to the cleaning up, removing, containing, additional insured is required by a contract or treating, detoxifying or neutralizing, or in agreement, the most we will pay on behalf of any way responding to, or assessing the the additional insured is the amount of effects of, pollutants. insurance required by the contract, less any This exclusion does not apply to the extent that amounts payable by any "controlling underlying valid "controlling underlying insurance" for the insurance". pollution liability risks described above exists or Additional insured coverage provided by this would have existed but for the exhaustion of insurance will not be broader than coverage underlying limits for "injury or damage". provided by the "controlling underlying d. Workers' Compensation And Similar Laws insurance". Any obligation of the insured under a workers' 2. Exclusions compensation, disability benefits or The following exclusions, and any other exclusions unemployment compensation law or any added by endorsement, apply to this Coverage similar law. Part. In addition, the exclusions applicable to any SECTION II – LIMITS OF INSURANCE "controlling underlying insurance" apply to this insurance unless superseded by the following 1. The Limits of Insurance shown in the Declarations, exclusions, or superseded by any other exclusions and the rules below fix the most we will pay added by endorsement to this Coverage Part. regardless of the number of: Insurance provided under this Coverage Part does a. Insureds; not apply to: b. Claims made or suits brought, or number of a. Medical Payments vehicles involved; Medical payments coverage or expenses that c. Persons or organizations making claims or are provided without regard to fault, whether or bringing suits; or not provided by the applicable "controlling d. Limits available under any "controlling underlying insurance". underlying insurance". b. Auto 2. The Limits of Insurance of this Coverage Part will Any loss, cost or expense payable under or apply as follows: resulting from any of the following auto a. This insurance only applies in excess of the coverages: "retained limit". (1) First-party physical damage coverage; b. The Aggregate Limit is the most we will pay for (2) No-fault coverage; the sum of all "ultimate net loss", for all "injury or damage" covered under this Coverage Part. (3) Personal injury protection or auto medical payments coverage; or However, this Aggregate Limit only applies to "injury or damage" that is subject to an (4) Uninsured or underinsured motorists aggregate limit of insurance under the coverage. "controlling underlying insurance". c. Pollution c. Subject to Paragraph 2.b. above, the Each (1) "Injury or damage" which would not have Occurrence Limit is the most we will pay for the occurred, in whole or in part, but for the sum of all "ultimate net loss" under this actual, alleged or threatened discharge, insurance because of all "injury or damage" dispersal, seepage, migration, release or arising out of any one "event". escape of pollutants at any time. d. If the Limits of Insurance of the "controlling (2) Any loss, cost or expense arising out of underlying insurance" are reduced by defense any: expenses by the terms of that policy, any (a) Request, demand, order or statutory or payments for defense expenses we make will regulatory requirement that any insured reduce our applicable Limits of Insurance in the or others test for, monitor, clean up, same manner. remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, pollutants; or Page 2 of 5 © Insurance Services Office, Inc., 2012 CX 00 01 04 13 FILED: NEW YORK COUNTY CLERK 02/23/2023 03:37 PM INDEX NO. 155086/2022 NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 02/23/2023 3. If any "controlling underlying insurance" has a 3. Duties In The Event Of An Event, Claim Or Suit policy period that is different from the policy period a. You must see to it that we are notified as soon of this Coverage Part then, for the purposes of this as practicable of an "event", regardless of the insurance, the "retained limit" will only be reduced amount, which may result in a claim under this or exhausted by payments made for "injury or insurance. To the extent possible, notice damage" covered under this insurance. should include: The Aggregate Limit of this Coverage Part applies (1) How, when and where the "event" took separately to each consecutive annual period of this place; Coverage Part and to any remaining period of this Coverage Part of less than 12 months, starting with (2) The names and addresses of any injured the beginning of the policy period shown in the persons and witnesses; and Declarations, unless the policy period is extended (3) The nature and location of any "injury or after issuance for an additional period of less than 12 damage" arising out of the "event". months. In that case, the additional period will be b. If a claim is made or suit is brought against any deemed part of the last preceding period for purposes insured, you must: of determining the Limits of Insurance. (1) Immediately record the specifics of the SECTION III – CONDITIONS claim or suit and the date received; and The following conditions apply. In addition, the (2) Notify us as soon as practicable. conditions applicable to any "controlling underlying insurance" are also applicable to the coverage You must see to it that we receive written provided under this insurance unless superseded by notice of the claim or suit as soon as the following conditions. practicable. 1. Appeals c. You and any other insured involved must: If the "controlling underlying insurer" or insured (1) Immediately send us copies of any elects not to appeal a judgment in excess of the demands, notices, summonses or legal amount of the "retained limit", we may do so at our papers received in connection with the own expense. We will also pay for taxable court claim or suit; costs, pre- and postjudgment interest and (2) Authorize us to obtain records and other disbursements associated with such appeal. In no information; event will this provision increase our liability beyond the applicable Limits of Insurance (3) Cooperate with us in the investigation or described in Section II – Limits Of Insurance. settlement of the claim or defense against the suit; and 2. Bankruptcy (4) Assist us, upon our request, in the a. Bankruptcy Of Insured enforcement of any right against any Bankruptcy or insolvency of the insured or of person or organization which may be liable the insured's estate will not relieve us of our to the insured because of "injury or obligations under this Coverage Part. damage" to which this insuranc