Preview
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
EXHIBIT “A”
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
Prepare. Protect. Prevail.
THE
HARTFORD
Business Insurance
Employee Benefits
Auto
Home
August 11, 2023
Re: Insured: PTS AMERICA INC
Policy Number: 12 UUN UH2741
Policy Term: 01/01/2023 – 01/01/2024
Writing Company: HARTFORD FIRE INSURANCE COMPANY
This will verify that, to the best of the undersigned's knowledge, the attached is a
complete and accurate representation of insurance policy referenced above. Documents
and/or information produced herewith are kept and maintained in the ord1nary course of
business.
Kyona Lawrence
Operations Support Specialist
Clinton Business Center
Hartford Office Location
301 Woods Park Dr.
Clinton, NY 13323
Toll Free: 888-525-2652
Fax: 866-809-1178
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
THE HARTFORD
BUSINESS SERVICE CENTER
3600 WISEMAN BLVD
SAN ANTONIO TX 78251 October 17, 2022
PTS AMERICA INC
222 5TH AVE
NEW YORK NY 10001
Policy Information:
Contact Us
Policy Number: 12 UUN UH2741
Visit https://business.thehartford.com
24/7 access to pay bills, view policy documents,
get your certificate of insurance and more.
Need Help? Start a live chat online or call us at
(866) 467-8730. We’re here weekdays from 8:00
AM to 8:00 PM ET.
You can find information about your policy enclosed. You can also find this info online at https://business.thehartford.com.
If you have any questions or concerns about what you see, contact us at any of the options listed on this page.
Thanks for choosing us for your business insurance needs.
Sincerely,
The Hartford
WLTR001
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
CONDITIONAL RENEWAL NOTICE - NEW YORK
Date: 10/17/22
Policy Number: 12 UUN UH2741
Renewal Date: 01/01/23
Your Hartford Agent: USI INSURANCE SERVICES LLC (866) 487-1744
PTS AMERICA INC
222 5TH AVE
NEW YORK NY 10001
Dear Valued Hartford Insured,
Your current policy provided by The Hartford will expire shortly. The purpose of this notice is to advise you of certain
changes to your policy upon renewal.
A. Policy Premium
The new premium for your policy for the upcoming term is indicated below. This premium amount is based on current
information known to us and may be subject to change based on any additional information we may receive from you
or your Hartford agent or broker. More information on your premium determination can be obtained from your agent
or broker, or from The Hartford.
() Premium Change: The premium for your renewal policy will be increased by more than 10%.
Renewal Premium =$
Amount of Increase =$
The reason(s) for the increase in premium is due to one or more of the following:
1. A change in rates or the method of calculating premium of more than 10% along with, if applicable,
2. A change in your exposures, loss experience, or other risk characteristics.
B. Coverage Changes (if applicable)
Your policy for the upcoming term will include certain coverage changes, as indicated by an (x) below.
() Increase in Deductible to:
() Reduction in Limits to:
( x) Reductions in Coverage: CG2132-0509-Communicable Disease Exclusion
() Other Changes or Restrictions in Coverage:
The coverage change is due to the following indicated reason(s):
() Your exposures, loss experience, or other risk characteristics indicate a need for the change.
( x) A change in our rules, forms or underwriting guidelines for your type of policy.
Further information regarding the reason for the coverage change(s) is available from the company or your agent or
broker. You may receive other notices of coverage changes for the upcoming policy term under separate cover.
Those other changes will apply in addition to the changes described above.
Form IH 70 02 06 18 (WC 66 03 66 C)
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
C. Other Information on Your Workers’ Compensation Policy
( ) Please see attached for information on your upcoming workers’ compensation policy.
Upon receipt of your written request, we will provide you through your agent with loss information covering the period
required by law. If you have any questions about your policy or about your overall insurance needs, please contact
your Hartford agent or broker.
Form IH 70 02 06 18 (WC 66 03 66 C)
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
Important Information
For New York Property
Owners and Tenants
As a result of New York Labor Law Section 240, you may be liable for injuries to
contractors you hire to do work at or on your property.
Learn more about this law and what you can do to reduce your risk.
As a New York property owner or a tenant who hires contractors to repair, alter, paint, erect, demolish,
clean or point a building or structure under New York Law Section 240, you may be liable for injuries
sustained by the contractor's workers who fall from heights or who are struck by falling objects.
This law places responsibility for worksite safety on owners and tenants who hire contractors. Liability
under New York Labor Law Section 240 may be imposed regardless of whether the property owner
exercised supervision or control over the injured worker.
Examples of Claims and Lawsuits
Contractors often work at heights and use ladders, scaffolding or other devices in order to get a job done.
It would not be uncommon for a contractor's employee (injured in a fall from a height on your property) to
bring a legal action against you or your company. Examples of situations that resulted in a claim and/or
lawsuit under Section 240 of the New York Labor Law include:
o A maintenance worker fell from a ladder and was injured while taking down ceiling tiles for a
store owner to correct a drafty condition created by improperly installed ceiling insulation.
o Trade Association hired a contractor to assist in installing a stage. Plaintiff, an employee of
the contractor, fell four feet and was injured.
o A worker was injured when he fell from an elevated height while removing and replacing
piping for a machine oil supply and return system for our manufacturing risk.
o A worker was injured in a fall from a steel beam. There was no scaffold beneath the beam.
In each of these cases, the property owner or business owner was alleged to be liable based on the fact
that they had hired a contractor to do work.
Impact on Insurance Coverage
Claims and lawsuits under Section 240 of the New York Labor Law may have an adverse effect on your
company's finances and insurance program.
o The most significant risk is a judgment against your company in excess of your policy's limit of
liability. Some claims based on this law have been $1 million or more.
o Your future insurance premiums may increase as a result of lawsuits against your company.
o Because favorable claim history is a key component of your insurability, liability insurance
may become difficult to obtain.
Form 106373 Page 1 of 2
© 2016, The Hartford
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
Reducing Your Risk
There are a few simple risk management techniques that should be considered in consultation with your
attorney or insurance agent to help reduce the chances of your business being involved in litigation:
1. Prior to the start of any work, have a written contract in place that includes an
appropriate indemnification clause. Ensure that all contracts and indemnification
clauses are reviewed by a qualified attorney prior to signing.
2. Be named as a "primary" and "non-contributory" Additional Insured on the
contractor's General Liability Policy. This method of transferring risk could be
significant in the event of a loss.
3. Only hire reputable contractors to perform work of any kind on your property, whether
owned or leased. Pre-qualify contractors by reviewing previous work, securing
recommendations from previous customers, reviewing the contractor's financial
condition, inquiring about past losses, and ensuring the contractor has adequate and
appropriate insurance coverage, including Workers' Compensation coverage.
4. Require all contractors you hire to strictly follow all OSHA and NY State Industrial
Regulations. Ensure that the contractor is aware of the applicable regulations and
laws that apply to this exposure.
Taking these simple steps will help minimize the possibility of the New York Labor Law having an adverse
effect on your company's finances and insurance program, as a result of hiring a contractor. For more
information about how The Hartford can help meet your business' risk management and insurance needs,
please contact your agent.
New York Labor Law Section 240 (1) provides, in part, as follows:
"All contractors and owners and their agents, except owners of one and two-family dwellings who
contract for but do not direct or control the work, in the erection, demolition, repairing, altering,
painting, cleaning or pointing of a building or structure shall furnish or erect, or cause to be furnished
or erected for the performance of such labor, scaffolding, hoists, stays, ladders, slings, hangers,
blocks, pulleys, braces, irons, ropes and other devices which shall be so constructed, placed and
operated as to give proper protection to a person so employed."
The information provided above is of a general nature and may not be considered legal advice. The content of this document may
omit certain details and cannot be regarded as advice that would be applicable to all businesses. As such, this information is
provided for informational purposes only. Readers seeking resolution of specific safety, legal or business issues or concerns
regarding this topic should consult their safety consultant, attorney and/or business advisors. The information presented is not a
substitute for a thorough loss control survey of your business or operations or an analysis of the legality or appropriateness of your
business practices. We do not warrant that the implementation of any view or recommendation contained herein will be an
appropriate legal or business practice. Further, we do not warrant that the implementation of any view or recommendation will avoid
any or all liability.
Form 106373 Page 2 of 2
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
IMPORTANT NOTICE TO NORTH CAROLINA
POLICYHOLDERS
THIS NOTICE APPLIES UNLESS THIS POLICY IS
SPECIFICALLY ENDORSED TO PROVIDE COVERAGE AT
ONE OR MORE LOCATIONS FOR LOSS FROM FLOODS,
EARTHQUAKES, MUDSLIDES, MUDFLOWS OR
LANDSLIDES.
THIS NOTICE APPLIES IF YOU HAVE A WINDSTORM OR
HAIL EXCLUSION ENDORSEMENT ON YOUR POLICY AS
SHOWN IN THE DECLARATIONS.
WARNING: THIS PROPERTY INSURANCE POLICY DOES
NOT PROTECT YOU AGAINST LOSSES FROM FLOODS,
EARTHQUAKES, MUDSLIDES, MUDFLOWS, LANDSLIDES,
WINDSTORM OR HAIL. YOU SHOULD CONTACT YOUR
INSURANCE COMPANY OR AGENT TO DISCUSS YOUR
OPTIONS FOR OBTAINING COVERAGE FOR THESE
LOSSES. THIS IS NOT A COMPLETE LISTING OF ALL OF
THE CAUSES OF LOSSES NOT COVERED UNDER YOUR
POLICY. YOU SHOULD READ YOUR ENTIRE POLICY TO
UNDERSTAND WHAT IS COVERED AND WHAT IS NOT
COVERED.
Form G-3253-2 Page 1 of 1
© 2012, The Hartford
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
IMPORTANT NOTICE TO POLICYHOLDERS
THE HARTFORD CYBER CENTER WEBSITE ACCESS
Thank you for choosing The Hartford for your business insurance needs.
You are receiving this Notice because you purchased a general liability or property policy from The Hartford, which
includes access to The Hartford Cyber Center. This portal was created because we recognize that businesses
face a variety of cyber-related exposures and need help managing the related risks. These exposures include
data breaches, computer virus attacks and cyber extortion threats.
Through the Hartford Cyber Center, you have access to:
o A panel of third party incident response service providers
o Third party cybersecurity pre-incident service providers and a list of approved services to help protect your
business before a cyber-threat occurs
o Risk management tools, including self-assessments, best practice guides, templates, sample incident
response plans, and data breach cost calculators
o White papers, blogs and webinars from leading privacy and security practitioners
o Up-to-date cyber-related news and events, including examples of privacy and security related events
Accessing The Hartford Cyber Center is easy
1. Visit www.thehartford.com/cybercenter
2. Enter policyholder information
3. Access code: 952689
4. Login to The Hartford Cyber Center
Please be aware that:
o The Hartford Cyber Center is a proprietary web portal exclusively provided to customers of The Hartford.
Please do not share the access code with anyone outside your organization.
o Registration is required to access the Cyber Center. You may register as many users as necessary.
o Contacting a service provider about any issue does not constitute providing The Hartford notice of a claim
as required under your insurance policy. Read your insurance policy and discuss any questions with your
agent or broker.
o The Hartford Cyber Center provides third party service provider references and materials for educational
purposes only. The Hartford does not specifically endorse any such service provider within The Hartford
Cyber Center and hereby disclaims all liability with respect to use of or reliance on such service providers.
All service providers are independent contractors and not agents of The Hartford. The Hartford does not
warrant the performance of the service providers, even if such services are covered under your policy.
We strongly encourage you to conduct your own assessments of the service providers' services and the
fitness or adequacy of such services for your particular needs. This Notice does not amend or otherwise
affect the provisions of your policy.
The Hartford offers a variety of endorsements to your policy that can help protect your business from a broad
range of cyber-related threats. Please review your coverage with your insurance agent or broker to determine the
most appropriate cyber coverages and limits for your business.
If you have a claim, you can report it by calling The Hartford's toll-free claims line at 1-800-327-3636.
Should you have any questions, please contact your insurance agent, broker or you may contact us directly.
We appreciate your business and look forward to being of continued service to you.
Form G-4033-1 (07/16 ED.) Page 1 of 1
© 2016, The Hartford
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
Insurance Policy Billing Information
Thank you for selecting The Hartford for your business insurance needs.
Shortly, you will receive your first bill from us. You are receiving this Notice so you know
what to expect as a valued customer of The Hartford. Should you have any questions after
reviewing this information, please contact us at 866-467-8730, and we will be happy to
assist you.
o Your total policy premium will appear on your policy’s Declarations Page. You will be billed based on the payment
plan you selected.
o You may pay the "minimum due" as it appears on your insurance bill or pay the policy balance in full.
o An installment service fee is added to each installment. A late fee will also be applied if the "minimum due" is not
received by the due date shown on your bill. Service and late payment fees do not apply in all states.
o If you selected installment billing, any credit or additional premium due as the result of a change made to your
policy, will be spread over the remaining billing installments. Additional premium due as a result of an audit will be
billed in full on your next bill date following the completion of the audit.
o If you elected Electronic Funds Transfer (EFT), policy changes may result in changes to the amount automatically
withdrawn from your bank account. The invoice you receive following a policy change will include future withdrawal
amounts. If you need to adjust or stop your next scheduled EFT withdrawal, please contact us at least 3 days
prior to the scheduled withdrawal date at the telephone number shown below.
o If you selected installment billing and pay the premiums for your first policy term on time, at renewal, your account
may qualify for our "Equal Installment" feature. This means that the percentage due for each installment, including
the initial renewal installment, will be the same throughout the policy term – helping you better manage cash flow.
Equal installments will continue as long as you pay your premiums on time and no cancellation notices are issued
for any policy on your account. If you no longer qualify for Equal Installments, future renewals will be billed based
on the payment plan you selected, which includes a higher initial installment amount.
o If your policy is eligible for renewal, your bill for the upcoming policy term will be sent to you approximately 30 days
prior to your policy’s renewal date. If your insurance needs change, please contact us at least 60 days prior to your
renewal date so we can properly address any adjustments needed.
o One bill convenience -- you have the option of combining all eligible Hartford policies on one single bill allowing
you to make one payment for all policies on your account as payments are due.
You’re In Control
In addition to selecting a bill plan option that best meets your budget, you have the flexibility to decide how your
payments are made …
o Repetitive EFT: Sign up for Repetitive EFT payments and have payments automatically withdrawn from your bank
account. This option saves you money by reducing the amount of the installment service fee.
o Pay Online: Register at www.thehartford.com/servicecenter. Online Bill Pay is Quick, Easy and Secure!
o Pay by Check: Send a check with your remittance stub in the envelope provided with your bill.
o Pay by Phone: Call toll-free 1-866-467-8730.
Should you have any questions about your bill, please call Customer Service toll-free number:
1-866-467-8730 - 7AM – 7PM CST. We look forward to being of service to you.
Form 100722 11th Rev. Printed in U.S.A.
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
Business Insurance Policy
Form HM 00 01 03 14 Page 1 of 1
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
This SPECIAL MULTI-FLEX POLICY is provided by the stock insurance company(s) of The Hartford Insurance
Group, shown below.
COMMON POLICY DECLARATIONS
POLICY NUMBER: 12 UUN UH2741 K1
RENEWAL OF: 12 UUN UH2741
Named Insured and Mailing Address: PTS AMERICA INC
(No., Street, Town, State, Zip Code) SEE IH1204
222 5TH AVE
NEW YORK , NY 10001
(NEW YORK COUNTY)
Policy Period: From 01/01/23 To 01/01/24
12:01 A.M., Standard time at your mailing address shown above.
In return for the payment of the premium, and subject to all of the terms of this policy, we agree with you to provide
insurance as stated in this policy. The Coverage Parts that are a part of this policy are listed below. The Advance
Premium shown may be subject to adjustment.
Total Advance Premium:
Coverage Part and Insurance Company Summary Advance Premium
PROPERTY CHOICE
HARTFORD FIRE INSURANCE COMPANY
ONE HARTFORD PLAZA
HARTFORD, CONNECTICUT 06155
LISTING OF ADDITIONAL COVERAGE PARTS CONTINUED ON THE FOLLOWING PAGE.
Form Numbers of Coverage Parts, Forms and Endorsements that are a part of this policy and that are not
listed in the Coverage Parts.
HM0001 IL00171198 IH00010795 IH01150795 IH09850115 IH12040312 IH12050221
IH99400409 IH99410409 IL00230702 IL01830808 IL02680114 PC00010109
HC00100798 HC00200295
Agent/Broker Name: USI INSURANCE SERVICES LLC
Countersigned by 12/15/22
(Where required by law) Authorized Representative Date
Form HM 00 10 01 07 PAGE 1 (CONTINUED ON NEXT PAGE)
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
COMMON POLICY DECLARATIONS (Continued)
POLICY NUMBER: 12 UUN UH2741
ADDITIONAL COVERAGE PARTS (CONTINUED)
COVERAGE PART AND INSURANCE COMPANY SUMMARY ADVANCE PREMIUM
COMMERCIAL GENERAL LIABILITY
EMPLOYEE BENEFITS LIABILITY
HARTFORD FIRE INSURANCE COMPANY
ONE HARTFORD PLAZA
HARTFORD, CONNECTICUT 06155
NEW YORK FIRE FEE
Form HM 00 10 01 07 PAGE 2
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
COMMON POLICY CONDITIONS
All Coverage Parts included in this policy are subject to the following conditions.
A.Cancellation C. Examination Of Your Books And Records
1. The first Named Insured shown in the We may examine and audit your books and records
Declarations may cancel this policy by mailing or as they relate to this policy at any time during the
delivering to us advance written notice of policy period and up to three years afterward.
cancellation. D. Inspections And Surveys
2. We may cancel this policy by mailing or delivering 1. We have the right to:
to the first Named Insured written notice of
cancellation at least: a. Make inspections and surveys at any time;
a. 10 days before the effective date of b. Give you reports on the conditions we find;
cancellation if we cancel for nonpayment of and
premium; or c. Recommend changes.
b. 30 days before the effective date of 2. We are not obligated to make any inspections,
cancellation if we cancel for any other reason. surveys, reports or recommendations and any
3. We will mail or deliver our notice to the first such actions we do undertake relate only to
Named Insured's last mailing address known to insurability and the premiums to be charged. We
us. do not make safety inspections. We do not
undertake to perform the duty of any person or
4. Notice of cancellation will state the effective date organization to provide for the health or safety of
of cancellation. The policy period will end on that workers or the public. And we do not warrant that
date. conditions:
5. If this policy is cancelled, we will send the first a. Are safe or healthful; or
Named Insured any premium refund due. If we
cancel, the refund will be pro rata. If the first b. Comply with laws, regulations, codes or
Named Insured cancels, the refund may be less standards.
than pro rata. The cancellation will be effective 3. Paragraphs 1. and 2. of this condition apply not
even if we have not made or offered a refund. only to us, but also to any rating, advisory, rate
6. If notice is mailed, proof of mailing will be service or similar organization which makes
sufficient proof of notice. insurance inspections, surveys, reports or
recommendations.
B. Changes
4. Paragraph 2. of this condition does not apply to
This policy contains all the agreements between you any inspections, surveys, reports or
and us concerning the insurance afforded. The first recommendations we may make relative to
Named Insured shown in the Declarations is certification, under state or municipal statutes,
authorized to make changes in the terms of this ordinances or regulations, of boilers, pressure
policy with our consent. This policy's terms can be vessels or elevators.
amended or waived only by endorsement issued by
us and made a part of this policy.
IL 00 17 11 98 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 2
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
E. Premiums If you die, your rights and duties will be transferred
The first Named Insured shown in the Declarations: to your legal representative but only while acting
within the scope of duties as your legal
1. Is responsible for the payment of all premiums; representative. Until your legal representative is
and appointed, anyone having proper temporary
2. Will be the payee for any return premiums we custody of your property will have your rights and
pay. duties but only with respect to that property.
F. Transfer Of Your Rights And Duties Under This
Policy
Your rights and duties under this policy may not be
transferred without our written consent except in the
case of death of an individual named insured.
Kevin Barnett, Secretary M. Ross Fisher, President
Page 2 of 2 © Insurance Services Office, Inc., 1998 IL 00 17 11 98
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
NUCLEAR ENERGY LIABILITY EXCLUSION
ENDORSEMENT - NEW YORK
(BROAD FORM)
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS POLICY
COMMERCIAL GENERAL LIABILITY COVERAGE PART
FARM COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART
OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
SPECIAL PROTECTIVE AND HIGHWAY LIABILITY POLICY NEW YORK DEPARTMENT OF TRANSPORTATION
1. The insurance does not apply: B. Under any Medical Payments coverage, to
A. Under any Liability Coverage to "bodily injury" or expenses incurred with respect to "bodily injury"
"property damage:" resulting from the "hazardous properties" of
"nuclear material" and arising out of the
(1) With respect to which an "insured" under the
operation of a "nuclear facility" by any person or
policy is also an insured under a nuclear
organization.
energy liability policy issued by Nuclear
C. Under any Liability Coverage, to "bodily injury" or
Energy Liability Insurance Association,
"property damage" resulting from the "hazardous
Mutual Atomic Energy Liability Underwriters,
properties" of "nuclear material," if:
Nuclear Insurance Association of Canada or
any of their successors, or would be an (1) The "nuclear material" (a) is at any "nuclear
insured under any such policy but for its facility" owned by, or operated by or on
termination upon exhaustion of its limit of behalf of, an "insured" or (b) has been
liability; or discharged or dispersed therefrom;
(2) Resulting from the "hazardous properties" of (2) The "nuclear material" is contained in "spent
"nuclear material" and with respect to which fuel" or "waste" at any time possessed,
(a) any person or organization is required to handled, used, processed, stored,
maintain financial protection pursuant, to the transported or disposed of by or on behalf of
Atomic Energy Act of 1954, or any law an "insured," or
amendatory thereof, or (b) the "insured" is, (3) The "bodily injury" or "property damage"
or had this policy not been issued would be, arises out of the furnishing by an "insured" of
entitled to indemnity from the United States services, materials, parts or equipment in
of America, or any agency thereof, under connection with the planning, construction,
any agreement entered into by the United maintenance, operation or use of any
States of America, or any agency thereof, "nuclear facility," but if such facility is located
with any person or organization. within the United States of America, its
territories or possessions or Canada, this
exclusion (3) applies only to "property
damage" to such "nuclear facility" and any
property thereat.
Form IH 00 01 07 95 Copyright, Hartford Fire Insurance Company, 1995 Page 1 of 2
(Includes copyrighted material of Insurance Services Office Inc.
with its permission. Copyright, Insurance Services Office, Inc., 1983, 1984)
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
2. As used in this endorsement: (c) Any equipment or device used for the
"Hazardous properties" include radioactive, toxic processing, fabricating or alloying of "special
or explosive properties; nuclear material" if at any time the total
amount of such material in the custody of
"Nuclear material" means "source material,"
the "insured" at the premises where such
"Special nuclear material" or "by-product
equipment or device is located consists of or
material," contains more than 25 grams of plutonium or
"Source material," "special nuclear material," and uranium 233 or any combination thereof, or
"by-product material" have the meanings given more than 250 grams of uranium 235;
them in the Atomic Energy Act of 1954 or in any
(d) Any structure, basin, excavation, premises
law amendatory thereof; "Spent fuel" means any
or place prepared or used for the storage or
fuel element or fuel component, solid or liquid,
disposal of "waste,"
which has been used or exposed to radiation in a
"nuclear reactor;" and includes the site on which any of the foregoing is
located, all operations conducted on such site and all
"Waste" means any waste material (a) containing
premises used for such operations;
"by-product material" other than the tailings or
wastes produced by the extraction or "Nuclear reactor" means any apparatus designed or
concentration of uranium or thorium from any ore used to sustain nuclear fission in a self-supporting
processed primarily for its "source material" chain reaction or to contain a critical mass of
content, and (b) resulting from the operation by fissionable material;
any person or organization of any "nuclear "Property damage" includes all forms of radioactive
facility" included under the first two paragraphs contamination of property.
of the definition of "nuclear facility."
"Nuclear facility" means:
(a) Any "nuclear reactor;"
(b) Any equipment or device designed or used
for (a) separating the isotopes of uranium or
plutonium, (2) processing or utilizing "spent
fuel," or (3) handling, processing or
packaging "waste;"
Page 2 of 2 IH 00 01 07 95
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NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADVANCE PREMIUM - NEW YORK
This endorsement modifies insurance provided under the following:
BOILER AND MACHINERY COVERAGE PART
COMMERCIAL AUTO COVERAGE PART
COMMERCIAL CRIME COVERAGE PART
COMMERCIAL GENERAL LIABILITY COVERAGE PART
COMMERCIAL GLASS COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
EMPLOYEE BENEFITS LIABILITY COVERAGE PART
HEALTH CARE FACILITIES LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
OWNERS AND CONTRACTORS COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SPECIAL PROPERTY COVERAGE PART
The following is added to DEFINITIONS:
"Advance Premium" means the estimated premium computed based on the exposures you told us about at the
inception of the policy.
Form IH 01 15 07 95
Copyright Hartford Fire Insurance Company, 1995
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GOODS AND SERVICES ENDORSEMENT
This endorsement modifies insurance provided under all Coverage Parts of this Policy.
We may offer or make "goods or services" available to you through this underwriting
company, a non-insurer subsidiary, or unaffiliated third parties as a part of this policy.
The "goods or services" may be provided for a charge, at a discount, on a subsidized
basis, or free of charge. In some cases, we may receive a fee from the unaffiliated
third parties that provide "goods or services". We do not warrant or guarantee the
"goods or services" provided by third parties, and such third parties shall be solely
liable and responsible for the "goods or services" they provide. The "goods or
services" offered or made available by us may be modified or discontinued at any
time.
"Goods or services" means goods, products or services, including but not limited to
risk mitigation, safety, and/or loss prevention services or equipment.
IH 12 05 02 21 Page 1 of 1
© 2021, The Hartford
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E
NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024
POLICY NUMBER: 12 UUN UH2741
THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN
RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK
INSURANCE ACT.
DISCLOSURE PURSUANT TO TERRORISM RISK
INSURANCE ACT
TERRORISM PREMIUM
Coverage: Premium (if Covered):
PROPERTY $
GENERAL LIABILITY $
TOTAL $
A. Disclosure Of Premium coerce the civilian population of the United
In accordance with the federal Terrorism Risk States or to influence the policy or affect the
Insurance Act, as amended (TRIA), we are conduct of the United States Government by
required to provide you with a notice disclosing the coercion.
portion of your premium, if any, attributable to C. Disclosure Of Federal Share Of Terrorism
coverage for "certified acts of terrorism" under Losses Under TRIA
TRIA. The portion of your premium attributable to The United States Department of the Treasury will
such coverage is shown above in this reimburse insurers for a portion of such insured
endorsement. losses as indicated in the table below that exceeds
B. The following definition is added with respect the applicable insurer deductible:
to the provisions of this endorsement: Calendar Year Federal Share of
A "certified act of terrorism" means an act that is Terrorism Losses
certified by the Secretary of the Treasury, in 2015 85%
accordance with the provisions of TRIA, to be an
act of terrorism under TRIA. The criteria contained 2016 84%
in TRIA for a "certified act of terrorism" include the 2017 8
Preview
FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 EXHIBIT “A” FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 Prepare. Protect. Prevail. THE HARTFORD Business Insurance Employee Benefits Auto Home August 11, 2023 Re: Insured: PTS AMERICA INC Policy Number: 12 UUN UH2741 Policy Term: 01/01/2023 – 01/01/2024 Writing Company: HARTFORD FIRE INSURANCE COMPANY This will verify that, to the best of the undersigned's knowledge, the attached is a complete and accurate representation of insurance policy referenced above. Documents and/or information produced herewith are kept and maintained in the ord1nary course of business. Kyona Lawrence Operations Support Specialist Clinton Business Center Hartford Office Location 301 Woods Park Dr. Clinton, NY 13323 Toll Free: 888-525-2652 Fax: 866-809-1178 FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 THE HARTFORD BUSINESS SERVICE CENTER 3600 WISEMAN BLVD SAN ANTONIO TX 78251 October 17, 2022 PTS AMERICA INC 222 5TH AVE NEW YORK NY 10001 Policy Information: Contact Us Policy Number: 12 UUN UH2741 Visit https://business.thehartford.com 24/7 access to pay bills, view policy documents, get your certificate of insurance and more. Need Help? Start a live chat online or call us at (866) 467-8730. We’re here weekdays from 8:00 AM to 8:00 PM ET. You can find information about your policy enclosed. You can also find this info online at https://business.thehartford.com. If you have any questions or concerns about what you see, contact us at any of the options listed on this page. Thanks for choosing us for your business insurance needs. Sincerely, The Hartford WLTR001 FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 CONDITIONAL RENEWAL NOTICE - NEW YORK Date: 10/17/22 Policy Number: 12 UUN UH2741 Renewal Date: 01/01/23 Your Hartford Agent: USI INSURANCE SERVICES LLC (866) 487-1744 PTS AMERICA INC 222 5TH AVE NEW YORK NY 10001 Dear Valued Hartford Insured, Your current policy provided by The Hartford will expire shortly. The purpose of this notice is to advise you of certain changes to your policy upon renewal. A. Policy Premium The new premium for your policy for the upcoming term is indicated below. This premium amount is based on current information known to us and may be subject to change based on any additional information we may receive from you or your Hartford agent or broker. More information on your premium determination can be obtained from your agent or broker, or from The Hartford. () Premium Change: The premium for your renewal policy will be increased by more than 10%. Renewal Premium =$ Amount of Increase =$ The reason(s) for the increase in premium is due to one or more of the following: 1. A change in rates or the method of calculating premium of more than 10% along with, if applicable, 2. A change in your exposures, loss experience, or other risk characteristics. B. Coverage Changes (if applicable) Your policy for the upcoming term will include certain coverage changes, as indicated by an (x) below. () Increase in Deductible to: () Reduction in Limits to: ( x) Reductions in Coverage: CG2132-0509-Communicable Disease Exclusion () Other Changes or Restrictions in Coverage: The coverage change is due to the following indicated reason(s): () Your exposures, loss experience, or other risk characteristics indicate a need for the change. ( x) A change in our rules, forms or underwriting guidelines for your type of policy. Further information regarding the reason for the coverage change(s) is available from the company or your agent or broker. You may receive other notices of coverage changes for the upcoming policy term under separate cover. Those other changes will apply in addition to the changes described above. Form IH 70 02 06 18 (WC 66 03 66 C) FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 C. Other Information on Your Workers’ Compensation Policy ( ) Please see attached for information on your upcoming workers’ compensation policy. Upon receipt of your written request, we will provide you through your agent with loss information covering the period required by law. If you have any questions about your policy or about your overall insurance needs, please contact your Hartford agent or broker. Form IH 70 02 06 18 (WC 66 03 66 C) FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 Important Information For New York Property Owners and Tenants As a result of New York Labor Law Section 240, you may be liable for injuries to contractors you hire to do work at or on your property. Learn more about this law and what you can do to reduce your risk. As a New York property owner or a tenant who hires contractors to repair, alter, paint, erect, demolish, clean or point a building or structure under New York Law Section 240, you may be liable for injuries sustained by the contractor's workers who fall from heights or who are struck by falling objects. This law places responsibility for worksite safety on owners and tenants who hire contractors. Liability under New York Labor Law Section 240 may be imposed regardless of whether the property owner exercised supervision or control over the injured worker. Examples of Claims and Lawsuits Contractors often work at heights and use ladders, scaffolding or other devices in order to get a job done. It would not be uncommon for a contractor's employee (injured in a fall from a height on your property) to bring a legal action against you or your company. Examples of situations that resulted in a claim and/or lawsuit under Section 240 of the New York Labor Law include: o A maintenance worker fell from a ladder and was injured while taking down ceiling tiles for a store owner to correct a drafty condition created by improperly installed ceiling insulation. o Trade Association hired a contractor to assist in installing a stage. Plaintiff, an employee of the contractor, fell four feet and was injured. o A worker was injured when he fell from an elevated height while removing and replacing piping for a machine oil supply and return system for our manufacturing risk. o A worker was injured in a fall from a steel beam. There was no scaffold beneath the beam. In each of these cases, the property owner or business owner was alleged to be liable based on the fact that they had hired a contractor to do work. Impact on Insurance Coverage Claims and lawsuits under Section 240 of the New York Labor Law may have an adverse effect on your company's finances and insurance program. o The most significant risk is a judgment against your company in excess of your policy's limit of liability. Some claims based on this law have been $1 million or more. o Your future insurance premiums may increase as a result of lawsuits against your company. o Because favorable claim history is a key component of your insurability, liability insurance may become difficult to obtain. Form 106373 Page 1 of 2 © 2016, The Hartford FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 Reducing Your Risk There are a few simple risk management techniques that should be considered in consultation with your attorney or insurance agent to help reduce the chances of your business being involved in litigation: 1. Prior to the start of any work, have a written contract in place that includes an appropriate indemnification clause. Ensure that all contracts and indemnification clauses are reviewed by a qualified attorney prior to signing. 2. Be named as a "primary" and "non-contributory" Additional Insured on the contractor's General Liability Policy. This method of transferring risk could be significant in the event of a loss. 3. Only hire reputable contractors to perform work of any kind on your property, whether owned or leased. Pre-qualify contractors by reviewing previous work, securing recommendations from previous customers, reviewing the contractor's financial condition, inquiring about past losses, and ensuring the contractor has adequate and appropriate insurance coverage, including Workers' Compensation coverage. 4. Require all contractors you hire to strictly follow all OSHA and NY State Industrial Regulations. Ensure that the contractor is aware of the applicable regulations and laws that apply to this exposure. Taking these simple steps will help minimize the possibility of the New York Labor Law having an adverse effect on your company's finances and insurance program, as a result of hiring a contractor. For more information about how The Hartford can help meet your business' risk management and insurance needs, please contact your agent. New York Labor Law Section 240 (1) provides, in part, as follows: "All contractors and owners and their agents, except owners of one and two-family dwellings who contract for but do not direct or control the work, in the erection, demolition, repairing, altering, painting, cleaning or pointing of a building or structure shall furnish or erect, or cause to be furnished or erected for the performance of such labor, scaffolding, hoists, stays, ladders, slings, hangers, blocks, pulleys, braces, irons, ropes and other devices which shall be so constructed, placed and operated as to give proper protection to a person so employed." The information provided above is of a general nature and may not be considered legal advice. The content of this document may omit certain details and cannot be regarded as advice that would be applicable to all businesses. As such, this information is provided for informational purposes only. Readers seeking resolution of specific safety, legal or business issues or concerns regarding this topic should consult their safety consultant, attorney and/or business advisors. The information presented is not a substitute for a thorough loss control survey of your business or operations or an analysis of the legality or appropriateness of your business practices. We do not warrant that the implementation of any view or recommendation contained herein will be an appropriate legal or business practice. Further, we do not warrant that the implementation of any view or recommendation will avoid any or all liability. Form 106373 Page 2 of 2 FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 IMPORTANT NOTICE TO NORTH CAROLINA POLICYHOLDERS THIS NOTICE APPLIES UNLESS THIS POLICY IS SPECIFICALLY ENDORSED TO PROVIDE COVERAGE AT ONE OR MORE LOCATIONS FOR LOSS FROM FLOODS, EARTHQUAKES, MUDSLIDES, MUDFLOWS OR LANDSLIDES. THIS NOTICE APPLIES IF YOU HAVE A WINDSTORM OR HAIL EXCLUSION ENDORSEMENT ON YOUR POLICY AS SHOWN IN THE DECLARATIONS. WARNING: THIS PROPERTY INSURANCE POLICY DOES NOT PROTECT YOU AGAINST LOSSES FROM FLOODS, EARTHQUAKES, MUDSLIDES, MUDFLOWS, LANDSLIDES, WINDSTORM OR HAIL. YOU SHOULD CONTACT YOUR INSURANCE COMPANY OR AGENT TO DISCUSS YOUR OPTIONS FOR OBTAINING COVERAGE FOR THESE LOSSES. THIS IS NOT A COMPLETE LISTING OF ALL OF THE CAUSES OF LOSSES NOT COVERED UNDER YOUR POLICY. YOU SHOULD READ YOUR ENTIRE POLICY TO UNDERSTAND WHAT IS COVERED AND WHAT IS NOT COVERED. Form G-3253-2 Page 1 of 1 © 2012, The Hartford FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 IMPORTANT NOTICE TO POLICYHOLDERS THE HARTFORD CYBER CENTER WEBSITE ACCESS Thank you for choosing The Hartford for your business insurance needs. You are receiving this Notice because you purchased a general liability or property policy from The Hartford, which includes access to The Hartford Cyber Center. This portal was created because we recognize that businesses face a variety of cyber-related exposures and need help managing the related risks. These exposures include data breaches, computer virus attacks and cyber extortion threats. Through the Hartford Cyber Center, you have access to: o A panel of third party incident response service providers o Third party cybersecurity pre-incident service providers and a list of approved services to help protect your business before a cyber-threat occurs o Risk management tools, including self-assessments, best practice guides, templates, sample incident response plans, and data breach cost calculators o White papers, blogs and webinars from leading privacy and security practitioners o Up-to-date cyber-related news and events, including examples of privacy and security related events Accessing The Hartford Cyber Center is easy 1. Visit www.thehartford.com/cybercenter 2. Enter policyholder information 3. Access code: 952689 4. Login to The Hartford Cyber Center Please be aware that: o The Hartford Cyber Center is a proprietary web portal exclusively provided to customers of The Hartford. Please do not share the access code with anyone outside your organization. o Registration is required to access the Cyber Center. You may register as many users as necessary. o Contacting a service provider about any issue does not constitute providing The Hartford notice of a claim as required under your insurance policy. Read your insurance policy and discuss any questions with your agent or broker. o The Hartford Cyber Center provides third party service provider references and materials for educational purposes only. The Hartford does not specifically endorse any such service provider within The Hartford Cyber Center and hereby disclaims all liability with respect to use of or reliance on such service providers. All service providers are independent contractors and not agents of The Hartford. The Hartford does not warrant the performance of the service providers, even if such services are covered under your policy. We strongly encourage you to conduct your own assessments of the service providers' services and the fitness or adequacy of such services for your particular needs. This Notice does not amend or otherwise affect the provisions of your policy. The Hartford offers a variety of endorsements to your policy that can help protect your business from a broad range of cyber-related threats. Please review your coverage with your insurance agent or broker to determine the most appropriate cyber coverages and limits for your business. If you have a claim, you can report it by calling The Hartford's toll-free claims line at 1-800-327-3636. Should you have any questions, please contact your insurance agent, broker or you may contact us directly. We appreciate your business and look forward to being of continued service to you. Form G-4033-1 (07/16 ED.) Page 1 of 1 © 2016, The Hartford FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 Insurance Policy Billing Information Thank you for selecting The Hartford for your business insurance needs. Shortly, you will receive your first bill from us. You are receiving this Notice so you know what to expect as a valued customer of The Hartford. Should you have any questions after reviewing this information, please contact us at 866-467-8730, and we will be happy to assist you. o Your total policy premium will appear on your policy’s Declarations Page. You will be billed based on the payment plan you selected. o You may pay the "minimum due" as it appears on your insurance bill or pay the policy balance in full. o An installment service fee is added to each installment. A late fee will also be applied if the "minimum due" is not received by the due date shown on your bill. Service and late payment fees do not apply in all states. o If you selected installment billing, any credit or additional premium due as the result of a change made to your policy, will be spread over the remaining billing installments. Additional premium due as a result of an audit will be billed in full on your next bill date following the completion of the audit. o If you elected Electronic Funds Transfer (EFT), policy changes may result in changes to the amount automatically withdrawn from your bank account. The invoice you receive following a policy change will include future withdrawal amounts. If you need to adjust or stop your next scheduled EFT withdrawal, please contact us at least 3 days prior to the scheduled withdrawal date at the telephone number shown below. o If you selected installment billing and pay the premiums for your first policy term on time, at renewal, your account may qualify for our "Equal Installment" feature. This means that the percentage due for each installment, including the initial renewal installment, will be the same throughout the policy term – helping you better manage cash flow. Equal installments will continue as long as you pay your premiums on time and no cancellation notices are issued for any policy on your account. If you no longer qualify for Equal Installments, future renewals will be billed based on the payment plan you selected, which includes a higher initial installment amount. o If your policy is eligible for renewal, your bill for the upcoming policy term will be sent to you approximately 30 days prior to your policy’s renewal date. If your insurance needs change, please contact us at least 60 days prior to your renewal date so we can properly address any adjustments needed. o One bill convenience -- you have the option of combining all eligible Hartford policies on one single bill allowing you to make one payment for all policies on your account as payments are due. You’re In Control In addition to selecting a bill plan option that best meets your budget, you have the flexibility to decide how your payments are made … o Repetitive EFT: Sign up for Repetitive EFT payments and have payments automatically withdrawn from your bank account. This option saves you money by reducing the amount of the installment service fee. o Pay Online: Register at www.thehartford.com/servicecenter. Online Bill Pay is Quick, Easy and Secure! o Pay by Check: Send a check with your remittance stub in the envelope provided with your bill. o Pay by Phone: Call toll-free 1-866-467-8730. Should you have any questions about your bill, please call Customer Service toll-free number: 1-866-467-8730 - 7AM – 7PM CST. We look forward to being of service to you. Form 100722 11th Rev. Printed in U.S.A. FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 Business Insurance Policy Form HM 00 01 03 14 Page 1 of 1 FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 This SPECIAL MULTI-FLEX POLICY is provided by the stock insurance company(s) of The Hartford Insurance Group, shown below. COMMON POLICY DECLARATIONS POLICY NUMBER: 12 UUN UH2741 K1 RENEWAL OF: 12 UUN UH2741 Named Insured and Mailing Address: PTS AMERICA INC (No., Street, Town, State, Zip Code) SEE IH1204 222 5TH AVE NEW YORK , NY 10001 (NEW YORK COUNTY) Policy Period: From 01/01/23 To 01/01/24 12:01 A.M., Standard time at your mailing address shown above. In return for the payment of the premium, and subject to all of the terms of this policy, we agree with you to provide insurance as stated in this policy. The Coverage Parts that are a part of this policy are listed below. The Advance Premium shown may be subject to adjustment. Total Advance Premium: Coverage Part and Insurance Company Summary Advance Premium PROPERTY CHOICE HARTFORD FIRE INSURANCE COMPANY ONE HARTFORD PLAZA HARTFORD, CONNECTICUT 06155 LISTING OF ADDITIONAL COVERAGE PARTS CONTINUED ON THE FOLLOWING PAGE. Form Numbers of Coverage Parts, Forms and Endorsements that are a part of this policy and that are not listed in the Coverage Parts. HM0001 IL00171198 IH00010795 IH01150795 IH09850115 IH12040312 IH12050221 IH99400409 IH99410409 IL00230702 IL01830808 IL02680114 PC00010109 HC00100798 HC00200295 Agent/Broker Name: USI INSURANCE SERVICES LLC Countersigned by 12/15/22 (Where required by law) Authorized Representative Date Form HM 00 10 01 07 PAGE 1 (CONTINUED ON NEXT PAGE) FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 COMMON POLICY DECLARATIONS (Continued) POLICY NUMBER: 12 UUN UH2741 ADDITIONAL COVERAGE PARTS (CONTINUED) COVERAGE PART AND INSURANCE COMPANY SUMMARY ADVANCE PREMIUM COMMERCIAL GENERAL LIABILITY EMPLOYEE BENEFITS LIABILITY HARTFORD FIRE INSURANCE COMPANY ONE HARTFORD PLAZA HARTFORD, CONNECTICUT 06155 NEW YORK FIRE FEE Form HM 00 10 01 07 PAGE 2 FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A.Cancellation C. Examination Of Your Books And Records 1. The first Named Insured shown in the We may examine and audit your books and records Declarations may cancel this policy by mailing or as they relate to this policy at any time during the delivering to us advance written notice of policy period and up to three years afterward. cancellation. D. Inspections And Surveys 2. We may cancel this policy by mailing or delivering 1. We have the right to: to the first Named Insured written notice of cancellation at least: a. Make inspections and surveys at any time; a. 10 days before the effective date of b. Give you reports on the conditions we find; cancellation if we cancel for nonpayment of and premium; or c. Recommend changes. b. 30 days before the effective date of 2. We are not obligated to make any inspections, cancellation if we cancel for any other reason. surveys, reports or recommendations and any 3. We will mail or deliver our notice to the first such actions we do undertake relate only to Named Insured's last mailing address known to insurability and the premiums to be charged. We us. do not make safety inspections. We do not undertake to perform the duty of any person or 4. Notice of cancellation will state the effective date organization to provide for the health or safety of of cancellation. The policy period will end on that workers or the public. And we do not warrant that date. conditions: 5. If this policy is cancelled, we will send the first a. Are safe or healthful; or Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first b. Comply with laws, regulations, codes or Named Insured cancels, the refund may be less standards. than pro rata. The cancellation will be effective 3. Paragraphs 1. and 2. of this condition apply not even if we have not made or offered a refund. only to us, but also to any rating, advisory, rate 6. If notice is mailed, proof of mailing will be service or similar organization which makes sufficient proof of notice. insurance inspections, surveys, reports or recommendations. B. Changes 4. Paragraph 2. of this condition does not apply to This policy contains all the agreements between you any inspections, surveys, reports or and us concerning the insurance afforded. The first recommendations we may make relative to Named Insured shown in the Declarations is certification, under state or municipal statutes, authorized to make changes in the terms of this ordinances or regulations, of boilers, pressure policy with our consent. This policy's terms can be vessels or elevators. amended or waived only by endorsement issued by us and made a part of this policy. IL 00 17 11 98 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 2 FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 E. Premiums If you die, your rights and duties will be transferred The first Named Insured shown in the Declarations: to your legal representative but only while acting within the scope of duties as your legal 1. Is responsible for the payment of all premiums; representative. Until your legal representative is and appointed, anyone having proper temporary 2. Will be the payee for any return premiums we custody of your property will have your rights and pay. duties but only with respect to that property. F. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured. Kevin Barnett, Secretary M. Ross Fisher, President Page 2 of 2 © Insurance Services Office, Inc., 1998 IL 00 17 11 98 FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT - NEW YORK (BROAD FORM) This endorsement modifies insurance provided under the following: BUSINESSOWNERS POLICY COMMERCIAL GENERAL LIABILITY COVERAGE PART FARM COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART SPECIAL PROTECTIVE AND HIGHWAY LIABILITY POLICY NEW YORK DEPARTMENT OF TRANSPORTATION 1. The insurance does not apply: B. Under any Medical Payments coverage, to A. Under any Liability Coverage to "bodily injury" or expenses incurred with respect to "bodily injury" "property damage:" resulting from the "hazardous properties" of "nuclear material" and arising out of the (1) With respect to which an "insured" under the operation of a "nuclear facility" by any person or policy is also an insured under a nuclear organization. energy liability policy issued by Nuclear C. Under any Liability Coverage, to "bodily injury" or Energy Liability Insurance Association, "property damage" resulting from the "hazardous Mutual Atomic Energy Liability Underwriters, properties" of "nuclear material," if: Nuclear Insurance Association of Canada or any of their successors, or would be an (1) The "nuclear material" (a) is at any "nuclear insured under any such policy but for its facility" owned by, or operated by or on termination upon exhaustion of its limit of behalf of, an "insured" or (b) has been liability; or discharged or dispersed therefrom; (2) Resulting from the "hazardous properties" of (2) The "nuclear material" is contained in "spent "nuclear material" and with respect to which fuel" or "waste" at any time possessed, (a) any person or organization is required to handled, used, processed, stored, maintain financial protection pursuant, to the transported or disposed of by or on behalf of Atomic Energy Act of 1954, or any law an "insured," or amendatory thereof, or (b) the "insured" is, (3) The "bodily injury" or "property damage" or had this policy not been issued would be, arises out of the furnishing by an "insured" of entitled to indemnity from the United States services, materials, parts or equipment in of America, or any agency thereof, under connection with the planning, construction, any agreement entered into by the United maintenance, operation or use of any States of America, or any agency thereof, "nuclear facility," but if such facility is located with any person or organization. within the United States of America, its territories or possessions or Canada, this exclusion (3) applies only to "property damage" to such "nuclear facility" and any property thereat. Form IH 00 01 07 95 Copyright, Hartford Fire Insurance Company, 1995 Page 1 of 2 (Includes copyrighted material of Insurance Services Office Inc. with its permission. Copyright, Insurance Services Office, Inc., 1983, 1984) FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 2. As used in this endorsement: (c) Any equipment or device used for the "Hazardous properties" include radioactive, toxic processing, fabricating or alloying of "special or explosive properties; nuclear material" if at any time the total amount of such material in the custody of "Nuclear material" means "source material," the "insured" at the premises where such "Special nuclear material" or "by-product equipment or device is located consists of or material," contains more than 25 grams of plutonium or "Source material," "special nuclear material," and uranium 233 or any combination thereof, or "by-product material" have the meanings given more than 250 grams of uranium 235; them in the Atomic Energy Act of 1954 or in any (d) Any structure, basin, excavation, premises law amendatory thereof; "Spent fuel" means any or place prepared or used for the storage or fuel element or fuel component, solid or liquid, disposal of "waste," which has been used or exposed to radiation in a "nuclear reactor;" and includes the site on which any of the foregoing is located, all operations conducted on such site and all "Waste" means any waste material (a) containing premises used for such operations; "by-product material" other than the tailings or wastes produced by the extraction or "Nuclear reactor" means any apparatus designed or concentration of uranium or thorium from any ore used to sustain nuclear fission in a self-supporting processed primarily for its "source material" chain reaction or to contain a critical mass of content, and (b) resulting from the operation by fissionable material; any person or organization of any "nuclear "Property damage" includes all forms of radioactive facility" included under the first two paragraphs contamination of property. of the definition of "nuclear facility." "Nuclear facility" means: (a) Any "nuclear reactor;" (b) Any equipment or device designed or used for (a) separating the isotopes of uranium or plutonium, (2) processing or utilizing "spent fuel," or (3) handling, processing or packaging "waste;" Page 2 of 2 IH 00 01 07 95 FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADVANCE PREMIUM - NEW YORK This endorsement modifies insurance provided under the following: BOILER AND MACHINERY COVERAGE PART COMMERCIAL AUTO COVERAGE PART COMMERCIAL CRIME COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL GLASS COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART EMPLOYEE BENEFITS LIABILITY COVERAGE PART HEALTH CARE FACILITIES LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SPECIAL PROPERTY COVERAGE PART The following is added to DEFINITIONS: "Advance Premium" means the estimated premium computed based on the exposures you told us about at the inception of the policy. Form IH 01 15 07 95 Copyright Hartford Fire Insurance Company, 1995 FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GOODS AND SERVICES ENDORSEMENT This endorsement modifies insurance provided under all Coverage Parts of this Policy. We may offer or make "goods or services" available to you through this underwriting company, a non-insurer subsidiary, or unaffiliated third parties as a part of this policy. The "goods or services" may be provided for a charge, at a discount, on a subsidized basis, or free of charge. In some cases, we may receive a fee from the unaffiliated third parties that provide "goods or services". We do not warrant or guarantee the "goods or services" provided by third parties, and such third parties shall be solely liable and responsible for the "goods or services" they provide. The "goods or services" offered or made available by us may be modified or discontinued at any time. "Goods or services" means goods, products or services, including but not limited to risk mitigation, safety, and/or loss prevention services or equipment. IH 12 05 02 21 Page 1 of 1 © 2021, The Hartford FILED: BRONX COUNTY CLERK 01/24/2024 10:42 AM INDEX NO. 808835/2023E NYSCEF DOC. NO. 29 RECEIVED NYSCEF: 01/24/2024 POLICY NUMBER: 12 UUN UH2741 THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT TERRORISM PREMIUM Coverage: Premium (if Covered): PROPERTY $ GENERAL LIABILITY $ TOTAL $ A. Disclosure Of Premium coerce the civilian population of the United In accordance with the federal Terrorism Risk States or to influence the policy or affect the Insurance Act, as amended (TRIA), we are conduct of the United States Government by required to provide you with a notice disclosing the coercion. portion of your premium, if any, attributable to C. Disclosure Of Federal Share Of Terrorism coverage for "certified acts of terrorism" under Losses Under TRIA TRIA. The portion of your premium attributable to The United States Department of the Treasury will such coverage is shown above in this reimburse insurers for a portion of such insured endorsement. losses as indicated in the table below that exceeds B. The following definition is added with respect the applicable insurer deductible: to the provisions of this endorsement: Calendar Year Federal Share of A "certified act of terrorism" means an act that is Terrorism Losses certified by the Secretary of the Treasury, in 2015 85% accordance with the provisions of TRIA, to be an act of terrorism under TRIA. The criteria contained 2016 84% in TRIA for a "certified act of terrorism" include the 2017 8