ACORE'' INSURANCE BINDER OP

Transcription

.,------OP lD: JBACORE''INSURANCE BINDERT EM P o RA RTH IS B N E R SN s U RANCE CONTRACT, S U BJ ECT TO THE6t9t20'17TH E R EV ERSE S D E OF T H IS F o RMcoN DIT o NS s H OWN o Nstin & Co., lnc.Corporate Woods BlvdHartford lnsurance GroupOAIEbany, NY 1221'l -2366na M. Payne, CPCUHON cooe,22436BINDER,AGENCY5 1 8 46 5-3 59 107 to1l'18[]NOONTHIS EINDER IS ISSUEO TO EXTENO COVEF{AGE IN THE ABOVE NAMED COMPANYPER ExPTRTNG POLTCY' 01UUNZLo827SUA CODEl-zcDESCRIPIION OF OPERATIONST1/EHTCLESJPROPERTY {lncludi.g Loc.tion)Binder Expires Upon Receipt of PolicyHebrew Language AcademyCharter School 2'1870 Stillwell AveINSUREDNEDATEXlla9-lt-oMl']12.01 I",[#, N.r,518465-39!829424EFFECTIVEBrooklyn NY 11223COVERAGESLIMITSTYPE OF IIISURANCEPROPERTYCAUSES OF LOSSBASICBROAOSPECBusiness Personal PopertyBusiness lncome/Extra Exp.Equipment Breakdown2500EACH OCCURRENCEDIfiAGETORENTED PREMTSESMED EXP (A.yone p rso.)PERSONAL & ADV INJURYCOMMERCIAL GENERAL LIABILITYct atMsMAoF280000750000lncludedGENERAL LIABIUTYllcorNs !nDEOUCTIBLEoccllRRETRO DATE FOR CLAIMS MADEAUTOMOBILE LIABILITY 1I SGENERAL]AGGREGATESPRODUCTS COMP/OP AGG 1000COI BINEO SINGLE LIIVITBODILY INJURY (Per person)BODILY INJURY (PerALL OWNED AUTOSsa6rde.l)!SCHEDULEO AUTOSxx HIREO AUTOSMED CAL PAYMENTSNON.OWNEDAUTOSPERSONAL INJURY PROT UNINSUREO MOTORISTAUTO PHYSrcALDAf,AGEDEDUCTIBLEALL VEHICLESSCHEDULEO VEHICLESACTUAL CASH VALUEcoLUSroN:STATED AMOUNTOTHER THAN COLOTHERsAUTO ONLY EAACCIDENT , GARAGE LIABILITYOTHERTHAN AUTO ONLYDENT AGGREGATE EACH ACCEXCESS UABIUIYEACH OCCURRENCEIIMBRFI IA FORM] o-ra* -"oru,t""aa* ao*,AGGREGATESELF NSI]REO RFTFNT ONRETRO DATE FOR CLAIMS MADEI WC STATUTORY LIMITSWORXER'S COMPENSATIONELEACH ACCIDENT EMPLOYER'S LIABILIIYELD SEASE EA EI'iPLOYEE EL DISEASESPECIALFEESOIHERTAXEScoN0rroN9POLICY Ll[,!lT COVERAGESESTIMATEO TOTALNAME & ADDRESS! sPREMIUM AOOITIONAL NSUREDMORTGAGEELOSS PAYEEAUIHORIZED REPRESENTATIVEy*-h-qACORD 75 (2004/09)b-q-1,2"-NOTEr IMPORTANT STATE INFORMATION ON REVERSESIDEO ACORD CORPORATION '1993-2004

HEBRL2CCONDITIONSThis Company binds the kind(s) of insurance stipulated on the reverse side. The lnsurance is subject to theterms, conditions and limitations of the policy(ies) in current use by the Company.This binder may be cancelled by the lnsured by surrender of this binder or by written notice to the Companystating when cancellation will be effeclive. This binder may be cancelled by the Company by notice to thelnsured in accordance with the policy conditions. This binder is cancelled when replaced by a policy. lf thisbinder is not replaced by a policy, the Company is entitled to charge a premium for the binder according to theRules and Rales in use by the Company.Applicable in CaliforniaWhen this form is used to provide insurance in the amount of one million dollars ( '1,000,000) or more, the titleof the form is changed from "lnsurance Binder" to "Cover Note".Applicable in ColoradoWith respect to binders issued to renters of residential premises, home owners, condo unit owners and mobile homeowners, the insurer has thirty (30) business days, commencing from the eflective date of coverage, to evaluate theissuance of the insurance policy.Applicable in DelawareThe mortgagee or Obligee of any mortgage or other instrument given for the purpose of creating a lien on realproperty shall accept as evidence of insurance a written binder issued by an authorized insurer or its agent ifthe binder includes or is accompanied by: the name and address of the borrower; the name and address of thelender as loss payee; a description of the insured real property; a provision that the binder may not be canceledwithin lhe lerm of the binder unless the lender and the insured borrower receive written notice of the cancellation at least ten (10) days prior to the cancellation; except in the case of a renewal of a policy subsequent tothe closing of the loan, a paid receipt of the full amount of the applicable premium, and the amount ofinsurance coverage.Chapter 2'l Title 25 Paragraph 21 19Applicable in FloridaExcept for Auto lnsurance coverage, no notice of cancellation or nonrenewal of a binder is required unless lheduration of the binder exceeds 60 days. For auto insurance, the insurer must give 5 days prior notice, unlessthe binder is replaced by a policy or another binder in lhe same company.Applicable in NevadaAny person who refuses to accept a binder which provides coverage of less than 1,000,000.00 when proof isrequired: (A) Shall be fined not more than 500.00, and (B) is liable to the party presenting the binder as proofof insurance for aclual damages sustained therelrom.ACORD 75 (2004/09)OP lD: JB

/-----OP lD: JBACORD"INSURANCE BINDER6t9t2017THIS BINDER IS A TEMPORARY INSURANCE CONTRACT, SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORMAGENCYconplnYBTNoER* 22437ustin & Co., lnc.Corporate Woods Blvd.Travelers lndemnity CompanyDATElbany, NY l22ll-2366na M. Payne, GENCY12to'ttrll]XTIMErz or07t01118euNOONTHIS BINOER IS ISSUEO TO EXTEND COVERAGE IN THE ABOVE NAMEO COMPANYPER ExPIRING PoLlcY #:106745289SUB CODE:HEBRL2CHebrew Language AcademyCharter School 2IIISUREDOATEx07to1t1718TIME0ESCRIPnON OF OPERATIONS/VEHICLEsi/PROPERTY(lncluding LGalion)Binder Expires Upon Receipt of Policy1870 StillwellAveBrooklyn NY 11223COVERAGESLIMITSDEDUCNALEOF INSURAXCE'YPEI@ERWceuses or rossBASTCBROADSPECGEITERAL UABILITY--il"orua"" ".*.*.,*",.,r",r" *o.I l o""r"I--t- ",EACH OCCURRENCE.I[IAGE-O RENTED PREMISESSEMqr.r9!9tr9!lLUEq INJURY AGGREGATE L 5PERSONAL & AOVGENERALRETRO OATE FOR CLAIMS I\,IAOEAUIOMOBI!E LlAAITIT"YS L!99 LYALL OWNEDAUTOSAGGLIMITPRODUCTS COMP/OPCOMBINED SINGLEl-ralx nuroCOINS %TNJURY (PerBOOILY INJURYp so.rI(P re dent)ilqP!E!!4U4qLSCHEOULED AUTOSHIRED AUTOSS MEDICAL PAYMENTSNON.OWNEDAUTOS SljEECo!4!!JU!!tE9I UNINSURED MOTORIST sAUTO PHYSICAL OAMAGEDEDUCTIBLEALLVEHICLESSCHEDULEO VEI]ICLESACTUAL CASH VALIJEcoLL stoNSTATEDAMOUNTOTHER THAN COLOTHERAUTO ONLY. EAACCIDENT OTHER THAN AUTO ONLYEACH ACCIDENTAGGREGATEEXCESS LIABILITYAGGREGAIEUMBRELTA FORM]orra* rro',OCCURRENCEEACHuru".*.o*,E;;".;;ilRETRO DATE FOR CLAIMS MADEwcWORKER'S COMPENSATIONEMPLOYER'S LIABILITYsmmpeeete ntio n 5SPECIAL0 0 0 F u nd s ra nsfer F fa udcoNotTroNsi/ s00 0 0 0 Rete ntio n c o m pute F fa udOTHER 2 50 ,0 0 Rete n ti o n 2, 500COVERAGES Cy ber R ts k Nrk a n d n fo rm at ton S ecu rity 0 0 0 000 r"STATUTORY LtMtTS IACCIDENTELEACHELOISEASE - EA EMPLOYEE ELOISEASE. POL1CY LI[,I TFEES sTAXESESTIMATED TOTALsPREMII]M NAME & ADORESSMORTGAGEEAOOITIONAL INSUREOLOSS PAYEEAIJTHORIZEO REPRESENTATIVEy."--h-q h-v/?4--ACORD 75 (2004/09)NOTE: IMPORTANT STATE INFORMATION ON REVERSESIDEO ACORD CORPORATION 1993.2004

HEBRL2CCONDITIONSThis Company binds the kind(s) of insurance stipulated on the reverse side. The lnsurance is subject to theterms, conditions and limitations of the policy(ies) in current use by the Company.This binder may be cancelled by the lnsured by surrender of this binder or by written notice to the Companystating when cancellation will be effective. This binder may be cancelled by the Company by notice to thelnsured in accordance with the policy conditions. This binder is cancelled when replaced by a policy. lf thisbinder is not replaced by a policy, the Company is entitled to charge a premium for the binder according to theRules and Rates in use by the Company.Applicable in CaliforniaWhen this form is used to provide insurance in the amount of one million dollars ( 1,000,000) or more, the titleof the form is changed from "lnsurance Binder" to "Cover Note".Applicable in ColoradoWith respect to binders issued to renters of residential premises, home owners, condo unit owners and mobile homeowners, the insurer has thirty (30) business days, commencing from the effective date of coverage, to evaluate theissuance of the insurance policy.Applicable in DelawareThe mortgagee or Obligee of any mortgage or other instrument given for the purpose of creating a lien on realproperty shall accept as evidence of insurance a written binder issued by an authorized insurer or its agent ifthe binder includes or is accompanied by: the name and address of the borrower; lhe name and address of thelender as loss payee; a description of the insured real property; a provision that the binder may not be canceledwithin lhe term of the binder unless the lender and the insured borrower receive written notice of the cancellation at least ten (10) days prior to the cancellation, except in the case of a renewal of a policy subsequent tothe closing of the loan, a paid receipt of the full amount of the applicable premium, and the amount ofinsurance coverage.Chapter 21 Title 25 Paragraph 21 19Applicable in FloridaExcept for Auto lnsurance coverage, no nolice of cancellation or nonrenewal of a binder is required unless theduration of the binder exceeds 60 days. For auto insurance, the insurer must give 5 days prior nolice, unlessthe binder is replaced by a policy or another binder in the same company.Applicable in NevadaAny person who refuses to accept a binder which provides coverage of less than 1,000,000.00 when proof isrequired: (A) Shall be fined not more than 500.00, and (B) is liable to the party presenting the binder as proofof insurance for actual damages suslained therefrom.ACORD 75 (2004/09)OP lD: JB

----OP lD: JB,ACORD"DATE (iIIM/ODI/YYY)!NSURANCE BINDER6t912017THIS BINDER IS A TEMPORARY INSURANCE CONTRACT. SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM.8rNDERrAGENCYAustin & Co., lnc.20 Corporate Woods Blvd.DATEAlbany, NY 12211-2366Tina M. Payne, CPCUEFFECTIVEliI,frl3xr,[. E,n. 5t 8-465-3591N.r5rB46s-3968DAIExTIME12:01 AM07t01t1812.01NOONTH S BINDER IS SSUED TO EXTEND COVERAGE N THE AAOVE NAI,IED COMPANYPER ExP R NG PoLrcY#880822suB cooE:CODEEXPIRATIONTIMEx07t01117OESCRIPTION OF OPERAnONS/VEHICLE9PROPERTY (lncludlng Locatlon)e3"' 3J." ,,. HEBRL2cHebrew Language AcademyCharter School 21870 Stillwell AveINSURED22431United Educators lnsurainceBinder Expircs Upon Receipt of PolicyBrooklyn NY 11223COVERAGESTYPE OF INSIJRANCEcotNs %DEDUCTIBLECAUSES OF LOSSBASICBROADSPECGENERAL LIABILITYxEACH OCCURRENCEDAMAGE TORENTED PREMISES [,lEO EXP (A.y o.e person) PERSONAL&ADV NJURY GENERAL AGGREGATE PRODUCTS. COMP/OP AGG COMB NED SINGLE LII4IT BODILY NJURY ALL OWNED AUTOSBODILY INJURY (Peraccdent) SCHEDULEO AUTOSPROPERTY OAMAGESH RED AUTOSIl,EDICAL PAYMENTSsNON,OWNEDAUTOSPERSONAL NJURY PROT UNINSURED MOTOR ST COM[,lERCIAL GENERAL LIABILITYCLAII\4S MADExxOCCURPER LOC, AGG. APPLIESRETRO DATE FOR CLAIMS MADEAUTOMOBILE LIABILITYarrtoPHYsrcaL DAMAGE DEDUCTTBLE] ,.u.n,c,es f]scr.or,.or.n,".u" 100000010000005000100000030000003000000ACTUAL CASH VALUEcoLL stoNSTATEO AMOUNTOTHER THAN COLOTHERGARAGE LIABILITYAUTO ONLY, EAACCIDENT OTIER THAN AUTO ONLYEACH ACCIDENTAGGREGATEEXCESS LIABILITYxOTHER THAN UMBRELLA FORMRETRO DATE FOR CLA MS MADEssEACH OCCIJRRENCESAGGREGATE SELF INSURED RETENTION 10,000,00010,000,00010,000WC STATUTORY LIM TSWORKER'S COMPENSATIONELEACH ACCIDENTANOEMPLOYER'S LIABIUTY ELD SEASE. EA EMPLOYEE EL O]SEASEExcess Educators Lesal Liability 10,000,000coNotTtoNs/ Excess Fiduciary Liability 3,000,000OTHERPolicy is agency billed annually.SPECIALPOLICY LIM]T FEES TAXESsESTIMATED TOTAL PREMIUMSCOVERAGESNAME & ADDRESSMORTGAGEExAOO T ONAL INSUREDLOSS PAYEEHebrew Language Charter555 8th AvenueNew York NY 10019ACORD 75 (2004/09)AUTHORlzED REPRESENTATIVEt/)-\t L4'--NOTE: IMPORTANT STATE INFORMATION ON REVERSESIDEO ACORD CORPORATION 1993.2004

HEBRL2CGONDITIONSThis Company binds the kind(s) of insurance stipulated on the reverse side. The lnsurance is subject to theterms, conditions and limitations of the policy(ies) in current use by the Company.This binder may be cancelled by the lnsured by surrender of this binder or by written notice to the Companystating when cancellation will be effective. This binder may be cancelled by the Company by notice to thelnsured in accordance with the policy conditions. This binder is cancelled when replaced by a policy. lf thisbinder is not replaced by a policy, the Company is entitled to charge a premium for the binder according to theRules and Rates in use by the Company.Applicable in CaliforniaWhen this form is used to provide insurance in the amount of one million dollars ( 1,000,000) or more, the titleof the form is changed from "lnsurance Binded'to "Cover Note".Applicable in ColoradoWith respect to binders issued to renters of residential premases, home owners, condo unit owners and mobile homeowners, the insurer has thirty (30) business days, commencing from the effeclive date of coverage, to evaluate theissuance of the insurance policy.Applicable in DelawareThe mortgagee or Obligee of any mortgage or other instrument given for the purpose of creating a lien on realproperty shall accept as evidence of insurance a written binder issued by an authorized insurer or its agent ifthe binder includes or is accompanied by: the name and address of the borrower; the name and address of thelender as loss payee; a description of the insured real properiy; a provision that the binder may not be canceledwithin the term of the binder unless the lender and the insured borrower receive written notice of the cancellation at least ten ('10) days prior to the cancellation; except in the case of a renewal of a policy subsequent tothe closing of the loan, a paid receipt of the full amount of the applicable premium, and the amount ofinsurance coverage.Chapter 21 Title 25 Paragraph 2119Applicable in FloridaExcept for Auto lnsurance coverage, no notice of cancellation or nonrenewal of a binder is required unless theduration of the binder exceeds 60 days. For auto insurance, the insurer must give 5 days prior notice, unlessthe binder is replaced by a policy or another binder in the same company.Applicable in NevadaAny person who refuses to accept a binder which provides coverage of less than 1,000,000.00 when proof isrequired: (A) Shall be fined not more than 500.00, and (B) is liable to the party presenting the binder as proofof insurance for actual damages sustained therefrom.acoRD 75 (2004/09)OP lD: JB

OP lD: JB,ACORD"INSURANCE B!NDER619t2017THIS BINDER IS A TEMPORARY INSURANCE CONTRACT, SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM22440BINDER'AGENCYtin & Co., lnc.0 Corporate Woods BlvdHartford lns.Co.of the MidwestDATEbany, NY 12211-2366ina M. Payne, zor]oTto'v17PER EXPTRTNG POLTCY #rvnoon0IWEAA2J6R{lncluding Location)DESCRIPTION OF OPERATIONS/vEHTCLES/PROPERTYHebrew Language AcademyCharter School 21870 Stillwell AveINSUREDXx'12i0'lTH]S BINDER IS ISSUED IO EXTENO COVERAGE IN THE ABOVE NAIIIED COMPANYSUE CODEHEBRL2CEFFECTTVEBinder Expires Upon Receipt of PolicyBrooklyn NY 11223COVERAGESLIMITSDEOUCTIBLETYPE OF INSURANCECOINS %PROPERTY causEs oF LossBAS]CSPECGENERAL LIABILITYIiCH OCCURRENCEi'Aff,mrTirRENTED PREMISESCOMMERCIAL GENERAL LLABILITYcLArMsMADE [-]o""r"RETRO DATE FOR CLAIMS MADEAUTOMOBILE LIABILITYperco.)& ADV IN,IIIRY PERSONALSGENERAL AGGREGATE PROOUCTS, COMP/OP AGG LIMITBOD LY INJURY (Per perso.)BODILY INJURY (Per a6rde.0PROPERTY DAMAGEMEDICAI PAYMENTSPERSONAL INJURY PROTSCHEOUIEDAUTOSHIREO AUTOSNONOWNEDAUTOSUNINSI]RED MOTORISTAUTO PHYSICAL OAMAGEDEDUCT]BLEALL VEI.]ICLESOMED ExP (A.y oneCOMBINEO SINGLEALT OWNEOAUTOS SCHEOULE D VEHIC LES S ACTUAL CASH VALUEcoLLtstoNSTATED AMOUNTOTHER THAN COLOTHERAUTO ONLY EAACCIDENTGARAGE LIABILITY sOTHER TNAN AUTO ONLYEACHACCIDENTAGGREGATEEXCESS L AAIUTYEACH OCCURRENCEUMBRELLAFORMOTHER THAN UMERELTA FORMRETRO OATE FOR CLAIMS MADESSSAGGREGATESSELF.INSUREDRETENTION WC STATIITORY I IMITSWORXER'S COiIPENSATIONELEACH ACCI'IFNTEMPLOYER'S L AAIL TYELDISEASE. EA EMPLOYEE EL DISEASEPOLICYLIMITSSPECIALFEES 00s SIIi,IATEO TOTAL PREMIUM NAME & ADDRESSMORTGAGEEAOO]T ONAL INSUREOLOSS PAYEEAUTHORIZED REPRESENTATIVE? t-/zrACORD 75 (2004/09)NOTE: IMPORTANT STATE INFORMATION ON REVERSESIDEO ACORD CORPORATION,t993-2004

HEBRL2CCONDITIONSThas Company bindsthe kind(s) of insurance stipulated on the reverse side. The lnsurance is subject to theterms, conditions and limitations of the policy(ies) in current use by the Company.This binder may be cancelled by the lnsured by surrender of this binder or by written notice to the Companystating when cancellation will be effective. This bander may be cancelled by the Company by notice to thelnsured in accordance with the policy conditions. This binder is cancelled when replaced by a policy. lf thisbinder is not replaced by a policy, the Company is entitled to charge a premium for the binder according to theRules and Rates in use by the Company.Applicable in CallforniaWhen this form is used to provide insurance in the amount of one million dollars ( 1,000,000) or more, the titleof the form is changed from "lnsurance Binded' to "Cover Note".Applicable in ColoradoWith respect to binders issued to renters of residential premises, home owners, condo unil owners and mobile homeowners, the insurer has thirty (30) business days, commencing from the effective date of coverage, to evaluate theissuance of the insurance policy.Applicable in DelawareThe mortgagee or Obligee of any mortgage or olher inslrument given for the purpose of creating a lien on realproperty shall accept as evidence of insurance a written binder issued by an authorized insurer or its agent ifthe binder includes or is accompanied by: the name and address of the borrower; the name and address of thelender as loss payee; a description of the insured real property; a provision that the binder may not be canceledwithin the term of the binder unless the lender and the insured borrower receive written notice of the cancellation at least ten (10) days prior to the cancellation; except in the case of a renewal of a policy subsequent tothe closing of the loan, a paid receipt of the full amount of the applicable premium, and the amount ofinsurance coverage.Chapter 2'l Title 25 Paragraph 2119Applicable in FloridaExcept for Auto lnsurance coverage, no notice of cancellation or nonrenewal of a binder is required unless theduration of the binder exceeds 60 days. For auto insurance, the insurer must give 5 days prior notice, unlessthe binder is replaced by a policy or another binder in the same company.Applicable in NevadaAny person who refuses to accept a binder which provides coverage of less than 1,000,000.00 when proof isrequired: (A) Shall be fined not more than 500.00, and (B) is liable to the party presenting the binder as proofof insurance for actual damages sustained therefrom.ACORD 75 (2004/09)OP lD: JB

-.----lOP lD: JBACORD"OATE (MM/DO/YYYY)INSURANGE BINDER619t2017THIS BINDER IS A TEMPORARY INSURANCE CONTRACT SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORMB NDER 22441ustin & Co., lncHartford lns.Co.of the Midwest0 Corporate Woods Blvdlbany, NY '12211-2366na M. Payne, CPCUPHONEe,r1,DATEoTtot t17518465-3591ffi, la,518455'3968CODEEXPIRATIONTIMExx12 0107lo1t1a12:O1'01WBAA2SoPHEBRL2CHebrew Language AcademyCharter School 2TIMEAMNOONTHIS EINDER IS ISSUEO TO EXTENO COVERAGE IN THE ABOVE NAMEO COMPANYPER EXPTRTNG PoLrcYSUB CODEiINSUREOEFFECTTVEDESCRIPTION OF OPERAnONS/vEHICLEiPROPERTY(lncludjng Loc.tlon)Binder Expires Upon Receipt of Policy1870 StillwellAveBrooklyn NY l'1223LIMITSCOVERAGESoEoucTtaLE cottsTYPE OF INSURANCE%PROPERfr c,rusEs or Lossaas cBROADSPECGENERAL LIABILITYCLAIMSMAOEEACH OCCURRENCEIRENTED PREMISES MED EXP (Any one person)sDIIFGEiOCOMMERCIAL GENERAL UAEILITYOCCURPERSONAL & ADVINJIIRYGENERAL AGGREGATEPROOUCTS . COMP/OPRETRO DATE FOR CLAIMS MAOEAIJTOMOBILE LIABILITYg AGG5COMBINE'] SINGIF I]MITBODILY INJURY (Perperson)ALL OWNEO AUTOSBOOILY INJURY (Per a@'denl)SCHEDULED AUTOSPROPERTY DAIviAGEHIREOAUTOSMEDICAL PAYMENTSNON,OWNEDAUTOSPERSONAL INJURYt sPROTUNINSURED MOTORISTS AUTO PHYSTCAL OAMAGE

INSURANCE BINDER COVERAGES LIMITS 6t9t2017 THIS BINDER IS A TEMPORARY INSURANCE CONTRACT, SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM Travelers lndemnity Company TIME 07to1t17 rll cooE:0HF107 AGENCY HEBRL2C x DATE EFFECNVE 12to't t ] 1 8465-359 OATE 07t01118 AGENCY T