Common use of INSURANCE PROCUREMENT Clause in Contracts

INSURANCE PROCUREMENT. Contractor shall obtain and maintain at all times while performing work for or at the request of the Unit Owner, at its sole cost and expense, the following insurance (a) workers compensation insurance with statutory limits and employer’s liability coverage of not less than $500,000; (b) commercial general liability insurance with a minimum limit of $1,000,000 per occurrence and $2,000,000 in the aggregate, including per-project aggregate endorsement, which insurance shall cover the following: premises and operations liability, products/completed operations, broad form property damage, broad form contractual liability, personal injury and independent contractor’s liability; (c) automobile liability insurance covering owned, hired and non-owned vehicles, with a minimum limit of liability of $1,000,000; and (d) umbrella liability insurance with a limit of $1,000,000 per occurrence and a general aggregate of $1,000,000. Contractor shall, by specific endorsements to its primary and umbrella/excess liability policy, cause Cooperative, Managing Agent, and Unit Owner to be named as additional insureds. Contractor shall, by specific endorsement to its primary liability policy, cause the coverage afforded to the additional insureds thereunder to be primary to and not concurrent with other valid and collectible insurance available to the additional insureds. Contractor shall, by specific endorsement to its umbrella/excess liability policy, cause the coverage afforded to the additional insureds hereunder to be first tier umbrella/excess coverage above the primary coverage afforded to the additional insureds and not concurrent with or excess to other valid and collectible insurance available to the additional insureds. Contractors’ insurance policies required herein shall include waiver of subrogation in favor of the additional insureds, and shall have no exclusions or limitations pertaining to the additional insureds relating injuries to the Contractor’s employees or subcontractor employees, the location of the work, or type of work performed on behalf of the Unit Owner. If the terms of this Agreement directly conflict with any other written agreements and/or Purchase Orders between the parties, the term contained in this Agreement shall supersede in that instance. Contractor Cooperative Managing Agent Unit Owner Name Name Name Name Signature Signature Signature Signature Date Date Date Date UNIT OWNER’S INDEMNIFICATION & INSURANCE AGREEMENT

INSURANCE PROCUREMENT. Contractor shall obtain and maintain at all times while performing work for or at the request of the Unit Owner, at its sole cost and expense, the following insurance (a) workers compensation insurance with statutory limits and employer’s liability coverage of not less than $500,000; (b) commercial general liability insurance with a minimum limit of $1,000,000 per occurrence and $2,000,000 in the aggregate, including per-project aggregate endorsement, which insurance shall cover the following: premises and operations liability, products/completed operations, broad form property damage, broad form contractual liability, personal injury and independent contractor’s liability; (c) automobile liability insurance covering owned, hired and non-owned vehicles, with a minimum limit of liability of $1,000,000; and (d) umbrella liability insurance with a limit of $1,000,000 per occurrence and a general aggregate of $1,000,000. Contractor shall, by specific endorsements to its primary and umbrella/excess liability policy, cause Cooperative, Managing Agent, and Unit Owner to be named as additional insureds. Contractor shall, by specific endorsement to its primary liability policy, cause the coverage afforded to the additional insureds thereunder to be primary to and not concurrent with other valid and collectible insurance available to the additional insureds. Contractor shall, by specific endorsement to its umbrella/excess liability policy, cause the coverage afforded to the additional insureds hereunder to be first tier umbrella/excess coverage above the primary coverage afforded to the additional insureds and not concurrent with or excess to other valid and collectible insurance available to the additional insureds. Contractors’ Contractors insurance policies required herein shall include waiver of subrogation in favor of the additional insureds, and shall have no exclusions or limitations pertaining to the additional insureds relating injuries to the Contractor’s employees or subcontractor employees, the location of the work, or type of work performed on behalf of the Unit Owner. If the terms of this Agreement directly conflict with any other written agreements and/or Purchase Orders between the parties, the term contained in this Agreement shall supersede in that instance. Contractor Cooperative Managing Agent Unit Owner Name Name Name Name Signature Signature Signature Signature Date Date Date Date UNIT OWNER’S INDEMNIFICATION & INSURANCE AGREEMENT

INSURANCE PROCUREMENT. Contractor shall obtain and maintain at all times while performing work for or at the request of the Unit OwnerShareholder, at its sole cost and expense, the following insurance (a) workers compensation insurance with statutory limits and employer’s liability coverage of not less than $500,000; (b) commercial general liability insurance with a minimum limit of $1,000,000 per occurrence and $2,000,000 in the aggregate, including per-project aggregate endorsement, which insurance shall cover the following: premises and operations liability, products/completed operations, broad form property damage, broad form contractual liability, personal injury and independent contractor’s liability; (c) automobile liability insurance covering owned, hired and non-owned vehicles, with a minimum limit of liability of $1,000,000; and (d) umbrella liability insurance with a limit of $1,000,000 per occurrence and a general aggregate of $1,000,000. Contractor shall, by specific endorsements to its primary and umbrella/excess liability policy, cause CooperativeCorporation, Managing Agent, and Unit Owner Shareholder to be named as additional insureds. Contractor shall, by specific endorsement to its primary liability policy, cause the coverage afforded to the additional insureds thereunder to be primary to and not concurrent with other valid and collectible insurance available to the additional insureds. Contractor shall, by specific endorsement to its umbrella/excess liability policy, cause the coverage afforded to the additional insureds hereunder to be first tier umbrella/excess coverage above the primary coverage afforded to the additional insureds and not concurrent with or excess to other valid and collectible insurance available to the additional insureds. Contractors’ Contractors insurance policies required herein shall include waiver of subrogation in favor of the additional insureds, and shall have no exclusions or limitations pertaining to the additional insureds relating injuries to the Contractor’s employees or subcontractor employees, the location of the work, or type of work performed on behalf of the Unit OwnerShareholder. If the terms of this Agreement directly conflict with any other written agreements and/or Purchase Orders between the parties, the term contained in this Agreement shall supersede in that instance. Contractor Cooperative Corporation Managing Agent Unit Owner Shareholder Name Name Name Name Signature Signature Signature Signature Date Date Date Date UNIT OWNERXXXXX CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YY) 00/00/0000 PRODUCER FAX * NAME AND ADDRESS OF INSURANCE CARRIER THIS CERTIFICATE ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED * NAME AND ADDRESS OF INSURED (Must match signed contract) INSURER A: xxxxxxxxxx INSURER B: xxxxxxxxxx INSURER C: INSURER D: INSURER E: COVERAGES THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXP DATE (MM/DD/YY) LIMITS A GENERAL LIABILITY $1,000,000/$2, 000.000 00/00/00 00/00/00 EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES $ 100,000 CLAIMS MADE OCCUR MED EXP (any 1 person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 GEN’L AGGREGATE LIMIT APPLIES PER: PRODUCTS – COMP/OP AGG $ 2,000,000 POLICY PROJECT LOC B AUTOMOBILE LIABILITY $1,000,000 minimum 00/00/00 00/00/00 COMBINED SINGLE LIMIT (Ea Accident) $1,000,000 ANY AUTO ALL OWNED AUTOS XXX XX X XXXXXX INJURY (per person) $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (per accident) $ NON OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY – EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ B EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ * WORKER’S INDEMNIFICATION & COMPENSATION AND $1,000,000 minimum 00/00/00 00/00/00 WC Statutory Limits Other EMPLOYER’S LIABILITY E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE –EA EMPLOYEE $1,000,000 E.L. DISEASE –POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS: Also additionally insured: Shareholder’s Name, Address and Apt. Number a) 00 Xxxxx Xxxxx Xxxx Owner’s Inc., 00 Xxxxx Xxxxx Xxxx, Xxxxxxx, XX 00000 b) Xxxxxxxx Management Realty Corp., 000 Xxxxxxxxxx Xxx, Xxxxxxxx, XX 00000 Date of Move /Delivery/ Work: CERTIFICATE HOLDER CANCELLATION 00 Xxxxx Xxxxx Xxxx Owner’s Inc. C/x Xxxxxxxx Management Realty Corp 000 Xxxxxxxxxx, Xxx. Harrison, NY 10528 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINDUPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Must have signature XX*IF WORKERS COMP IS NOT ON THIS CERTIFICATE – YOU MUST PROVIDE (2) CERTIFICATES FROM STATE INSURANCE AGREEMENTFUND (ONE FOR EACH ADDITIONAL INSURED)

INSURANCE PROCUREMENT. Contractor shall obtain and maintain at all times while performing work for or at the request of the Unit OwnerShareholder, at its sole cost and expense, the following insurance (a) workers compensation insurance with statutory limits and employer’s liability coverage of not less than $500,000; (b) commercial general liability insurance with a minimum limit of $1,000,000 per occurrence and $2,000,000 in the aggregate, including per-project aggregate endorsement, which insurance shall cover the following: premises and operations liability, products/completed operations, broad form property damage, broad form contractual liability, personal injury and independent contractor’s liability; (c) automobile liability insurance covering owned, hired and non-owned vehicles, with a minimum limit of liability of $1,000,000; and (d) umbrella liability insurance with a limit of $1,000,000 per occurrence and a general aggregate of $1,000,000. Contractor shall, by specific endorsements to its primary and umbrella/excess liability policy, cause CooperativeCorporation, Managing Agent, and Unit Owner Shareholder to be named as additional insureds. Contractor shall, by specific endorsement to its primary liability policy, cause the coverage afforded to the additional insureds thereunder to be primary to and not concurrent with other valid and collectible insurance available to the additional insureds. Contractor shall, by specific endorsement to its umbrella/excess liability policy, cause the coverage afforded to the additional insureds hereunder to be first tier umbrella/excess coverage above the primary coverage afforded to the additional insureds and not concurrent with or excess to other valid and collectible insurance available to the additional insureds. Contractors’ Contractors insurance policies required herein shall include waiver of subrogation in favor of the additional insureds, and shall have no exclusions or limitations pertaining to the additional insureds relating injuries to the Contractor’s employees or subcontractor employees, the location of the work, or type of work performed on behalf of the Unit OwnerShareholder. If the terms of this Agreement directly conflict with any other written agreements and/or Purchase Orders between the parties, the term contained in this Agreement shall supersede in that instance. Contractor Cooperative Corporation Managing Agent Unit Owner Shareholder Name Name Name Name Signature Signature Signature Signature Date Date Date Date UNIT OWNERXXXXX CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YY) 00/00/0000 PRODUCER FAX * NAME AND ADDRESS OF INSURANCE CARRIER THIS CERTIFICATE ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED * NAME AND ADDRESS OF INSURED (Must match signed contract) INSURER A: xxxxxxxxxx INSURER B: xxxxxxxxxx INSURER C: INSURER D: INSURER E: COVERAGES THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXP DATE (MM/DD/YY) LIMITS A GENERAL LIABILITY $1,000,000/$2, 000.000 00/00/00 00/00/00 EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES $ 100,000 CLAIMS MADE OCCUR MED EXP (any 1 person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 GEN’L AGGREGATE LIMIT APPLIES PER: PRODUCTS – COMP/OP AGG $ 2,000,000 POLICY PROJECT LOC B AUTOMOBILE LIABILITY $1,000,000 minimum 00/00/00 00/00/00 COMBINED SINGLE LIMIT (Ea Accident) $1,000,000 ANY AUTO ALL OWNED AUTOS XXX XX X XXXXXX INJURY (per person) $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (per accident) $ NON OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY – EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ B EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ * WORKER’S INDEMNIFICATION & COMPENSATION AND $1,000,000 minimum 00/00/00 00/00/00 WC Statutory Limits Other EMPLOYER’S LIABILITY E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE –EA EMPLOYEE $1,000,000 E.L. DISEASE –POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS: Also additionally insured: Shareholder’s Name, Address and Apt. Xxxxxx 0000 Xxxxxxx Xxx. Tenants Corp, Bronxville, NY 10708 Xxxxxxxx Management Realty Corp., 000 Xxxxxxxxxx Xxx, Xxxxxxxx, XX 00000 Date of Move /Delivery/ Work: CERTIFICATE HOLDER CANCELLATION 0000 Xxxxxxx Xxx. Tenants Corp C/X Xxxxxxxx Management Realty Corp. 000 Xxxxxxxxxx Xxx. S-512 Harrison, NY 10528 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINDUPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Must have signature XX*IF WORKERS COMP IS NOT ON THIS CERTIFICATE – YOU MUST PROVIDE (2) CERTIFICATES FROM STATE INSURANCE AGREEMENTFUND (ONE FOR EACH ADDITIONAL INSURED)

INSURANCE PROCUREMENT. Contractor shall obtain and maintain at all times while performing work for or at the request of the Unit OwnerShareholder, at its sole cost and expense, the following insurance (a) workers compensation insurance with statutory limits and employer’s liability coverage of not less than $500,000; (b) commercial general liability insurance with a minimum limit of $1,000,000 per occurrence and $2,000,000 in the aggregate, including per-project aggregate endorsement, which insurance shall cover the following: premises and operations liability, products/completed operations, broad form property damage, broad form contractual liability, personal injury and independent contractor’s liability; (c) automobile liability insurance covering owned, hired and non-owned vehicles, with a minimum limit of liability of $1,000,000; and (d) umbrella liability insurance with a limit of $1,000,000 per occurrence and a general aggregate of $1,000,000. Contractor shall, by specific endorsements to its primary and umbrella/excess liability policy, cause Cooperative, Managing Agent, and Unit Owner Shareholder to be named as additional insureds. Contractor shall, by specific endorsement to its primary liability policy, cause the coverage afforded to the additional insureds thereunder to be primary to and not concurrent with other valid and collectible insurance available to the additional insureds. Contractor shall, by specific endorsement to its umbrella/excess liability policy, cause the coverage afforded to the additional insureds hereunder to be first tier umbrella/excess coverage above the primary coverage afforded to the additional insureds and not concurrent with or excess to other valid and collectible insurance available to the additional insureds. Contractors’ insurance policies required herein shall include waiver of subrogation in favor of the additional insureds, and shall have no exclusions or limitations pertaining to the additional insureds relating injuries to the Contractor’s employees or subcontractor employees, the location of the work, or type of work performed on behalf of the Unit OwnerShareholder. If the terms of this Agreement directly conflict with any other written agreements and/or Purchase Orders between the parties, the term contained in this Agreement shall supersede in that instance. Contractor Cooperative Managing Agent Unit Owner Shareholder Name Name Name Name Signature Signature Signature Signature Date Date Date Date UNIT OWNER’S INDEMNIFICATION & INSURANCE AGREEMENTAGREEMENT Whereas (“Shareholder”) is and will be performing renovation work in Unit No. within Xxxxxx Court Apartment Corp. (“Cooperative”) located at 000 Xxxxxxxx Xxx., Mamaroneck, New York 10543, managed by Xxxxxxxx Management Realty Corp. (“Managing Agent”), pursuant to decoration or alteration agreements and/or the contract/proposal dated , now therefore, as to all such work, the Shareholder, Cooperative and Managing Agent hereby agree:

INSURANCE PROCUREMENT. Contractor shall obtain and maintain at all times while performing work for or at the request of the Unit OwnerShareholder, at its sole cost and expense, the following insurance (a) workers compensation insurance with statutory limits and employer’s liability coverage of not less than $500,000; (b) commercial general liability insurance with a minimum limit of $1,000,000 per occurrence and $2,000,000 in the aggregate, including per-project aggregate endorsement, which insurance shall cover the following: premises and operations liability, products/completed operations, broad form property damage, broad form contractual liability, personal injury and independent contractor’s liability; (c) automobile liability insurance covering owned, hired and non-owned vehicles, with a minimum limit of liability of $1,000,000; and (d) umbrella liability insurance with a limit of $1,000,000 per occurrence and a general aggregate of $1,000,000. Contractor shall, by specific endorsements to its primary and umbrella/excess liability policy, cause CooperativeCorporation, Managing Agent, and Unit Owner Shareholder to be named as additional insureds. Contractor shall, by specific endorsement to its primary liability policy, cause the coverage afforded to the additional insureds thereunder to be primary to and not concurrent with other valid and collectible insurance available to the additional insureds. Contractor shall, by specific endorsement to its umbrella/excess liability policy, cause the coverage afforded to the additional insureds hereunder to be first tier umbrella/excess coverage above the primary coverage afforded to the additional insureds and not concurrent with or excess to other valid and collectible insurance available to the additional insureds. Contractors’ Contractors insurance policies required herein shall include waiver of subrogation in favor of the additional insureds, and shall have no exclusions or limitations pertaining to the additional insureds relating injuries to the Contractor’s employees or subcontractor employees, the location of the work, or type of work performed on behalf of the Unit OwnerShareholder. If the terms of this Agreement directly conflict with any other written agreements and/or Purchase Orders between the parties, the term contained in this Agreement shall supersede in that instance. Contractor Cooperative Corporation Managing Agent Unit Owner Shareholder Name Name Name Name Signature Signature Signature Signature Date Date Date Date UNIT OWNERXXXXX CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YY) 00/00/0000 PRODUCER FAX * NAME AND ADDRESS OF INSURANCE CARRIER THIS CERTIFICATE ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED * NAME AND ADDRESS OF INSURED (Must match signed contract) INSURER A: xxxxxxxxxx INSURER B: xxxxxxxxxx INSURER C: INSURER D: INSURER E: COVERAGES THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXP DATE (MM/DD/YY) LIMITS A GENERAL LIABILITY $1,000,000/$2, 000.000 00/00/00 00/00/00 EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES $ 100,000 CLAIMS MADE OCCUR MED EXP (any 1 person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 GEN’L AGGREGATE LIMIT APPLIES PER: PRODUCTS – COMP/OP AGG $ 2,000,000 POLICY PROJECT LOC B AUTOMOBILE LIABILITY $1,000,000 minimum 00/00/00 00/00/00 COMBINED SINGLE LIMIT (Ea Accident) $1,000,000 ANY AUTO ALL OWNED AUTOS XXX XX X XXXXXX INJURY (per person) $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (per accident) $ NON OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY – EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ B EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ * WORKER’S INDEMNIFICATION & COMPENSATION AND $1,000,000 minimum 00/00/00 00/00/00 WC Statutory Limits Other EMPLOYER’S LIABILITY E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE –EA EMPLOYEE $1,000,000 E.L. DISEASE –POLICY LIMIT $1,000,000 OTHER Also additionally insured: Shareholder’s Name, Address and Apt. Number Beacon Hill Estates Cooperative Inc. 000 Xxxxxx Xxxx Xxxxx, Xxxxx Xxxxx, XX 00000 Xxxxxxxx Management Realty Corp., 000 Xxxxxxxxxx Xxx, Xxxxxxxx, NY 10528 Date of Move /Delivery/ Work: CERTIFICATE HOLDER CANCELLATION Beacon Hill Estates Cooperative Inc. C/X Xxxxxxxx Management Realty Corp. 000 Xxxxxxxxxx Xxx. S-512 Harrison, NY 10528 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINDUPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Must have signature XX*IF WORKERS COMP IS NOT ON THIS CERTIFICATE – YOU MUST PROVIDE (2) CERTIFICATES FROM STATE INSURANCE AGREEMENTFUND (ONE FOR EACH ADDITIONAL INSURED)

INSURANCE PROCUREMENT. Contractor shall obtain and maintain at all times while performing work for or at the request of the Unit OwnerShareholder, at its sole cost and expense, the following insurance (a) workers compensation insurance with statutory limits and employer’s liability coverage of not less than $500,000; (b) commercial general liability insurance with a minimum limit of $1,000,000 per occurrence and $2,000,000 in the aggregate, including per-project aggregate endorsement, which insurance shall cover the following: premises and operations liability, products/completed operations, broad form property damage, broad form contractual liability, personal injury and independent contractor’s liability; (c) automobile liability insurance covering owned, hired and non-owned vehicles, with a minimum limit of liability of $1,000,000; and (d) umbrella liability insurance with a limit of $1,000,000 per occurrence and a general aggregate of $1,000,000. Contractor shall, by specific endorsements to its primary and umbrella/excess liability policy, cause Cooperative, Managing Agent, and Unit Owner Shareholder to be named as additional insureds. Contractor shall, by specific endorsement to its primary liability policy, cause the coverage afforded to the additional insureds thereunder to be primary to and not concurrent with other valid and collectible insurance available to the additional insureds. Contractor shall, by specific endorsement to its umbrella/excess liability policy, cause the coverage afforded to the additional insureds hereunder to be first tier umbrella/excess coverage above the primary coverage afforded to the additional insureds and not concurrent with or excess to other valid and collectible insurance available to the additional insureds. Contractors’ insurance policies required herein shall include waiver of subrogation in favor of the additional insureds, and shall have no exclusions or limitations pertaining to the additional insureds relating injuries to the Contractor’s employees or subcontractor employees, the location of the work, or type of work performed on behalf of the Unit OwnerShareholder. If the terms of this Agreement directly conflict with any other written agreements and/or Purchase Orders between the parties, the term contained in this Agreement shall supersede in that instance. Contractor Cooperative Managing Agent Unit Owner Shareholder Name Name Name Name Signature Signature Signature Signature Date Date Date Date UNIT OWNER’S INDEMNIFICATION & INSURANCE AGREEMENTAGREEMENT Whereas (“Shareholder”) is and will be performing renovation work in Unit No. within 80 Xxxxxxx Tenants Corp. (“Cooperative”) located at 80 Xxxxxxx Tenants Corp. 000 Xxxxxx Xxxxxx, Xx. Xxxxxx, NY 10552. managed by Xxxxxxxx Management Realty Corp. (“Managing Agent”), pursuant to decoration or alteration agreements and/or the contract/proposal dated , now therefore, as to all such work, the Shareholder, Cooperative and Managing Agent hereby agree:

INSURANCE PROCUREMENT. Contractor shall obtain and maintain at all times while performing work for or at the request of the Unit Owner, at its sole cost and expense, the following insurance (a) workers compensation insurance with statutory limits and employer’s liability coverage of not less than $500,000; (b) commercial general liability insurance with a minimum limit of $1,000,000 per occurrence and $2,000,000 in the aggregate, including per-project aggregate endorsement, which insurance shall cover the following: premises and operations liability, products/completed operations, broad form property damage, broad form contractual liability, personal injury and independent contractor’s liability; (c) automobile liability insurance covering owned, hired and non-owned vehicles, with a minimum limit of liability of $1,000,000; and (d) umbrella liability insurance with a limit of $1,000,000 per occurrence and a general aggregate of $1,000,000. Contractor shall, by specific endorsements to its primary and umbrella/excess liability policy, cause CooperativeCondominium, Managing Agent, and Unit Owner to be named as additional insureds. Contractor shall, by specific endorsement to its primary liability policy, cause the coverage afforded to the additional insureds thereunder to be primary to and not concurrent with other valid and collectible insurance available to the additional insureds. Contractor shall, by specific endorsement to its umbrella/excess liability policy, cause the coverage afforded to the additional insureds hereunder to be first tier umbrella/excess coverage above the primary coverage afforded to the additional insureds and not concurrent with or excess to other valid and collectible insurance available to the additional insureds. Contractors’ Contractors insurance policies required herein shall include waiver of subrogation in favor of the additional insureds, and shall have no exclusions or limitations pertaining to the additional insureds relating injuries to the Contractor’s employees or subcontractor employees, the location of the work, or type of work performed on behalf of the Unit Owner. If the terms of this Agreement directly conflict with any other written agreements and/or Purchase Orders between the parties, the term contained in this Agreement shall supersede in that instance. Contractor Cooperative Condominium Managing Agent Unit Owner Name Name Name Name Signature Signature Signature Signature Date Date Date Date UNIT OWNER’S INDEMNIFICATION & INSURANCE AGREEMENT

INSURANCE PROCUREMENT. Contractor shall obtain and maintain at all times while performing work for or at the request of the Unit OwnerShareholder, at its sole cost and expense, the following insurance (a) workers compensation insurance with statutory limits and employer’s liability coverage of not less than $500,000; (b) commercial general liability insurance with a minimum limit of $1,000,000 per occurrence and $2,000,000 in the aggregate, including per-project aggregate endorsement, which insurance shall cover the following: premises and operations liability, products/completed operations, broad form property damage, broad form contractual liability, personal injury and independent contractor’s liability; (c) automobile liability insurance covering owned, hired and non-owned vehicles, with a minimum limit of liability of $1,000,000; and (d) umbrella liability insurance with a limit of $1,000,000 per occurrence and a general aggregate of $1,000,000. Contractor shall, by specific endorsements to its primary and umbrella/excess liability policy, cause CooperativeCorporation, Managing Agent, and Unit Owner Shareholder to be named as additional insureds. Contractor shall, by specific endorsement to its primary liability policy, cause the coverage afforded to the additional insureds thereunder to be primary to and not concurrent with other valid and collectible insurance available to the additional insureds. Contractor shall, by specific endorsement to its umbrella/excess liability policy, cause the coverage afforded to the additional insureds hereunder to be first tier umbrella/excess coverage above the primary coverage afforded to the additional insureds and not concurrent with or excess to other valid and collectible insurance available to the additional insureds. Contractors’ Contractors insurance policies required herein shall include waiver of subrogation in favor of the additional insureds, and shall have no exclusions or limitations pertaining to the additional insureds relating injuries to the Contractor’s employees or subcontractor employees, the location of the work, or type of work performed on behalf of the Unit OwnerShareholder. If the terms of this Agreement directly conflict with any other written agreements and/or Purchase Orders between the parties, the term contained in this Agreement shall supersede in that instance. Contractor Cooperative Corporation Managing Agent Unit Owner Shareholder Name Name Name Name Signature Signature Signature Signature Date Date Date Date UNIT OWNERXXXXX CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YY) 00/00/0000 PRODUCER FAX * NAME AND ADDRESS OF INSURANCE CARRIER THIS CERTIFICATE ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED * NAME AND ADDRESS OF INSURED (Must match signed contract) INSURER A: xxxxxxxxxx INSURER B: xxxxxxxxxx INSURER C: INSURER D: INSURER E: COVERAGES THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXP DATE (MM/DD/YY) LIMITS A GENERAL LIABILITY $1,000,000/$2, 000.000 00/00/00 00/00/00 EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES $ 100,000 CLAIMS MADE OCCUR MED EXP (any 1 person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 GEN’L AGGREGATE LIMIT APPLIES PER: PRODUCTS – COMP/OP AGG $ 2,000,000 POLICY PROJECT LOC B AUTOMOBILE LIABILITY $1,000,000 minimum 00/00/00 00/00/00 COMBINED SINGLE LIMIT (Ea Accident) $1,000,000 ANY AUTO ALL OWNED AUTOS XXX XX X XXXXXX INJURY (per person) $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (per accident) $ NON OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY – EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ B EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ * WORKER’S INDEMNIFICATION & COMPENSATION AND $1,000,000 minimum 00/00/00 00/00/00 WC Statutory Limits Other EMPLOYER’S LIABILITY E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE –EA EMPLOYEE $1,000,000 E.L. DISEASE –POLICY LIMIT $1,000,000 OTHER Also additionally insured: Shareholder’s Name, Address and Apt. Number Crest Manor Housing Corp., 000 Xxxxx Xxxxxxxx, Xxxxxxx, Xxx Xxxx 00000 Xxxxxxxx Management Realty Corp., 000 Xxxxxxxxxx Xxx, Xxxxxxxx, XX 00000 Date of Move /Delivery/ Work: CERTIFICATE HOLDER CANCELLATION Crest Manor Housing Corp C/X Xxxxxxxx Management Realty Corp. 000 Xxxxxxxxxx Xxx, Xxxxxxxx, NY 10528 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINDUPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Must have signature XX*IF WORKERS COMP IS NOT ON THIS CERTIFICATE – YOU MUST PROVIDE (2) CERTIFICATES FROM STATE INSURANCE AGREEMENTFUND (ONE FOR EACH ADDITIONAL INSURED)

INSURANCE PROCUREMENT. Contractor shall obtain and maintain at all times while performing work for or at the request of the Unit OwnerShareholder, at its sole cost and expense, the following insurance (a) workers compensation insurance with statutory limits and employer’s liability coverage of not less than $500,000; (b) commercial general liability insurance with a minimum limit of $1,000,000 per occurrence and $2,000,000 in the aggregate, including per-project aggregate endorsement, which insurance shall cover the following: premises and operations liability, products/completed operations, broad form property damage, broad form contractual liability, personal injury and independent contractor’s liability; (c) automobile liability insurance covering owned, hired and non-owned vehicles, with a minimum limit of liability of $1,000,000; and (d) umbrella liability insurance with a limit of $1,000,000 per occurrence and a general aggregate of $1,000,000. Contractor shall, by specific endorsements to its primary and umbrella/excess liability policy, cause Cooperative, Managing Agent, and Unit Owner Shareholder to be named as additional insureds. Contractor shall, by specific endorsement to its primary liability policy, cause the coverage afforded to the additional insureds thereunder to be primary to and not concurrent with other valid and collectible insurance available to the additional insureds. Contractor shall, by specific endorsement to its umbrella/excess liability policy, cause the coverage afforded to the additional insureds hereunder to be first tier umbrella/excess coverage above the primary coverage afforded to the additional insureds and not concurrent with or excess to other valid and collectible insurance available to the additional insureds. Contractors’ insurance policies required herein shall include waiver of subrogation in favor of the additional insureds, and shall have no exclusions or limitations pertaining to the additional insureds relating injuries to the Contractor’s employees or subcontractor employees, the location of the work, or type of work performed on behalf of the Unit OwnerShareholder. If the terms of this Agreement directly conflict with any other written agreements and/or Purchase Orders between the parties, the term contained in this Agreement shall supersede in that instance. Contractor Cooperative Managing Agent Unit Owner Shareholder Name Name Name Name Signature Signature Signature Signature Date Date Date Date UNIT OWNER’S INDEMNIFICATION & INSURANCE AGREEMENTAGREEMENT Whereas (“Shareholder”) is and will be performing renovation work in Unit No. within Larchmont Hills Owners Corp. (“Cooperative”) located at 00 X. Xxxxxxxxxx, Xxxxxxxxx, Xxx Xxxx 00000 managed by Xxxxxxxx Management Realty Corp. (“Managing Agent”), pursuant to decoration or alteration agreements and/or the contract/proposal dated , now therefore, as to all such work, the Shareholder, Cooperative and Managing Agent hereby agree:

INSURANCE PROCUREMENT. Contractor shall obtain and maintain at all times while performing work for or at the request of the Unit OwnerShareholder, at its sole cost and expense, the following insurance (a) workers compensation insurance with statutory limits and employer’s liability coverage of not less than $500,000; (b) commercial general liability insurance with a minimum limit of $1,000,000 per occurrence and $2,000,000 in the aggregate, including per-project aggregate endorsement, which insurance shall cover the following: premises and operations liability, products/completed operations, broad form property damage, broad form contractual liability, personal injury and independent contractor’s liability; (c) automobile liability insurance covering owned, hired and non-owned vehicles, with a minimum limit of liability of $1,000,000; and (d) umbrella liability insurance with a limit of $1,000,000 per occurrence and a general aggregate of $1,000,000. Contractor shall, by specific endorsements to its primary and umbrella/excess liability policy, cause Cooperative, Managing Agent, and Unit Owner Shareholder to be named as additional insureds. Contractor shall, by specific endorsement to its primary liability policy, cause the coverage afforded to the additional insureds thereunder to be primary to and not concurrent with other valid and collectible insurance available to the additional insureds. Contractor shall, by specific endorsement to its umbrella/excess liability policy, cause the coverage afforded to the additional insureds hereunder to be first tier umbrella/excess coverage above the primary coverage afforded to the additional insureds and not concurrent with or excess to other valid and collectible insurance available to the additional insureds. Contractors’ insurance policies required herein shall include waiver of subrogation in favor of the additional insureds, and shall have no exclusions or limitations pertaining to the additional insureds relating injuries to the Contractor’s employees or subcontractor employees, the location of the work, or type of work performed on behalf of the Unit OwnerShareholder. If the terms of this Agreement directly conflict with any other written agreements and/or Purchase Orders between the parties, the term contained in this Agreement shall supersede in that instance. Contractor Cooperative Managing Agent Unit Owner Shareholder Name Name Name Name Signature Signature Signature Signature Date Date Date Date UNIT OWNER’S INDEMNIFICATION & INSURANCE AGREEMENTAGREEMENT Whereas (“Shareholder”) is and will be performing renovation work in Unit No. within Larchmont Xxxxxx Owners Corp. (“Cooperative”) located at Larchmont Xxxxxx Owners Corp., 0000 Xxxxxx Xxx, Larchmont, New York 10538. managed by Xxxxxxxx Management Realty Corp. (“Managing Agent”), pursuant to decoration or alteration agreements and/or the contract/proposal dated , now therefore, as to all such work, the Shareholder, Cooperative and Managing Agent hereby agree:

INSURANCE PROCUREMENT. Contractor shall obtain and maintain at all times while performing work for or at the request of the Unit OwnerShareholder, at its sole cost and expense, the following insurance (a) workers compensation insurance with statutory limits and employer’s liability coverage of not less than $500,000; (b) commercial general liability insurance with a minimum limit of $1,000,000 per occurrence and $2,000,000 in the aggregate, including per-project aggregate endorsement, which insurance shall cover the following: premises and operations liability, products/completed operations, broad form property damage, broad form contractual liability, personal injury and independent contractor’s liability; (c) automobile liability insurance covering owned, hired and non-owned vehicles, with a minimum limit of liability of $1,000,000; and (d) umbrella liability insurance with a limit of $1,000,000 per occurrence and a general aggregate of $1,000,000. Contractor shall, by specific endorsements to its primary and umbrella/excess liability policy, cause CooperativeCorporation, Managing Agent, and Unit Owner Shareholder to be named as additional insureds. Contractor shall, by specific endorsement to its primary liability policy, cause the coverage afforded to the additional insureds thereunder to be primary to and not concurrent with other valid and collectible insurance available to the additional insureds. Contractor shall, by specific endorsement to its umbrella/excess liability policy, cause the coverage afforded to the additional insureds hereunder to be first tier umbrella/excess coverage above the primary coverage afforded to the additional insureds and not concurrent with or excess to other valid and collectible insurance available to the additional insureds. Contractors’ Contractors insurance policies required herein shall include waiver of subrogation in favor of the additional insureds, and shall have no exclusions or limitations pertaining to the additional insureds relating injuries to the Contractor’s employees or subcontractor employees, the location of the work, or type of work performed on behalf of the Unit OwnerShareholder. If the terms of this Agreement directly conflict with any other written agreements and/or Purchase Orders between the parties, the term contained in this Agreement shall supersede in that instance. Contractor Cooperative Corporation Managing Agent Unit Owner Shareholder Name Name Name Name Signature Signature Signature Signature Date Date Date Date UNIT OWNERXXXXX CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YY) 00/00/0000 PRODUCER FAX * NAME AND ADDRESS OF INSURANCE CARRIER THIS CERTIFICATE ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED * NAME AND ADDRESS OF INSURED (Must match signed contract) INSURER A: xxxxxxxxxx INSURER B: xxxxxxxxxx INSURER C: INSURER D: INSURER E: COVERAGES THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXP DATE (MM/DD/YY) LIMITS A GENERAL LIABILITY $1,000,000/$2, 000.000 00/00/00 00/00/00 EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES $ 100,000 CLAIMS MADE OCCUR MED EXP (any 1 person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 GEN’L AGGREGATE LIMIT APPLIES PER: PRODUCTS – COMP/OP AGG $ 2,000,000 POLICY PROJECT LOC B AUTOMOBILE LIABILITY $1,000,000 minimum 00/00/00 00/00/00 COMBINED SINGLE LIMIT (Ea Accident) $1,000,000 ANY AUTO ALL OWNED AUTOS XXX XX X XXXXXX INJURY (per person) $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (per accident) $ NON OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY – EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ B EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ * WORKER’S INDEMNIFICATION & INSURANCE AGREEMENTCOMPENSATION AND $1,000,000 minimum 00/00/00 00/00/00 WC Statutory Limits Other EMPLOYER’S LIABILITY E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE –EA EMPLOYEE $1,000,000 E.L. DISEASE –POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS: Also additionally insured: Shareholder’s Name, Address and Apt. Number a) 280-290 Xxxxxxx Owners Corp., 000-000 Xxxxxxx Xxx, Mt. Vernon, NY 10552 b) Xxxxxxxx Management Realty Corp., 000 Xxxxxxxxxx Xxx, Xxxxxxxx, XX 00000 Date of Move /Delivery/ Work: CERTIFICATE HOLDER CANCELLATION 280-290 Xxxxxxx Owners Corp. C/x Xxxxxxxx Management Realty Corp 000 Xxxxxxxxxx, Xxx. Harrison, NY 10528 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINDUPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Must have signature

INSURANCE PROCUREMENT. Contractor shall obtain and maintain at all times while performing work for or at the request of the Unit OwnerShareholder, at its sole cost and expense, the following insurance (a) workers compensation insurance with statutory limits and employer’s liability coverage of not less than $500,000; (b) commercial general liability insurance with a minimum limit of $1,000,000 per occurrence and $2,000,000 in the aggregate, including per-project aggregate endorsement, which insurance shall cover the following: premises and operations liability, products/completed operations, broad form property damage, broad form contractual liability, personal injury and independent contractor’s liability; (c) automobile liability insurance covering owned, hired and non-owned vehicles, with a minimum limit of liability of $1,000,000; and (d) umbrella liability insurance with a limit of $1,000,000 per occurrence and a general aggregate of $1,000,000. Contractor shall, by specific endorsements to its primary and umbrella/excess liability policy, cause CooperativeCorporation, Managing Agent, and Unit Owner Shareholder to be named as additional insureds. Contractor shall, by specific endorsement to its primary liability policy, cause the coverage afforded to the additional insureds thereunder to be primary to and not concurrent with other valid and collectible insurance available to the additional insureds. Contractor shall, by specific endorsement to its umbrella/excess liability policy, cause the coverage afforded to the additional insureds hereunder to be first tier umbrella/excess coverage above the primary coverage afforded to the additional insureds and not concurrent with or excess to other valid and collectible insurance available to the additional insureds. Contractors’ Contractors insurance policies required herein shall include waiver of subrogation in favor of the additional insureds, and shall have no exclusions or limitations pertaining to the additional insureds relating injuries to the Contractor’s employees or subcontractor employees, the location of the work, or type of work performed on behalf of the Unit OwnerShareholder. If the terms of this Agreement directly conflict with any other written agreements and/or Purchase Orders between the parties, the term contained in this Agreement shall supersede in that instance. Contractor Cooperative Corporation Managing Agent Unit Owner Shareholder Name Name Name Name Signature Signature Signature Signature Date Date Date Date UNIT OWNERXXXXX CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YY) 00/00/0000 PRODUCER FAX * NAME AND ADDRESS OF INSURANCE CARRIER THIS CERTIFICATE ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED * NAME AND ADDRESS OF INSURED (Must match signed contract) INSURER A: xxxxxxxxxx INSURER B: xxxxxxxxxx INSURER C: INSURER D: INSURER E: COVERAGES THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXP DATE (MM/DD/YY) LIMITS A GENERAL LIABILITY $1,000,000/$2, 000.000 00/00/00 00/00/00 EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES $ 100,000 CLAIMS MADE OCCUR MED EXP (any 1 person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 GEN’L AGGREGATE LIMIT APPLIES PER: PRODUCTS – COMP/OP AGG $ 2,000,000 POLICY PROJECT LOC B AUTOMOBILE LIABILITY $1,000,000 minimum 00/00/00 00/00/00 COMBINED SINGLE LIMIT (Ea Accident) $1,000,000 ANY AUTO ALL OWNED AUTOS XXX XX X XXXXXX INJURY (per person) $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (per accident) $ NON OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY – EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ B EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ * WORKER’S INDEMNIFICATION & COMPENSATION AND $1,000,000 minimum 00/00/00 00/00/00 WC Statutory Limits Other EMPLOYER’S LIABILITY E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE –EA EMPLOYEE $1,000,000 E.L. DISEASE –POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS: Also additionally insured: Shareholder’s Name, Address and Apt. number a) Orienta Gardens Owners, Inc., Orienta Gardens, Mamaroneck, NY 10543 b) Xxxxxxxx Management Realty Corp., 000 Xxxxxxxxxx Xxx, Xxxxxxxx, XX 00000 Date of Move /Delivery/ Work: CERTIFICATE HOLDER CANCELLATION Orienta Gardens Owners, Inc. C/X Xxxxxxxx Management Realty Corp 000 Xxxxxxxxxx, Xxx. Harrison, NY 10528 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINDUPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Must have signature XX*IF WORKERS COMP IS NOT ON THIS CERTIFICATE – YOU MUST PROVIDE (2) CERTIFICATES FROM STATE INSURANCE AGREEMENTFUND (ONE FOR EACH ADDITIONAL INSURED)