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. Name Name Name Name Signature Signature Signature Signature Date Date Date Date

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 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. Name Name Name Name Signature Signature Signature Signature Date Date Date DateShareholder.

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. Name Name Name Name Signature Signature Signature Signature Date Date Date Date

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. Name Name Name Name Signature Signature Signature Signature Date Date Date DateDate ▇▇▇▇▇ 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. INSURED * NAME AND ADDRESS OF INSURED (Must match signed contract) INSURER A: xxxxxxxxxx INSURER B: xxxxxxxxxx INSURER C: INSURER D: INSURER E: 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 ▇▇▇ ▇▇ ▇ ▇▇▇▇▇▇ 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 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. ▇▇▇▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇. Tenants Corp, Bronxville, NY 10708 ▇▇▇▇▇▇▇▇ Management Realty Corp., ▇▇▇ ▇▇▇▇▇▇▇▇▇▇ ▇▇▇, ▇▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ Date of Move /Delivery/ Work: ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇. Tenants Corp C/▇ ▇▇▇▇▇▇▇▇ Management Realty Corp. ▇▇▇ ▇▇▇▇▇▇▇▇▇▇ ▇▇▇. 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.

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. Name Name Name Name Signature Signature Signature Signature Date Date Date DateDate ▇▇▇▇▇ 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. INSURED * NAME AND ADDRESS OF INSURED (Must match signed contract) INSURER A: xxxxxxxxxx INSURER B: xxxxxxxxxx INSURER C: INSURER D: INSURER E: 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 ▇▇▇ ▇▇ ▇ ▇▇▇▇▇▇ 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 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) ▇▇▇▇▇▇▇▇ Management Realty Corp., ▇▇▇ ▇▇▇▇▇▇▇▇▇▇ ▇▇▇, ▇▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ Date of Move /Delivery/ Work: CANCELLATION Orienta Gardens Owners, Inc. C/▇ ▇▇▇▇▇▇▇▇ Management Realty Corp ▇▇▇ ▇▇▇▇▇▇▇▇▇▇, ▇▇▇. 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.

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. Name Name Name Name Signature Signature Signature Signature Date Date Date DateDate ▇▇▇▇▇ 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. INSURED * NAME AND ADDRESS OF INSURED (Must match signed contract) INSURER A: xxxxxxxxxx INSURER B: xxxxxxxxxx INSURER C: INSURER D: INSURER E: 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 ▇▇▇ ▇▇ ▇ ▇▇▇▇▇▇ 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 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., ▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇, ▇▇▇ ▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇▇▇ Management Realty Corp., ▇▇▇ ▇▇▇▇▇▇▇▇▇▇ ▇▇▇, ▇▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ Date of Move /Delivery/ Work: Crest Manor Housing Corp C/▇ ▇▇▇▇▇▇▇▇ Management Realty Corp. ▇▇▇ ▇▇▇▇▇▇▇▇▇▇ ▇▇▇, ▇▇▇▇▇▇▇▇, 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.

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. Name Name Name Name Signature Signature Signature Signature Date Date Date DateDate Whereas (“Shareholder”) is and will be performing renovation work in Unit No. within Larchmont Hills Owners Corp. (“Cooperative”) located at ▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇, ▇▇▇ ▇▇▇▇ ▇▇▇▇▇ managed by ▇▇▇▇▇▇▇▇ 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. Name Name Name Name Signature Signature Signature Signature Date Date Date DateDate Whereas (“Shareholder”) is and will be performing renovation work in Unit No. within ▇▇▇▇▇▇ Court Apartment Corp. (“Cooperative”) located at ▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇., Mamaroneck, New York 10543, managed by ▇▇▇▇▇▇▇▇ 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. Name Name Name Name Signature Signature Signature Signature Date Date Date DateDate ▇▇▇▇▇ 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. INSURED * NAME AND ADDRESS OF INSURED (Must match signed contract) INSURER A: xxxxxxxxxx INSURER B: xxxxxxxxxx INSURER C: INSURER D: INSURER E: 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 ▇▇▇ ▇▇ ▇ ▇▇▇▇▇▇ 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 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) ▇▇ ▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇ Owner’s Inc., ▇▇ ▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇, ▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ b) ▇▇▇▇▇▇▇▇ Management Realty Corp., ▇▇▇ ▇▇▇▇▇▇▇▇▇▇ ▇▇▇, ▇▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ Date of Move /Delivery/ Work: ▇▇ ▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇ Owner’s Inc. C/▇ ▇▇▇▇▇▇▇▇ Management Realty Corp ▇▇▇ ▇▇▇▇▇▇▇▇▇▇, ▇▇▇. 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.

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. Name Name Name Name Signature Signature Signature Signature Date Date Date DateDate Whereas (“Shareholder”) is and will be performing renovation work in Unit No. within 80 ▇▇▇▇▇▇▇ Tenants Corp. (“Cooperative”) located at 80 ▇▇▇▇▇▇▇ Tenants Corp. ▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇. ▇▇▇▇▇▇, NY 10552. managed by ▇▇▇▇▇▇▇▇ 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. Name Name Name Name Signature Signature Signature Signature Date Date Date Date

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. Name Name Name Name Signature Signature Signature Signature Date Date Date DateDate Whereas (“Shareholder”) is and will be performing renovation work in Unit No. within Larchmont ▇▇▇▇▇▇ Owners Corp. (“Cooperative”) located at Larchmont ▇▇▇▇▇▇ Owners Corp., ▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇, Larchmont, New York 10538. managed by ▇▇▇▇▇▇▇▇ 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. Name Name Name Name Signature Signature Signature Signature Date Date Date DateDate ▇▇▇▇▇ 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. INSURED * NAME AND ADDRESS OF INSURED (Must match signed contract) INSURER A: xxxxxxxxxx INSURER B: xxxxxxxxxx INSURER C: INSURER D: INSURER E: 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 ▇▇▇ ▇▇ ▇ ▇▇▇▇▇▇ 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 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. ▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇ ▇▇▇▇▇, ▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇▇▇ Management Realty Corp., ▇▇▇ ▇▇▇▇▇▇▇▇▇▇ ▇▇▇, ▇▇▇▇▇▇▇▇, NY 10528 Date of Move /Delivery/ Work: Beacon Hill Estates Cooperative Inc. C/▇ ▇▇▇▇▇▇▇▇ Management Realty Corp. ▇▇▇ ▇▇▇▇▇▇▇▇▇▇ ▇▇▇. 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.