2022/11/01 Crown Building Maintenance Co.P.g. 1 of 1
CERTIFICATE OF LIABILITY INSURANCE OAT€ IXIJUODTYYYY)
Lt /0L/2022
THIS CERTIFICATE IS ISSUED AS A MATTEN OF INFORMATION ONLY ANO CONFERS NO RIGHTS UPON THE CERTIFTCATE HOLDEN, THIS
CEBTIFICATE DO€S NOT AFFIRMATIVELY OR NEGATIVELY AMENO, EXTENO OR ALTER THE COVERAGE AFFOROEO BY THE POLICIES
SELOW. THIS CERTTFTCATE OF TNSURANCE OOES NOT CONSTTTUTE A CONTRACT BETWEEN THE ISSUING Ii{SUBER(S), AUTHOBIZEO
BEPRESENTATIVE OR PROOUCER, AND THE CERNFICATE HOLOEB.
IMPORTAttT: ll tho cerllflcsle holder ls an ADDITIONAL INSI,JHED, the pollcy(ies) musl have ADDITIONAL INSUnEO provieions or be endoBed.
ll SUBROGATIOT{ lS WAIVED, lublocl lo the terms 6nd condltlon! o, the pollcy, cenaln policles msy rlqulrc an sndorsemenl. A llatemenl on
lhis certlflcate does not conler rlghts to tho c.rllficate holder ln lleu of guch 6ndoBement(s).
PnooucGnItIL!. rtrr. rrt.on soutlr...t,c/o 26 C.ntuly llrat
P,O. Bo, 305191
rar.hwtl1., tlf 3t23051r1 OBI
II€UfiEOcaon htldtrg x.IrtG- co. Ll lbt. lulldlDg LLt.!D{
u A.a tn<t{.t!l.r tD@rtb!.t-d c.aoy
ar,!1 Lhlord Dsrcody Ar.4l, ault 500
ltl&t., G 3031t
l{iLl"i. lor.ar ra.t.on c.rtific.t. c.Dt.!
1-877-9a5-r378 1-848-467-23?8
c.rti.!iclt.r€ri11i. - co
It{suFEF{S)AFFOROI G COVERAGE AtCa
22661tirsuFEaAr rca rfi.lLc.n lD.u..nc. c€ Pany
IIEUFEF B
ItlSUiEiC i
It€UnEF O,
II.EUFEF E:
ac, tlotf,rty 6 C..u.Ity In.ulrnc. Cqr.y 20699
tnd&DLty In.urrnc. Coryoy ol North r!..i a357!1
COVERAGES cERTIFICATE NUMBER. n26s71r15 BEVISION NUMSERT
THIS IS TO CEHTIFY THAT THE POLICIES OF INS{JBANCE LISTED AELOW HAVE SEEN ISSUED TO THE II.].SURED NAMED ABOVE FOF THE POLICY PEFIOO
INOICATED, TIOTWTHSTANOING ANY REOUIREMENT. TERII OR CONDITION OF ANY CONTBACT OH OTHEF DOCUMEN'T WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUEO OR MAY PERTAIN, THE INSUHANCE AFFOROEO BY THE POLICIES DESCNIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES LII\,IITS SHOWN MAY HAVE BEEN REOUCEO BY PAID CLAII\JS.
ao0r- suaRTYPE Of IIISUFANCE LIl/lTS
!7 /A7/2A22 tt/07/2023xs! c{?3o0tt8X xco
X poltcv PBO
-
JECT
-
2, OOO, 000
:,000,00
GEN L AGCFEOATE LIMIT APPLIES PEB
LOC
EACH OCCUFISEITCE
PREMISES !Ea o*rron.el
PERSONAL A AOV INJIJBY
GENERAL AGGFEGATE , I
PRODLICIS COMP/OP AGG t
6,000, 000
2, OO0, 000
2,000, 0oo
X COII IIEFCIA! O EI{EFAI LIABILITY
X tl, ooo, ooo srR
cralMs-M^oE T *"u"
5,000, 000
€ODILY INJUBV lPer psonl 3
lsl 8106 9142 5 1,1, /01/2022x
X PAO I
I
lllOr/2021 SODIIY rrul.lFtY lP...ccjdsn| t-
SCBEOULEO. - AIJIOS
AUIO|IOBILE UAEIUTY
X ANY AUTO
OWt\lEOAUTOS C'..ILY
HIBEOAUIOS T'{LY
xx
X aere t.ltoltDED
OCCUR
CLAIMS,MAOE
10,000
uxBnEt! uAE
gIcESS UAB
,,0,0oo,000EACHOCCUBFENCE
10,000, 000
ixlu G2?910465 008 L!/Ot /2022. 11/01/2023 aGGFEGATE
wonKEFS COatPEt{gAItOl{
AND EMPLOYEhS' LIAEIIIIY
lIIYPFOPNIETOFIiPAFTNERTEXECUIIVE
OFFICER,MEMBER€XCLUOEO?rrLR c506?7 370
1,000, 000
c
L9I4TI]IEx
t!/o\/2022 !!/o1/2023'
E,L, DISEASE. POLICY LIM I
1,000, 000
1.000,000
E L, EACH ACCIOENT I
E,L. DISEASE EA EMPLOYEEI '
o€scFlmor oF oPEnalor€ / localrotas, vEHcLEa {Ameo r0r. Addlron.r Frt.*. 9ch.drb. m.y !. -Eh.d n mor..9... i...$rr.d)
Tb. Clty of lllnlr.., itr courcll D-b.!., oflic..., .g.ntr. .nd qloy..t rr. Lnelud.d .. ldditlon.l InluE d (.rc.pt
rort.r. cdE.n.rtion) to th. .-l.nt r.qul!.d by rrj.t!.n contr.ct. rb. 6.mrrL U.bility .nd lulo Ll.bil.lty potlci..
.r. PlL ry .nd aon-coDtrllutory rlr.!. !.qulr.d bt' rEltt.n contlrct.
CERTIFICATE HOLDER CANCELLATION
clty o! !r.Di.!..
29?14 AruD Ro.d
x.nll... cr 92586
SHOULD At{Y OF THE AAOVE DESCRIAEO POUCIES BE CA CELLEO BEFOFE
THE EXflNATIOT{ OATE TXEREOF, T{OIICE $'ILL AE OELIVEBED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTTIOFIZEO FEPFESENTATIVE
/a41ta frala,o
@ 1988-2016 ACOBD coRPoHATlON. All rlghts relorvGd.
Th€ ACOnD name and logo are regl8tored marks ol ACORD
sr !D:23269S77 r rcll: 2?25869 2ot4 7114
ACORD 25 (20r6/03)
$
t
$
tr
2
ADDITIONAL INSURED -
DESIGNATED PERSONS OR ORGANIZATIONS
Named lnsured ABM lndustries lncorporated Endorsement Number
3
Policy Symbol
ISA
Policy Number
H10691825
Policy P6riod
't 1t0112022 10 11t01t2023
Eflecbve Date of Endorsement
lssued By (Name ot lns{rrance Company)
ACE American lnsurance Company
lnao( th6 pohcy numbsr Th. r.m.rndar ol th6 rnlorrnetd1 rE to b6 complolad only wh€n thia endos6r6ntl5lss!€d Eubssquentto th€ gropsrelon
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided underthe following:
BUSINESS AUTO COVERAGE FORM
AUTO DEALERS COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
EXCESS BUSINESS AUTO COVERAGE FORM
Additional lnsured(s)Anv oerson or oroanization whom vou hav aoreed to include as an additional insured
under a written contract. provided such contract was executed prior to the date of loss
For a covered "auto,'VVho ls lnsured is amended to include as an 'insured," the persons or organizations
named in this endorsement. However, these persons or organizations are an "ansured" only for "bodily
injury" or "property damage" resulting from acts or omissions of:
1. You.
2. Any of your'employees" or agents.
3. Any person operating a covered "auto" with permission from you, any of your "employees" or agents
The persons or organizatons named in this endorsement are not liable for payment of your premium.
Authorized Representatve
B
DA-gU74c (03/16)Page '1 of 1
Nemed lnsured ABM Industries lncorporated Endorsement Nu rnb or
2
Policy Symbol
ISA
Polrcy Number
H10691825
Policy P6nod
1110112022 'to 1't 10112023
Eflectrve Date of Endorsement
lssued 8y (Name ol lnsurance Company)
ACE American lnsurance Company
2
NON.CONTRIBUTORY ENDORSEMENT FOR ADDITIONAL INSUREDS
Lnserl the policy numb.r Th€ r.Inarnd6r olho informaton 16 tobe completed onlywhcn thb.ndo66rn nit3 ia6ucd subslqu6ntto thc proparoton olth€ policy
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
AUTO DEALERS COVERAGE FORM
Schedule
Orqanization Additional lnslled En!!oLlgment
Any additional insured with whom you have agreed to provide such non-
contribubry insurance, pursuant to and as required under a written contact
executed prior to the date of loss.
(lt no infomation is filled in. the schedule shall rcad. 'All persons or cnliltes addad as additional insureds
through an endarsement with the term "Additional lnsuted" in the tille)
For organizations that are listed in the Schedule above that are also an Additional Insured under an endorsement
attached to this policy, the following is added to the Other lnsurance Condition under General Conditions:
lf otrer insurance is available to an insured we cover under any of the endorsements listed or described
above (the "Additional lnsured") for a loss we cover under this policy, this ansurance will apply to such loss
on a primary basis and we will not seek contribulion from the oher insurance available to the Additional
lnsured.
Authorized Representative
DA-21886b (06/'14)Page 1 of 1
Named lnsured ABM Industries lncorporated Endors!mont Numbar
zo
Policy Symbol
XSL
Policy Number
G47300198
Polrcy Penod
1 1 t01 t2022 ra I 1 101 12023
Eflective Date of Endorsement
lssu€d By (Name ol lhsurance Company)
ACE American lnsurance Company
BLANKET ADDITIONAL INSURED
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ ITCAREFULLY.
THIS ENOORSEMENT MODIFIES INSURANCE PROVIDED UNOER THE FOLLOWNG:
EXCESS COMMERCIAL GENERAL LIABILITY POLICY
Any person or organizaton whom you have agreed to anclude as an additional insured in a written contract is included as
an additional insured under this policy, but only to the extent required by and in accordance with the terms of such written
contract executed prior to loss, provided that written contract does not specify an ISO endorsement or other specific
wording, and only with respect to liability for "bodily injury", "property damage", or "personal and advertising injury" arising
out of your ongoing or completed operations.
MS-309963.2 (11/20)Ochubb 2016 All righls roserv€d Page 1 of 1
1
NON.CONTRIBUTORY ENDORSEMENT FOR ADDITIONAL INSUREDS
ABM lndustries lncorporated
EndorE.m.nt NumbsrI
Polic, Symbol
XSL G47300198 1 1 I U r2O22 to 1 I I 0 1 t2o23
Efiocl,v. 08lo ol EndoGement
l6su€dEy (Nsme ol logurance Company)
ACE American lnsurance Company
nsc( th. po |cy number Th. remarnder olthe nformaton rs to b6 completed only when thls..dors.nEnt s rss!cd subsequ€ntto thc preparatjon ol lhc polcy
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Thls endorsernent modifies insurance provided under the following:
EXCESS COMMERCIAL GENERAL LIABILITY POLICY
Schedule
Orqanization Ad nal ln ured Endo me nt
Any additional insured with whom you have agreed to provide such non-
contributory insurance, pursuant to and as required under a written contact
executed prior to the date of loss.
(lf no informetion is fi .d in, the schedule shall raad: 'All peBons or antitios added es additional insureds
lhrough an endorsemcnt wilh lhe term "Addilonal lnsured" in the lile)
For organizations that are listed in the Schedule abov€ that are also an Additional lnsured under an
endorsement attached to this policy, the following is added to Section lV.4:
lf other insurance is available to an insured we cover under any of the endorsements listed or described above
(the "Additional lnsured") tor a loss we cover under this policy, this insurance will apply to such loss and is
primary (subject to satisfaction of th6 "retained limit"). meaning that we will not seek contribution from the otler
insurance available to th8 Addilional lnsured. Your "retained limit" still applies to such loss, and we will only pay
the Additional lnsured for the "ultimate net loss' in excess of the "retained limit" shown in the Declarations of titis
policy.
Authorized Representative
XS-20288a (05/14)OChubb. 2016. All rights reserved Page 1 of 1