2023/01/01 LexisNexis Copologic Solutions, Inc.----\ -A,(:tofra L,CERTIFICATE OF LIABILITY INSURANCE
COVERAGES CERTIFICATE NUMBEB: 5700s707 4287 REVISION NUMBEB:
CANCELLATION
@1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORo
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CEBTIFICATE HOLOEB
DATE(MWDD,YYYY)
1A2A12A22
ATEATILYATTEB
ATI GATFICATE
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BEPBESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER
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(800) 363-0105(866) 281-7122
ADORESS
INSUFERlS) AFFONDING COVEFAGE
PFOOUCEH
Aon Risk 5ervi ces llortheast,
Boston MA office
53 State Streetsuite 2201
Boston MA 02109 UsA
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22667tNsuFERA: ACE AmeriCan Insurance company
165 35tNsuREB Br zuri.h american Ins co
AA17 59ItlsuFEF c: Zurla
AA112862 3TNSUREFO: Lloyd's Syndicate No 2623
INSUFED
Lexi sNexi s coploqic
1000 Alderman Drivealpharerra GA 10005
sol utions Inc
USA
OICATE
C PE DoTEHEABOVDFOEENDDETEHNUHVEEBSUENISBDELENCISTENNTEPOLcOFESHF]T S CEIO HT T CHH HT ST\ITH SPE cE TOooTl-r E tlDOC E,/N coN ACTTRTRMECONORlooDTNTANoEUEMEITHSTNOTWDNNGDN HT TE IJSBJEUTOCTLLEDEEBHoEINESSDTEHPOLCESUDORENESTHEEBESEUoDECTICLA]IVSENDEUllDCD Li ilsOWt-l N E AELITS[,1 SU1-l Lrclo SEDNNco]T OND oS S CFEXCSUStoN
s1,000,EACI]OCCUBBENCE
$1,000,000PFEMISESJ5,000ME0 EXP lA.y ono porso.)
$1,000,000PEFSONAL& AOV NJUFY
2,OGENEBALAGGAEGATE
J2,000.000PBOOUCIS. COMP/OP AGG
$5 ,000,
COMMERCIAL G ENE BAL LIABIIITY
GEN LAGGFEGATE LIMITAPPLIES PEF
OCCUB
tocJECT
$5,000,000COMBINED SINGLE LIMII
BODILY INJUSY I Pvp66on)
BOD LY INJURYIPoT accdsf0
0t/ot/2o23 o1/0r/2o il8AP 8176848 24E
AUTOS ONLY
SCHEOULED
NON-OWNEO
AUTOSONLY
AUTOMOgILE LJAA]LIIY
$4s,000,000OCCUR
EXCESS TIAB
51GBCGP
OED FETENTLON
X
E L EACHACCIOENT
$1,000,000E L OISEASE EA EMPLOYEE
51,.000E L. DISEASE POLICY LLMIT
FXEFS COMPENSAIION AI]O
EiiPlOYEFS' LIABIIITY
ANY PROPRIETOA/ PAFTI]EF / EXECUIIVE
OFFICER]MEMAEN ETCLUDEO'
O€SCFIPTION OF OPEaATiONS belo*
$30.000,000t231'ions Per C'lain
Aggreqate
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ANY OF THE ASOVE DESChIBED POLICIES BE CANCELLED BETOFE THE
FIpInATON OATE IHEnEOF. NOTICE WLL BE OEtIVERED lt'l ACCOAOANCE WTH
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AUTHORIZED EEPRESEI{IATIVEr ty
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ACORD 25 (2016/03)
ALTERAMEND,
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AGENCY CUSTOMER lD: 570000055869
LOC #:,o,<:R}ADDITIONAL BEMARKS SCHEDULE Page _ of _
AGENCY
Aon Risk serv'ices Northeast, Inc.
NAMED INSUFED
Lexi sNexi s coplogic Solutions Inc.
See Certi ficate Number: 570097074287
See Certi fi cate Number: 5700970742g7
NAC COOE
EFTECTIVE OATE:
ADDITIONAL REMARKS
KS FORM IS A SCHEOULE TO ACORD FORM,
FORM NUMBEB: ACORD 25 FoBM TITLE: Cedificate of Liabi|
THIS ADOITIONAL REMAR
ity lnsurance
ADI)l r roN,\t, Pol,t( rt.ts ll a policy below does not includc
ccrtificatc [orn) for policy limits.
limir information. refcr to the corresponding policy on rhc ACORI)
INSURER(S) AFFORDING COVERAGE NAIC #
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DATE
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6ENERAL LIABILITY
oGtG46663160 07/01,/ 2023 ot/01,/2024 oeductible $15,000
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Th€ ACOBD name and toro are regisrered mark3 ot ACORO
@ 20OB ACOBD CORPOBAT|Oi|. Alt.ights reserved.
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AGENCY CUSTOMER lD: 570000055869
LOC #:.a,<-R>"ADDITIONAL REMARKS SCHEDULE Page - of -
Aon Risk services Northeast, Inc.Lexi sNexi s coploqic solut'ions rnc
see certi fi cate Number: 570097074287
see certi ficate Number: 570097074287
NA|C COOE
ADOITIONAL REMARKS
Companies Affording coverage
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THIS AOOITIONAL BEMAFKS FOBM IS A SCHEDULE TO ACORO FOBM,
FORM NUMBER: ACORD 25 FOBM TITLE; Certificale of Liabil lnsurance
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10016515r/L/2023 7/1/2024BAP 8176848 24Busi ness Auto coverage
AA112 8 (L loyd' s syndicate No. 2623t/L/2023 L2/31./2021FscEo2 30001-5E&o - Profess'ionalLiability - Primary
AA1126(Nt2/ 37/ 2023 Lloyd's syndicate No. 623r/ t/ 2023FSCEo2300015E&o - Professi onalLiab'ility - Primary
AA17 80(zurich rnsurance Plct/t/2o23 72 / 3r/ 2023GBCGP2 301519Excess Liability
covera9e
10022667ACE Ameri can Insurance ComPanY7/7/20241,/7/ 2O23oG1C46663160General LiabilitY
coverage
100165t5)./t/ 2024 zurich Ameri can lns cor/L/2021tvc837684524vvorkers Compensati on
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88rhe subicribins insuters, o\iqaxian| Dnder concfacts ot insurance to ||hich they su-bscriDe ale 'ewetal a[d not jaint an't ate
liniteat so7ely to rhe exrerr at their individual subicriptian|. The eubscribing insuftrg are not reeponsible tor the subscription
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acoaD tot (2008/ol )
The ACOBD name and logo ars regist€r€d marks ol aCORD
O 2OOA ACOBD COFPOFATIO . All dghts reserved.
Zurich ameri can Ins Co
certif icate No : 57009707 4290
Ciiv of Menifee
29644 Haun Road
Menifee CA 92586 USA
Wednesday, December 28, 2022
MSC# 17755 lAon
P.O. Box 1447
Lincolnshire, lL 60069
AON
To whom it may concern:
Followinq a concentrated effort to reduce our environmental footprint and provide_timely certificate
Oeiiveiv.-non *ltt Oegin delivering our Certificates of lnsurance eiectronically in PDF format.
please utilize one of the following methods to ensure you will receive the electronic copy of your
Certiiicate (Certificate No: 570097074290) for future renewals:
- Visit aon.com/e-cert; or
- Utilize the QR Code below to enter/validate your information.
lf vour email address has chanqed or will be changing in the future, or you no longer require this
ceirtificate, please let us know using one of the methods above.
Thank you for your cooperation and willingness to help us reduce our impact to the environment.
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