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<br />,a►'cv CERTIFICATE OF LIABILITY INSURANCE DATER AADDflYYYy
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<br />2702p17
<br />THIS CERTIFICATE 13 ISSUED AS A (MATTER OF INFORMATION ONLY AND CONFERS NORIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR. ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IIHSURER'jSj,AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATEHOLDER.
<br />IMPORTANT: If the certificate holder its an ADDITIONAL INSURED, the policy(iesj (must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUIBROGATION' IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not center rights to the certificate holder in lieu of suohpponpdorsement s .
<br />PRODUCER
<br />(1.AldE: CT
<br />Double Eagle Agency, Inc.
<br />PARdCe�$C , E.IL (616) 609-0D60 ac Nol:(616) 609.0046
<br />S
<br />372 Wllllis Ave
<br />Mineola, NY 11601
<br />AZURE$$:
<br />INSURERIStAFFORgefGC.q RAGE .t... NAYCi
<br />.........
<br />INSURER A The Hartford }29424 ,
<br />... .........
<br />INSURED
<br />INSURER B: _.._ ..,, 1... ..............
<br />Tessellate LLC
<br />UISURER C 1
<br />163 E 32nd Sit3
<br />INSURERD:
<br />i1..
<br />New York, NY' 10016
<br />INSURER E:
<br />INSURER. F:
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED.. NOTWTHSTANDiNG ANY REQUIREMENT, TERM OR CONDITION' OF ANY CONTRACTOR' OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHO4IMN MAY 14AVE BEEN REDUCED BY PAID CLAIMS.
<br />IN SR TYPE OF 6NSURAMCE ADDLSUHR POLICYIfUMDER -....... POLICY EFF POUCYEXP ...... LxMIIS _.
<br />A
<br />X..YCOMMERCIALOENFRALLIABILITY
<br />EACH
<br />S 1,000,000
<br />......
<br />$MANE X I OCCUN
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<br />11112712017{ 1112712019 FDARIAGETOREHTEO
<br />PREMISS (EaoccurreTuyej
<br />S 1,000„000
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<br />_
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<br />MEDEXP(Any one Person)
<br />S 10,000
<br />PERSONAL & ADV INJURY
<br />S 1,000,000
<br />2,000,000
<br />GErIk
<br />.K
<br />AGGREGATE LIlNYT APPLIES PER.
<br />PQh.ICYf .._.POFCY .'..� LOC
<br />GENCRAL AOCRECATF.,,
<br />PRODUCTS COIAPfCPAGC
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<br />$ 2,0001,000
<br />OTHER,
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<br />AUTOMOBILE LIABILITY
<br />I COMBINED SINGLE LIMIT
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<br />ANYAUTO
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<br />EXCESSUAB CLAIM&MAOE�
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<br />WORMERS COMPENSATION
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<br />DISEASE -POLICY LIMIT
<br />DESCRIPTION OF OPERATIONS ee4rae
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<br />„-„EL
<br />DESCRIPTOR OF OPERATIONS r LOCATIONS r VEHICLES IACONO 101, AddIPlonal Rrmuks Schedule, mayhe®tlacheddmone space is required)
<br />PROOF OF INSURANCE
<br />ACORD 25 (2016103)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE', THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />AUTHORIZED REPRESENTATIVE
<br />/' t'Y 1111L-£iN
<br />Q 1995•2015 ACORD CORPORATION. All rights reserved,
<br />The ACORD name and logo are registered (marks of ACORD
<br />r EXPERIENCES 47
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