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AC" CERTIFICATE OF LIABILITY INSURANCE DATE`/30120YYYY'
<br /> 0913012022
<br /> 11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS 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 INSURER(S),AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pc icy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION 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 confer rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT Robert P-Silverstein
<br /> NAME:
<br /> Atlas Insurance Agency,Inc. IAHo No Ext: (808)533-3222 (AICFAX,1 (808)533-8777
<br /> 201 Merchant Street E-MAIL
<br /> ADDRESS:
<br /> Suite 1100 INSUREI AFFORDING COVERAGE NAIL 4
<br /> Honolulu HI 96813 INSURERA: *Evanston Insurance CD. 35378
<br /> INSURED INSURER B; North River Ins.Co. 21105,
<br /> AEGOS,Inc. INSURER C: Hawaii Employers'Mutual Ins Co Inc. 10781
<br /> 45-939 Kamehameha Hwy., Room 104 INSURER D: American Alternative Insurance Carp.(HIMI) 19720
<br /> INSURER E; 'Broker:Synapse Services,LLC
<br /> Kaneohe HI 96744 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 22-23 MISC2 REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD
<br /> INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAYBE 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 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR ADDLSUi POLICYEFF POLICY FXP LIMITS
<br /> LTR TYPE OF INSURANCE INSD WV❑ POLICY NUMBER MMIDDIYYYY MMIDDlYYYY
<br /> X COMMERCIAL GENERAL LIA21LITY `This insurance contract is issued by an Ins ircrwhich is not EACH OCCURRENCE S 2,000,000
<br /> licensed by the State of Hawaii and is not s jbject to its DAMAGE TO RENTED
<br /> 77 GIAiMS-MADE OCCUR regulation or examination.If the Insurer is i and insolvent, PREMISES Ea occurrence 5 300,000
<br /> XI Deductible:$2,500 claims under this contract are not covered y any guaranty 25,000
<br /> fund of the State of Hawaii. M£D I(Any one person) 5
<br /> A *MKLV2ENV103066 0912712022 09/27/2023 PERSONAL&ADV INJURY S 2,000,060
<br /> Broker Name.Synapse Service,LLC
<br /> GEN'LAGGREGATE LIMITAPPLIES PER: License# 374802 GENERALAGGREGATE g 2,000,000
<br /> POLICY 1-1PRO ❑ LOC Address:3322 Route 22 West,Suite 1105, ranchburg,NL 1 202 2,000,000
<br /> JECT PRODUCTS-COMPIOPAGG S
<br /> S
<br /> OTHER
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 5
<br /> Ea accident)
<br /> X ANYAUTC BCOILYINJURY(Per person) $ 1.000,000
<br /> g OWNED SCHEDULED 1337522589 09127/2022 09/27/2023 BODILY INJURY(Per accident) S 1,000.000
<br /> AUTOS ONLY AUTOS
<br /> MIRED �/ NON-OWNED PROPERTY DAMAGE 5 1,000,000
<br /> X AUTOS ONLY X AUTOS ONLY Peracciden0
<br /> 5
<br /> UMBRELLA LIAB x OCCUR EACH OCCURRENCE 5 5,000,000
<br /> A X EXCESS LIAB CLAIMS-MADE `MKLV2EFX10099C 09/27/2022 0912712D23 AGGREGATE $ 6,000,000
<br /> DED I I RETENTIONS S
<br /> WORKERS COMPENSATION X STATUTE ERH
<br /> AND EMPLOYERS'LIABILITY Y f N
<br /> ANY PRCPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT S 1,000,000
<br /> C OFFICERIMEMBER EXCLUDED? El N lA WC0011755(Inca. USL&H) 09127/2022 09/27/2023
<br /> (Mandatory in Ni E.L.DISEASE-EA EMPLOYEE 5 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OE OPERATIONS below E.L,DISEASE-POLICY LIMIT S
<br /> Professional Liability 1 Maritime Liability
<br /> See Attached Remarks 0912712022 09/27/2023 See Attached Remarks
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
<br /> Proof of insurance certificate provided for coverages indicated.
<br /> RECEIVED M 0 5 2022
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
<br /> AECOS,inc. ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 45-939 Kamehameha Hwy. Rm 104
<br /> AUTHORIZED REPRESENTATIVE
<br /> Kaneohe HI 96744-0000 —
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
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