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<br /> ,CORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD(YYYY)
<br /> ‘rir .------ 09/27/2023
<br /> 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 policy(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. PHONE (808)533-3222 FAX (808)533-8777
<br /> IA/C,No,ail: c,Nal:
<br /> 201 Merchant Street E-MAIL
<br /> ADDRESS:
<br /> Suite 1100 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Honolulu HI 96813 INSURER A: 'Evanston Insurance Co. 35378
<br /> INSURED B: North River Ins.Co. 21105.
<br /> AECOS,Inc. INSURER c: Hawaii Employers'Mutual Ins Co Inc. 10781
<br /> 45-939 Ka.mehameha Hwy.,Room 104INSURER D: American Alternative Insurance Corp.(HIMI) 19720
<br /> INSURER E: 'Broker Synapse Services,LLC
<br /> Kaneohe HI 96744 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 23-24 MISC2 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. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND COND TIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR ADDL SU POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER _IMM/DDJYYYY) _IMMIODIYYYYI LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY 'This insurance contract is issued dy an Inslrer which Is not EACH OCCURRENCE s 2,000,000
<br /> licensed by the State of Hawaii and is not su 7jec1 to its DAMAGE TO RENTED 300,000
<br /> CLAIMS-MADE X.OCCUR regulation or examination_ If the Insurer is found insolvent, PREMISES Ea occurrence!. S
<br /> X BI/PD Deductible:$2,500 claims under this contract are not covered B1 any guaranty MED PEP(Any one parson) $ 25,000
<br /> A `MKLV2ENV103757 09/2712023 09!2712024 PERSONAL SADVINJURY $ 2,000,000
<br /> Broker Name:Synapse Service,LLC 2,000000
<br /> GEN'LAGGREGATE LIMIT APPLIES PER' License#:374802 GENERAL AGGREGATE $ ,
<br /> PRO- Address:3322 Route 22 West,Suite'1105,Eranchburg,NL 2,000,000
<br /> H POLICY SECT LOC
<br /> 13202 PRODUCTS-COMPIOPAGG $
<br /> —
<br /> OTHER( S
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
<br /> SEs accident)
<br /> X ANY AUTO BODILY INJURY(Per person) $ 1,000,000
<br /> B OWNED — SCHEDULED 133-755035-4 09/2712023 09/27/2024 BODILY INJURY(Per accident) $ 1,000,000
<br /> AUTOS ONLY AUTOS _
<br /> X HAUTOIREDS ONLY X AUTNONOS O-0VMJNLED PROPERTY DAMAGE
<br /> Jeer accident) $ 1,000,000
<br /> Y
<br /> $
<br /> UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> A X EXCESS LIAB CLAIMS-MADE 'MKLV2EFX101207 09/2712023 09127/2024 AGGREGATE $ 5,000,000
<br /> OED RETENTION$ _ _ $
<br /> WORKERS COMPENSATION X MUTE ETH
<br /> AND EMPLOYERS'LIABILITY Y!N
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> C' OFFICER/MEMBER EXCLUDED? ,N/A WC0011755(Incl.USL&H) 09127/2023 09127/2024 -
<br /> IMandatoryinNHIEL DISEASE-EA EMPLOYEE $ 1,000,000 '
<br /> If yes,describe under 1OODDD 0
<br /> DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ , ,
<br /> Professional Liability 1 Maritime Liability
<br /> See Attached Remarks 09/27/2023 ' 09/27/2024 See Attached Remarks
<br /> DESCRIPTION OF OPERATIONS!LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Proof of insurance certificate provided for coverages indicated.
<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 /> t
<br /> Kaneohe HI 96744-0000 ,--;;_,Ogt-E,73
<br /> ©1988-2015 ACORD CORPORAATION,61All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of AOR
<br /> ECE T VES r rT V L E:4
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