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Acord Logo CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
12/25/2018
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
SADLER & COMPANY, INC.
P.O. BOX 5866
COLUMBIA, SOUTH CAROLINA 29250-5866
CONTACT NAME: Sports Dept
PHONE (A/C, No. Ext): 800-622-7370   |   FAX (A/C, No): 803-256-4017
E-MAIL ADDRESS: instructor@sadlersports.com
PRODUCER CUSTOMER ID#:
INSURED

Leslie Alex Baril
DBA Baril's Elite Performance

135 Ocean Parkway
1R
Brooklyn , NY 11218

Application ID: 239935

A Member of the Sports, Leisure & Entertainment RPG

INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A: Nationwide Mutual Insurance Company
INSURER B:
INSURER C:
INSURER D:
COVERAGES CERTIFICATE NUMBER REVISION NUMBER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSD
LTR
TYPE OF INSURANCE ADDL
INSD
SUBR
WVD
POLICY NUMBER POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY)
LIMITS
A COMMERCIAL GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
   CLAIMS MADE   OCCUR
____________________
____________________
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY   PROJECT   LOC
OTHER
X   6BRPG0000006255900 12:01AM ET 08/18/2018 12:01AM ET 08/18/2019
EACH OCCURRENCE $500,000
DAMAGE TO RENTED PREMISES (fire legal liability) $500,000
MEDICAL EXP (other than participant) $5,000
PERSONAL & ADV INJURY $500,000
GENERAL AGGREGATE (other than products-completed operations) $5,000,000
PRODUCTS-COMP/OP AGG $500,000
PROFESSIONAL LIABILITY $500,000
LEGAL LIAB TO PARTICIPANTS $500,000
ABUSE, MOLESTATION, HARRASSMENT OR SEXUAL CONDUCT DEFENSE COSTS REIMBURSEMENT $100,000
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
NOT PROVIDED WHILE IN HAWAII
   
COMBINED SINGLE LIMIT (Ea Accident)  
BODILY INJURY (Per person)  
BODILY INJURY (Per accident)  
PROPERTY DAMAGE (Per accident)  
   
   
 
UMBRELLA LIAB   OCCUR
EXCESS LIAB   CLAIMS-MADE
DEDUCTIBLE
RETENTION
   
EACH OCCURRENCE  
AGGREGATE  
   
  WORKERS COMPENSATION AND EMPLOYERS' LIABILITY
Y/N
ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under DESCRIPTION OF OPERATIONS below
    N/A
PER STATUE

OTHER
 
E.L. EACH ACCIDENT  
E.L. DISEASE - EA EOMPLOYEE  
E.L. DISEASE - POLICY LIMIT  
  MEDICAL PAYMENTS FOR PARTICIPANTS    
PRIMARY MEDICAl  
EXCESS MEDICAL  
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

RE: Instructor of Personal Training, (CERTIFIED)

Re: Urban Associates, LLC, The Brodsky Organization, LLC, 400 West 59th Street Partners, LLC, Brodcom West Development Co, Beaux Arts II, LLC, Beaux Arts Realty, LLC, Park South Towers Associates, 400 West 59th Street Partners, LLC, 12 East 86th Street LLC, 200 West 60th Street Associates LLC, 42/9 Residential, LLC, 420 West 42nd Street, LLC, 24 Fifth Avenue Associates, LLC, West, Pierre Associates, LLC, Morningside Associates, LLC, City Point Residential, LLC, 7 Dekalb Owners, LLC, J.S.B. Properties, LLC are added as additionally insured


The certificate holder is added as an additional insured, but only for liability caused, in whole or in part, by the acts or omissions of the named insured.
CERTIFICATE HOLDER CANCELLATION
RELATIONSHIP:
Property Owner/Lessor

Urban Associates, LLC
400 West 59th Street
Third Floor
New York, NY 10019
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
John Sadler Signature

Coverage is only extended to U.S. events and activities
** NOTICE TO TEXAS INSUREDS: The Insurer for the purchasing group may not be subject to all the insurance laws and regulations of the State of Texas.
ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD

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ISO | Commercial General Liability Forms | 07/01/04

POLICY NUMBER: 6BRPG0000006255900 COMMERCIAL GENERAL LIABILITY
INSURED: Leslie Alex Baril CG 20 26 04 13

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

1. Name of Additional Insured Person(s) or Organizations(s):

Urban Associates, LLC
400 West 59th Street
Third Floor
New York, NY 10019
(Information required to complete this Schedule, if not shown above, will be shown in the Declarations.)

A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf:

1. In the performance of your ongoing operations; or
2. In connection with your premises owned by or rented to you.

However:

1. The insurance afforded to such additional insured only applies to the extent permitted by law; and
2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.

B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance:

If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:

1. Required by the contract or agreement; or
2. Available under the applicable Limits of Insurance shown in the Declarations;

whichever is less.

This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.

Date Added: 08/17/2018 04:27:07 PM

CG 20 26 04 13

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