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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 />INSURER(S) AFFORDING COVERAGE
<br />INSURER F :
<br />INSURER E :
<br />INSURER D :
<br />INSURER C :
<br />INSURER B :
<br />INSURER A :
<br />NAIC #
<br />NAME:CONTACT
<br />(A/C, No):FAX
<br />E-MAILADDRESS:
<br />PRODUCER
<br />(A/C, No, Ext):PHONE
<br />INSURED
<br />REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
<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 />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 />OTHER:
<br />(Per accident)
<br />(Ea accident)
<br />$
<br />$
<br />N / A
<br />SUBR
<br />WVD
<br />ADDL
<br />INSD
<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 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 />$
<br />$
<br />$
<br />$PROPERTY DAMAGE
<br />BODILY INJURY (Per accident)
<br />BODILY INJURY (Per person)
<br />COMBINED SINGLE LIMIT
<br />AUTOS ONLY
<br />AUTOSAUTOS ONLY NON-OWNED
<br />SCHEDULEDOWNED
<br />ANY AUTO
<br />AUTOMOBILE LIABILITY
<br />Y / N
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />DESCRIPTION OF OPERATIONS below
<br />If yes, describe under
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />$
<br />$
<br />$
<br />E.L. DISEASE - POLICY LIMIT
<br />E.L. DISEASE - EA EMPLOYEE
<br />E.L. EACH ACCIDENT
<br />EROTH-STATUTEPER
<br />LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />EXCESS LIAB
<br />UMBRELLA LIAB $EACH OCCURRENCE
<br />$AGGREGATE
<br />$
<br />OCCUR
<br />CLAIMS-MADE
<br />DED RETENTION $
<br />$PRODUCTS - COMP/OP AGG
<br />$GENERAL AGGREGATE
<br />$PERSONAL & ADV INJURY
<br />$MED EXP (Any one person)
<br />$EACH OCCURRENCE
<br />DAMAGE TO RENTED $PREMISES (Ea occurrence)
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS-MADE OCCUR
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY PRO-JECT LOC
<br />CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
<br />CANCELLATION
<br />AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2016/03)
<br />© 1988-2016 ACORD CORPORATION. All rights reserved.
<br />CERTIFICATE HOLDER
<br />The ACORD name and logo are registered marks of ACORD
<br />HIRED
<br />AUTOS ONLY
<br />E
<br />C
<br />4,900,000
<br />12/01/2018
<br />XSLG27871252
<br />Manashi Mukherjee
<br />SCFC64618957 (WI)
<br />CLE-006319917-01
<br />2,000,000
<br />10,000,000
<br />WLRC64618945 (CA,MA)
<br />X
<br />43575
<br />10,000,000
<br />SIR
<br />of Marsh USA Inc.
<br />Attn: NBCU.Certrequest@marsh.com Fax 212-948-5143
<br />N
<br />X
<br />SIR: $100,000
<br />12/01/2017
<br />Agri General Insurance Company
<br />1
<br />12/01/2018
<br />12/01/2017
<br />20702
<br />12/01/2018
<br />12/01/2018
<br />ISAH09063407
<br />Excess Workers Compensation
<br />B
<br />25,000,000
<br />4,900,000
<br />WLRC64618969 (TN)
<br />20699
<br />Indemnity Ins Co Of North America
<br />2,000,000
<br />X
<br />A
<br />X
<br />existing insurance and limited to liability arising out of the operations of the named insured and where required by written contract.
<br />08/29/2018
<br />5,000,000
<br />12/01/2017
<br />2,000,000
<br />12/01/2017
<br /> NBCUniversal Media, LLC subsidiaries include, but are not limited to: National Center for Safety Initiatives LLC DBA Southeastern Security Consultants Subsidiary of SportsEngine
<br />
<br />X
<br />12/01/2017
<br /> Hillsborough, NC 27278
<br /> Orange County North Carolina
<br />ACE Fire Underwriters Ins. Co.
<br />Orange County North Carolina is included as additional insured (except workers’ compensation) where required by written contract with the Named Insured. This insurance is primary and non-contributory over any
<br />X
<br />A
<br />D
<br />ACE Property And Casualty Ins Co
<br />298523-NBCU-CAS.-17-18
<br />Ea Acc/Dis Employee/Dis Policy
<br />10,000
<br />12/01/2018
<br />10,000,000
<br />XOO G27924840 003
<br />A
<br />6,000,000
<br />22667
<br />4,900,000
<br />2,000,000
<br />12/01/2018
<br />WLRC64618933 (AOS)
<br />1717 Arch Street
<br />Marsh USA Inc.
<br />X
<br />Philadelphia, PA 19103-2797
<br />a fully owned subsidiary of Comcast Corporation
<br />NBCUniversal Media, LLC
<br />New York, NY 1011230 Rockefeller Plaza
<br />X
<br />WCUC64618970
<br />12/01/2017
<br /> 200 South Cameron Street
<br />12/01/2017
<br />12/01/2017
<br />A
<br />12/01/2018
<br />42757
<br />12/01/2018
<br />ACE American Insurance Company
<br />DocuSign Envelope ID: 1D11AAED-9FD9-4DE1-A02D-53C80F1EFCFC
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