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<br />'03/18/2005 15:52 FAX 16305980476 <br /> <br />ALLEN J FLOOD <br /> <br />~004 <br /> <br />.z=r. <br />AAIC <br />AMI.1cM ..ruUva.......... Cort-dlon <br />5$5 Cdlqe Road Ealt <br />~ Pffn121M N.J. 08Ul.5212 <br /> <br />MEMBER CERTIFlCA TE <br />COMMERCIAL GENERAL LIABILITY <br /> <br />\ <br /> <br />.i;lli'l'il'fo;tm'F6RMS;;um;IDilj)' "'liiiroms'c1lBmlbii:tEiit'ti. ...... ,,, <br />form H Edition DII,tc Fonn Natn~ <br />CL 2000 (01/96) Common Poli~y Dee <br />lLOO17 (\J 98) Common Policv Conditions <br />GUOOO.. 01196) GL Covemllc Part Dec. <br />VLCWOl (05/96) Sign.o.rure Endot"$ernc:nt <br />CG 00 01 1001 Commercial General Liabihrv Covera,Qc Fonn <br />CG 00 62 1202 EXl;!u5ion- War Liabilitv <br />CG OJ 99 1093 JJ1iooi~ Chanac5 <br />CG 02 00 0487 Illinois Chanlilcs - CUlccllation And NOI1.Renewat <br />CG 21 35 1001 E'tclu5ion~ COVCfllllC C- Medical Payments <br />CG 21 46 0798 I Exclusion- Abwc 01 Molestation <br />CG 21 47 0798 Exclwilon- EmoloYmcnt Related Practice! <br />CG 2149 0999 Exclusion- Total Pollution <br />CG 21 67 0402 Exelusion- Fun~i Or Blac1c:ri1l <br />CG 21 75 1202 Exclusion ~Ccrtificd Acl~ Of T crrori:trn And Other Acts Ofr errorism <br />GL Z004 II/OJ Exclusion- Asbestos <br />GL2005 1lI03 Exclmllon- Lead <br />IL 00 21 0487 Exclusion- Nuclear En~r8Y LiabilJ!r_ <br />SRGLlOO 0804 Menl~1' Cel;1ificatc - Commercial General Liability <br />SRGLIOI 0804 tIlred D.rtd Non-Owned Automobile Liability <br />SROL102 0804 A$sociation Amendatorv <br />SRGLl 03 0804 Condition Monthly R.Dortmg . <br />SRGLlO4 0604 COJJditi,on - Umc:iC;rved Sc:atiD2. <br />SRGL 105 0804 Condition - Wuivcr and Relcl\sC <br />SRGLI06 0804 Contin~wofCover~e <br />SRGLl 07 0804 Exc1usil)n- A_reraft, AutOs or Watcn::Il\f1: <br />SRGLl 08 0804 Exclusion- ColJao5e of T ~1lIT Structures <br />SRGLI09 0804 Exclusion- Desie.nated CJperations or Acti'\litic~ <br />SRGL I 10 0804 Exclusion- Expected Or Intended TniuT'V <br />SRGLIII 0804 Exclusion- Hecatitis TSE: mv, un. v or AIDS <br />SRGLl12 0804 -LExel.u$\OO- Profelj,ional Liability <br />SRGLI13 0804 I Exclusion- Pyrotechnics <br />IIIlI UlrIISIf F-. AIlI EllUlfMlllJs APPU:Aaf II .. lDTJlCAII AT IUllE II . "'1lIl/l8 fir ....... till .. AM1lIIII <br />.II1II....... my h8VI _ '-d III8r lIlI r.... or llIII nMIl1c11J II Y1IL To...... VlllIID8111 _ _18' II I'8lIIV8 8 <br /> or 1lI8 "Y. 8IIn8 cullllct lJII.................... <br /> <br />SRGL100 (08104) <br /> <br />CopyrighI200' AlTI6tk:J" Altom.,tj~ I05urlilnCll Corporllll6n <br />Includlls copyrighted material 0' tho InSUnlnC8 S8Nice5 Office. lne. wI!h lis pArl"l'llnloR. <br /> <br />AS TO f'Uh.<> <br />APPROVED ._ <br /> <br />~+') <' l> ______. <br />-:~~,z<< 'It Sheedy <br />La-ld L. '.' A.ttorney <br />AssisU:.\IlL L <br /> <br />Page 3 of 4 <br />