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Home My WebLink About1977 TOWN OF SOUTHOLD PERMIT FOR PUBLIC DISPLAY OF FIREWORKS I, JUDITH T_ TERRY, Town Clerk,of the Town of Southold, Suffolk County, New York, being an officer duly designated by the Town Board of the Town of Southold for this purpose, DO HEREBY GRANT TO Beach Court Association A PERMIT FOR THE PUBLIC DISPLAY OF FIREWORKS by said organization in accordance with the provisions of Section 405.00 of the Penal Law of the State of New York, on July 4, 1977 at 9:00 P.M. Rain Date: July 5, 1977 at 9:00 P.M. at the time and place set forth in the application therefor. ON CONDITION THAT the bond (indemnity insurance) required shall ~~ continue in full force and effect in favor of the Town of Southo DATED at SOUTHOLD, New York, this 31st day of MaY 197rj. ~tGL~~ l~ ~ ~~~9/` JUDITH T. TERRY, To Clerk Town of Southold, Suffolk County, New York. `S E A L __ _ _ _ J D~~~ ~.` c ~~. ,,,~ ~~ s ~~~ ~~~ ~~ , _ \ T_ ~ ~' _ - -} ~~ l~~~~ _____w_~_.~n__ ~_._.. ~~ ~__________- ~..w.._._.~.~ T ~v.4 ~w 1 a,o o ,- _.. _ - ---,_.~~. ~'~„_ FjRI t~ AJPt~~, O vet NA~Q ~ ~ ., 1 ~ ~ ~ ~ ~ F ~~ a P~E'a~ls ttite~~ ~,~ ~ fur f~~c~+t ~r`'~'~•~~ ~ ~ ~ ~~4eil ~ ~' ~~ n1E . ~ ~ ~ ~' F pR(L L F~ ou4. ---pt1R ~i r-- ~~.~~.,. ~.._ --~- ~ ?ARC 6 ~~~r ~~° e`~. APPLICATION T0: JUDITH T. TERRY, TOWN CLERK, TOWN OF 50UTHOLD APPLICATION IS HEREBY MADE, pursuant to the pro- visions of Section 405.00 of the Penal Law of the State of New York, for a permit to display fireworks as hereinafter speci~fined: ~`, The display is to be sponsored by f~-~~E'~ ~^'"`'~'~ with principal office at ~ LU1~' ~'~'1 ~w New York, and will be held on qti,~ ay ~ mon h 19 'l'I at P.M. hour RAIN DATE: ,j I °1 ~ ~ The following persons are to be in charge of the actual shooting of the fireworks: Name Age fiti o ~, ,~ ~ ~! hi~i t",Q. 3 ~ (•\o /3 P,1 f~rstivi~ ~/ GR~r,~~ ~c.4~~i.~R 3i Experience ~ ~ YP~2s !7 `~P~4R3 ~~ y~.~R~ sical Condition G~~~J C4~~~~ G~~~f~ Number and type of fireworks is as follows: APP(~ox~,~„4Te JVe• - ioa-pis The fireworks will be stored in a covered truck prior to the shooting on the grounds. Attached hereto and made a part hereof is a diagram of the grounds on which the display is to be held. Also attached is the certificate or policy of insurance coverage. Respectfully submitted, n~a~me oQ,f, org/an/izat/i/"off By ~!~. l~rJ~_x-~~ Dated: `1Ma-~ 3~i ~5 ~ 7 at ~c9+-~~'~-S~t-/ New York. -, t J ~ Royal- Globe Insurance •• COri1 F'ANL ES EXECUTIVE OFiICE 150 WILLIAM STREET NEW YORK, NEW YORK 100Je SELECT-COVER POLICY (General Provisions) G3o~~~a ~16~~ac~rr SH I RLEY WEXLER ~ J~ .fie S'.u1ie - e SOUTHHOLD AREA CODE 201 ~ 35tS-0pbg /03 EAST HIGH STREET LONG ISLAND NY J BOUND BROOD, N. J. 08805 ._., These GENERAL PROYISIONS, the DECLARATIONS and the coverage PART(S) and endorsements referred to in the DECLARATIONS complete the contract of insurance. The company designated in the DECLARATIONS made a part hereof, (a stock insurance cempany, herein called the company), in consideration of the pay- ment of the Dremium, in reliance upon the statements in the DECLARATIONS, and subject to all the terms of this policy and its designated coverage PART(S), agrees with the named insured as follows and as contained in the PART(S) designated in the declarations. SUPPLEMENTARY PAYMENTS The company will pay, in addition to the applicable limit of liability (a) all expenses incurred by the company, all costs taxed against the insured in any suit defended by the company and ail interest on the entire amount of any judgment therein which accrues after entry of the judgment and before the company has paid or tendered or de- posited in court that part of the judgment which does not exceed the limit of the company's liability thereon; 16I premiums on appeal bonds required in any such suit, premiums on bonds to release attachments in any such suit for an amount not in excess of the applicable limit of liability of this policy, and the cost of bail bonds required of the insured because of accident or traffic law violation arising out of the use of any vehicle to which this policy applies, not to exceed $250 per bail bond, but the company shall have no obligation to apply for or furnish any such bonds; (c) expenses incurred by the insured for first aid to others at the time of an accident, for bodily injury le which this policy applies; (dl reasonable expenses incurred by the insured at the company's re- quest in assisting the company in the investigation or defense of any claim or suit, including actual loss of earnings not to exceed $25 per day. SPECIAL ADDITIONAL EXCLUSION The following exclusion modifies the provisions of the policy relating to ALL LIABILITY AND MEDICAL PAYMENTS INSURANCE OTHER THAN COMPREHENSIVE PERSONAL ANO FARMER'S COMPREHENSIVE PERSONAL INSURANCE. NUCLEAR ENERGY LIABILITY EXCLUSION (Broad Form) It is agreed that I. The policy does not apply: A. Under any Liability Coverage, to bodily injury or property dam- age (1) with respect to which an insured under the policy is also an insured under a nuclear energy liability policy issued by Nuclear Energy Liability Insurance Association, Mutual Atomic Energy Liability Underwriters or Nuclear Insur- ance Association of Canada, or would be an insured un~ der any such policy but for its termination upon exhaus- tion of its limit of liabilty; or f21 resulting from the hazardous properties of nuclear mate• riot and with respect to which (al any person or organiza- tion is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law amendatory lhereol, or (b) the insured is, or had this policy not been issued would 6e, entitled to indemnity from the United States of America, or any agency thereof, under any agree• ment entered into by the United States of America, or any agency thereof, with any person or organization. B. Under any Medical Payments Coverage, or under any Supple- mentary Payments provision relating to first aid, to expenses incurred with respect to bodily injury resulting from the haz• Cl 6790IC Page 1 _.. . as- ~ ..•'-.~,•,z ~-y~.°~ ~',l`m'~' ' ~p` wY a'w ~rv'~ `:a r .. *~,'~:'~~"x.....a__~..^_ *'.,,, ,.:.~-_~ ' '-a > .d.~,.,:t.~: _.v-,.......v..:..:.,.-......w . ,.. ~an7~_...r xp~l~i ardous properties of nuclear material and arising out of the operation of a nuclear facility by any person or organization. C. Under any Liability Coverage, to bodily injury or property dam- age resulting from the hazardous properties of nuclear mate- rial, if (1) the nuclear material (a) is at any nuclear Tacility owned by, or operated by or on behalf of, an insured or (b) has been discharged or dispersed therefrom; (2) the nuclear material is contained in spent fuel or waste at any time possessed, handled, used, processed, stared, transported or disposed of by or on behalf of an insured; or l3) the 6adily injury or property damage arises out of the fur- nishing by an Insured of services, materials, parts or equipment in connection with the planning, construction, maintenance, operation or use of any nuclear facility, Dut if such facility is Located within the United States of America, its territories or possessions or Canada, this ex- clusien t3) applies only to property damage to such nuclear facility and any property thereat. II. As used in this endorsement: "hazardous properties" includes radioactive, toxic or explosive properties; "nuclear material" means source material, special nuclear material or byproduct material; "source material; "'special nuclear material;' and "byproduct mate- rial" have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof; I quldt whech has beenyusedl oreexposed to Brad anon ~~da oudear reactor; "waste" means any waste material tl) containing byproduct mate• riot and (2) resulting from the operation by any person o! organiza- tion of any nuclear facility included within the dehmtian of nuclear lacility under paragraph (a) or (b1 thereof; "nuclear facility" means (a) any nuclear reactor, Ill se a tb) any equipment or device designed ar used tSYlrocesvng rating the isotopes of uranium or plutonium, t2r I or ack• or utilizing spent fuel, or t3) handling, processing P aging waste, (abrica- (c) any equipment or device used for the processir~B~an time ling or alloying of special nuclear material if ; d of the the total amount of such material in the cus r or device Insured at the premises where such equipmenF rams of is located consists of or contains more than 2 r 8 plutonium or uranium 233 or any combination Iliereof, qr more than 250 grams of uranium 235, lace re- (d) any structure, basin, excavation, premises or D P pared or used for the storage or disposal of waste, operationseconducted on suchhsite andtall premises usedcfor such operations; fo sustain "nuclear reactor" means any apparatus designed or used contain a 'nuclear fission in aself-supporting chain reaction or U critical mass of fissionable material; "property damage" includes all forms of radioactive cnritaminatlon of property. NEW YORK EXCEPTION: This exclusion does not apply to Automobile Liability Insurance in New York State. DEFINITIONS When trsed~ in this polity hnduding erdonements forming a Dart (21 jnured tat ~easil of the operations ha~re been complctedtor mimed herro0: UI when the portion of the work out of which the inlwy or amage d b a non or organiza- °automohile" means a land motor vehicle, trailer or semi-trailer do- signed for trml on public roads liixludin8 any mxhinery or apparatus altxhed lheretot. 6ul does rot indrde mobile equipment; "hed0y fajory" mean bodily injury, sickness or disease witained by any person wnwh ocwrs during Ue policy period, including death at any rime Rsullma itkrthom; 'teeyMM epenWas b7art' iKludet !edify loiury aril property taaate ar»mg out Ot egtraUOr,s a re4antt cpon a represenlatwn or wxrasry aside al ser t+me w.t! rtsoeei tnnete~ bet only it the bodily iaAry a f+'+M+t/ testa Dews an.r saxs oo-rratcm tine been cmr• to ~+e Ymri ~~iraMsaw~ ~~+~.a pvri U reC-D awe tprasnW ra~xaxmKTM rl,rne+•Rh. Lta+ra<cm tiaKr ix det^r=ed ix+npar'/d't M tT,t err`<e'i! er tt.e ~'K'-r^~'c s:l wlme rA cgrarawna la b W+bmn/ lY as ~ 7-4rar d tsr aumwt a.urea rmbe set mrtdre4 tvwe au+m senWursna, arses haz been Cut to ds mtende use y rry De lien other than another contractor or subcontrxtor engaged in performing operatipn for a gincipal as a part of the same pro)ect. Operation which may require further service U maintenance work, or correction, rewir U reDixtment txtause of my detect or defiaency. but which are olnetwise complete. shall De deemed Completed. The completed operations huard does not Include beefy Injury or propert- damage easing out of r unless W dpent~om in tonneetwn fithdamage ui~aa+ot of ~ nor ~ m U tk hed,ly lajery o< grope b a+ a venzde utated br tee baC,ng or ca+baC~:.i t]rreoi, U =s Cat t9e ernttnu W taodti u~asla7W e•peiPax°e a +b+a'"s'"'~ tired as".n+ah. Y ill xYw+aa •:ma M ,MieA M rtavl tan51•rtd nyr gip' w tAe :ym:•+r7 s IwIW+iA q+yptrti "out" d H+~sY"'"uAS~- } ~ ' 1 v Aa 5A1tYFtY!rtiY'~a{awy,~f~,r? ~Myeq+r?w~+w ~4 nrtacn nrr rou,n n u ~ w ac ~, a ~~ .. ~~ "elevator" means any hoisting or lowering device to connect floors or landings, whether or not in service, and all appliances thereat includ- ing any car, platform, shaft, hoistway, stairway, runway, power equip- ment and machinery; but does not include an autamohile servicing hoist, cr a hoist without a platform outside a building if without mechanical power or if not attached to building walls, or a hod or material hoist used in alteration, construction or demolition operations, or an inclined conveyor used exclusively for carrying property or a dumbwaiter used exclusively for carrying property and having a compartment height not exceeding tour feet. "incidental contract" means any written (1) lease of premises, (2) easement agreement, except in connection with construction or demoli- tion operations on or adjacent to a railroad, t3) undertaking to indemnify a municipality required by municipal ordinance, except in connection with work far the municipality, l4) sidetrack agreement, or (bl elevator maintenance agreement; "insured" means anv person ar organization qualifying as an insured in the "Persons Insured" provision of the applicable insurance coverage. The insurance afforded applies separately to each insured against whom claim is made or suit is brought, except with respect to the,limils of the company's liability; "mobile equipment" means a land vehicle (including any machinery or apparatus attached thereto), whether or not self-propelled, tl) not subject to motor vehicle registration, or t2) maintained for use exclu- sively on premises owned by or rented to the named insured, including the ways immediately adjoining, or (3l designed for use principally off public roads, or (41 designed or maintained for the sole purpose of affording mobility tc equipment of the following types forming an in- tegral part of or permanently attached to such vehicle: Dower cranes, shovels, loaders, diggers and drills; concrete mixers (other than the mix~in-transit type); graders, scrapers, rollers and other road construc- tion or repair equipment; air-compressors, pumps and generators, in- cluding spraying, welding and building cleaning equipment; and geo- physical exploration and well servicing equipment; "named insured" means the person or organization named i2 Item 1.. of the declarations of this policy; "named insured's products" means goods or products manufactured, sold, handled or distributed by the named insured or by others trading under his name, including any container thereof (other than a vehicle). but "named insured's products" shall not include a vending machine or any property other than such container, rented to or located for use of others but not sold; "occurrence" means an accident, including continuous or repeated exposure to conditions, which results in bodily injury or property damage neither expected nor intended from the standpoint of the insured; "policy territory" means: ll) the United States of America, its territories or possessions, or Can- ada, or 121 international waters or air space, provided the bodily injury or prop- erty damage does not occur in the course of travel or transportation to or from any other country, state or nation, or 131 anywhere in the world with respect to damages because of bodily injury or property damage arising out of a product which was sold for use or consumption within the territory described in paragraph (]) above, provided the original suit for such damages is brought within such territory; "products hazard" includes hodily injury and property damage arising out of the named insured's products or reliance upon a representation or warranty made at any time with respect thereto, but only if the hodily injury or property damage occurs away from premises owned by or rented to the named rnsured and after physical possession of such prod- ucts has been relinquished to others; "property damage" means (1) physical injury to or destruction of tangi- ble properly which occurs during the policy period, including the loss of use thereof at any time resulting therefrom, or (2) loss of use of tangible property which has not been physically injured or destroyed provided such loss of use is caused 6y an occurrence during the policy pertod. CONDITIONS 1. Premium All premiums for this policy shall be computed in ac- cordance with the company's rules, rates, rating plans, premiums and minimum premiums applicable to the insurance afforded herein. Premium designated in this policy as "advance premium" is a deposit premium only which shall be credited to the amount of the earned pre- mium due at the end of the policy period. At the close of each period (or part thereof terminating with the end of the policy period) designated in the declarations as the audit period the earned premium shall he com- puted for such period and, upon notice thereof to the named insured, shall become due and payable. If the total earned premium for the policy period is less than the premium previously paid, the company shall return to the named insured the unearned portion paid by the named insured. The named insured shall maintain records of such information as is necessary for premium computation, and shall send copies of such records to the company at the end of the policy period and at such times during the policy period as the company may direct. 2. Inspection and Audit The company shall be permitted but not obli- gated to inspect the named insured'S property and operations at any time. Neither the company's right to make in- spections nor the making thereof nor any report thereon shall constitute an undertaking, on behalf of or for the benefit of the named insured or others, to determine or warrant that such property or operations are safe or healthful, or are in compliance with any law, rule or regulation. The company may examine and audit the named insured's books and records at any time during the policy period and extensions thereof and within three years after the final termination of this policy, as far as they relate to the subject matter of this insurance. 3. Financial Responsihility Laws When this policy is certified as proof of financial responsibility for the fu- ture under the provisions of any motor vehicle financial responsibility law, such insurance as is afforded by this policy for bodily injury lia- bility or for property damage liability shall comply with the provisions of such law to the extent of the coverage and limits of liability required by such law. The insured agrees to reimburse the company for any pay- ment made by the company which it would not have been obligated to make under the terms of this policy except for the agreement contained in this paragraph. 4. Insured's Duties in the Event of Occurrence, Claim or Suit (a) In the event of an occurrence, written notice containing particulars sufficient to identify the insured and also reasonably ohtainable information with respect to the time, place and circumstances thereof, and the names and addresses of the injured and of availa- ble witnesses, shall be given by or for the insured to the company or any of its authorized agents as soon as practicable. (b) If claim is made or suit is brought against the insured, the insured shall immediately forward to the company every demand, notice, summons or other process received by him or his representative. (cl The insured shall cooperate with the company and, upon the com- pany's request, assist in making settlements, in the conduct of suits and in enforcing any right of contribution or indemnity against any person or organization who may be liable to the insured be- cause of injury or damage with respect to which insurance is afforded under this policy; and the insured shall attend hearings and trials and assist in securing and giving evidence and obtaining the attendance of witnesses. The insured shall not, except at his own cost, voluntarily make any payment, assume any obligation or incur any expense other than for first aid to others at the time of accident. 5. Action Against Company No action shall lie against the company unless, as a condition precedent thereto, there shall have been full compliance with all of the terms of this policy, nor until the amount of the insured's obligation to pay shall have been finally determined either by judgment against the insured after actual trial or by written agreement of the insured, the claimant and the company. Any person or organization or the legal representative thereof who has secured such judgment or written agreement shall thereafter be entitled to recover under this policy to the extent of the insurance afforded by this policy- No person or organization shall have any right under [his policy to join the company as a party to any action against a w9otc Page 3 the insured to determine the insured's liability, nor shall the company 6e impleaded by the insured or his legal representative. Bankruptcy er insolvency of the insured or of the insured's estate shall not relieve the company of any of its obligations hereunder. 6. Other Insurance The insurance afforded by this policy is primary insurance. except v+hen slated to apply in excess of or contingent upon the absence of other insurance. When this irv surance is primary and the insured has other insurance which is stated to be applicable to the loss on an excess or contingent basis. the amount of the company's liability under this policy shall not be reduced by the existence of such other insurance. When both this insurance and other insurance apply to the loss on the same basis, whether primary, excess or contingent, the company shall not be liable under this policy for a greater proportion of the loss than that stated in the applicable contribution provision below: (a) Contribution by Equal Shares. If all of such other valid and col- lectible insurance provides for contribution by equal shares, the company shall not be-liable for a greater proportion of such loss than would he payable if each insurer contributes an equal share until the share of each insurer equals the lowest applicable limit of liability under any one policy ar the full amount of the loss is paid, and with respect to any amount of loss not so paid the re- maining insurers then continue to contribute equal shares of the remaining amount of the loss until each such insurer has paid its limit in full ar the full zmount of the to=_s is paid. Ibl Contribution by Limits. If any of such other insurance does not provide for contribution by equal shares, the compzny shall not be liable for a greater proportion of such loss than the applicable limit of liability under this policy for such loss bears to the fatal applicable limit of liability of all valid and collectible insurance against such loss. 1. Suhregation In the event of any payment under this policy, the company shall 6e subrogated to all the insured's rights of recovery therefor against any person or organization and the insured shall execute and deliver instruments and papers and do whatever else is necessary to secure such rights. The insured shall do nothing after loss to prejudice such rights. 8. Changes Notice to any agent or knowledge possessed by any agent or by any other Derson shall not effect a waiver or a change in any part of this policy or estop the company from asserting any right under the terms of this Dolicy; nor shall the terms of this policy be waived or changed, except by endorsement issued to form a part of this policy. 9. Assignment Assignment of interest under this policy shall not bind the company until its consent is endorsed here on; i( however, the named insured shall die, such insurance as is a4 forded by this Dolicy shall apply U? to the named insured's Legal repre- sentative, as the named insured, buf only while acting within the scope of his duties as such, and 12) with respect to the property of the named insured, to the person having proper temporary custody thereof, as in- sured, but only until the appointment and qualification of the legal representative. 70. Three Year Policy If this policy is issued for a period of three years any limit of the company's liability stated in this policy as "aggregate" shall apply separately to each consecutive annual period thereof. 11. Cancellation This policy may be cancelled by the named insured by surrender thereof to the company or any of its authorized agents or by mailing to the company written notice stating when thereafter the cancellation shall be effective. This Dolicy may be cancelled by the company by mailing to the named insured at the ad- dress shown in this Dolicy, written notice stating when not less than ten days thereafter such cancellation shall be effective. The mailing of notice as aforesaid shall be sufficient proof of notice. The time of sur- render or the effective date and hour of cancellation stated in the notice shall become the end of the policy Deriod. Delivery of such written notice either by the named insured or 6y the company shall be equivalent to mailing. If the named insured cancels, earned premium shall be computed in accordance with the customary short rate table and procedure. If the company cancels. earned premium shall be computed Dro rata. Premium adjustment may be made either at the time cancellation is effected or as soon as practicable after cancellation becomes effective, but payment or tender of unearned premium is not a condition of cancellation. 72. Declarations By acceptance of this Dolicy, the named insured agrees that the statements in the declarations are his agreements and representations, that this policy is issued in reliance upon the truth of such representations and that this policy embodies all agreements existing between himself and the company or any of its agents relating to this insurance. In Witness Whereof, the company has caused this policy to be executed and attested, but this policy shall not 6e valid unless countersigned on the declarations page by a duly authorized representative of the company. ,,~ «~ ~i ~' Corporate Suretorp President/U.S. Afanager CANCELLATION CONDITION-AMENDMENT OF FIRST PARAGRAPH Applicable to policies issued or delivered in Michigan It is agreed that with respell to the "Czncellation" provisions of the policy: 1. The words "at the address shown in this policy", appearing in the first paragraph of the "Cancellation" Condition, are amended to read "at his address last known to the tympany ar its authorized agent". 2. The provisions (if forming a part of the policy) of the endorsement entitled "Amendment of Termination Provisions (Michigan)" apply as stated therein. 3. The provisions, if any, forming a part of the policy which (hy endorsement or otherwise) amend the "Cancellation" provisions of the policy other than as stated or designated in this endorsement are deleted. A 0002 G 503 'CL 6i901C Page 4 SELECT-COVER POLICY ROYAL-GLOBE INSURANCFr C0.M-ANIES cGMPANY' These DECLARATIONS when combined-wish-iAaGENERAL PROVISIONS and the corerage PART(S) and endorsements lesignated $YMBO~. POLICY NUMBER herein, complete the contract of insurance numbered below. Coverage is provided by the Company tlesigoaled by eotry of N rl.u 4 0 7 5 p Q "X" before the eoolpny name. RENEWAL Y J PcoDENUMBER• C I 01.2+ OFNVMBER•r N~~ I~~' ag 86 ~ ^ Royal Indemnity Company ^ Royal Globe Insurance Company ^ Globe Indemnity Company ^ Safeguard Insurance Company ~ SHIRLEY WEXLER ~ ' uEMEO SOU7HHOLD ' INSURE06 LONG ISLAND NY ' ADDRESS ~ I ® Newark Insurance Company ^ American and Foreign Insurance Company KISSEL AGENCY REM 2. POLICY PERIOD 12:01 A.M. Standard time at the BUSINESS OF THE NAMED INSURED 7~4~77 7~5~77 address of the Named Insured as From To stated in Item 1 THE NAMED INSURED I& ® Individual ^ Partnership ^ Corporation Joint Venture ^ Other LOCATION OF ALL PREMISES OWNED, RENTED OR CONTROLLED BY THE NAMED INSURED PART OCCURFD IMSWEa'a INEERE$i BY OWNED. IENAXI, CFML (ENTER "SAME" IF SAME LOCATION AS ABOVE ADDRESS( NMIFB INSURFe [LESSEE. OiXER SPECIFY SANS Rtu o. T6.. :., ...,. erln.a ed .e nnlo Wifh rn nrf fn aunh nfEhA }M lnwinv cnvera PP Pa ref it ac are indicated by entN Of an "X" below. ^ Put l-Comprehensive General Liability Insurance ^ Put6-Comprehensive Personal Insurance ^ Part 11-Automobile Medical Payments Insurance ^ Put 2-Manufacturers' and Contractors' Liability Insurance ^ Part 1-Owners' and Contractors' Protective liability Insurance ^ Part 12-Protection Against Uninsured Motorists Insurance ® Par13-Owners'Landlords'and Tenants' - Liability Insurance ^ Putd-Contractual liability Insurance ^ Part 13-Automobile Physical Damage Insurance ^ Part 4-Completed Operations and - Products Liability Insurance ^ Put 9-Comprehensive Automobile Liabibty Insurance ^ Part 14-Basic Auto Liability Insurance ^ Put S-Premises Medical Payments Insurance - ^~ Part 10-Carage Insurance -; ^ Pari 15-Automobile Physical Damage Ihsu ranee fDealersl~ ' (SPECIFY PART N0. & TITLE) REM3b. The insurance afforded is only with respect to such of the following eorerage(s), contained in the coverage Part(sl designated above, as are indicated by specific premium charge or charges. The limit of the company's liability against each such corerage shall be as stated herein, subject to all the terms of the policy hating reference thereto. APPLICABLE LIMITS OF LIABILITY AOVANGE TO PARTS COVERAGES EACN PERSON EACH OCCURRENCE• AGGREGATE PREMIUM i thmugh5 Bodily injury Liability X X X X X D XXXX $ DD Other th property Damage Liability X X X X X $ an Automobile Premises Medical Payments X X X X X X $ g Bodily Injury Liability X X X X X X $ (Automobile) property Damage liability X X X X X X X X X X X $ Other See Applicable Coverage Part $ LSDORSNAFNiS aNACNEp At OME pF I$$VE NOT APPLICABLE IN TEXAS pplicy period ¢ more than II one year, premum rs payable Ef FECTIVE DATE $ 1st ANNIVERSARY $ Pna ANNIV ER$ARY $ Total Advance Premium g ']5•DD EACH ACCIDENT AS RESPECTS 'PREMISES MEDICAL PAYMENTS" Countersigned by 6]np2 E __ __ . - ~' etwottsexaurr Qyn°«°,< \~ This rndorsement is issued for attachment to and is hrrcb)~ malea part of [he policy designated below and is effective as of the date and hour indicated, stavdard time at [he address ni the named insured ~s stated in the poliq•. VoliaT Number Name of CompaR7 n orseraent (Month, ar. cart Edeeti.e NLU407590 NEWARK INSURANCE COMPANY Ingle 5-25-77 Nxmed Inured Addrboml Pmlum ~ Retum Premium Shirlev Wexler & or Beach Court Association li nil ;s nil ERcctlee HOnr I Producer P onr e r 13:01 12:00 A.A[. ^ Noon Kissel Agency 1530124 IN CONSIDERATION OF THE PREMIUM CHARGES THIS POLICY IS EXTENDED TO COVER SECTION 405.00 OF THE PENAL LAW OF THE STATE OF NEW YORK. THE TOWN OF SOUTHOLD, LONG ISLAND, NEW YORK IS ALSO SHOWN AS AN ADDITIONAL INSURED. ALL else to remain the same. Nothing herein contained shall be held to waive, alter, vary or extend any of the terms or provisions of the policy, uecpt as herein stated, nor shall this endoreemnlt bind the company unless countersigned by a duly authorized representative of the company. Countersigned by: /~~l t Authorized Represents ' e PRESIDENT Fr1R hFF)/'F IICC lLVrv TRAN SgITI ON LI 5 EFF E%PIR to Tve[ so. e, DEPT LINE EORM CLq;; R.I, ,, o. F%POSURE TA% STATE TERR qU0 PER TERM uo. , vR. .o. . vx. 8.1. PREMIUM P, 0. PREMIUM 1 4 - I t- ~ _ _- __ _~_ _ _ T CL 20010)-200M 1-SB The following does not form a part of the poligr and is furnished for information only. DESCRIPTION OF TERMS USED AS PREMIUM BASES: When used as a premium basis: 1. "admissions" means the total number of persons, other than employees of the named. insured, admitted to the event insured or to events conducted on the premises whether on paid admission tickets, com- plimentary tickets or passes; (Comprehensive General; Owners', Landlords and Tenants') 2. ''cost" means the total cost to the named insured with respell To operations performed for the named insured during the policy period by independent contractors of all work let or sub-let in connection with each specific project, including the cost of all labor, materials and equipment furnished, used or delivered for use in the execution of such work, whether furnished by the owner, contractor. or_subcontractor, in- cluding all fees, allowances, bonuses or commissions made, paid or due; (Comprehensive General; Manufacturers' and Contractors';Owners', Landlords' and Tenants; Owners' and Contractors' Protective) 3. "receipts" means the gross amount of money charged by the named insured for such operations by the named insured or by others during the policy period as are rated on a receiptsbasis other than receipts from telecasting, broadcasting or motion pictures, and includes taxes, other than taxes which the named insured collects as a separate item and remits directly to o governmental division; (Comprehensive General; Manufacturers' and Contractors'; Owners', Landlords' and Tenants'; Completed Operations and Products) 4. "remuneration" means the entire remuneration earned during the policy period by proprietors and by all employees of the named insured, other than chauffeurs (except operators of- mobile equipment) and air' crafr pilots and co-pilots, subject to any overtime earnings or limitation of remuneration rule applicable in - accordance with the manuals in use by the company; (Comprehensive General; Manufacturers' and Contractors'; Owners', Landlords' and Tenants' which in- dudes coverage for structural alterations, new construction and demolition operations) . 5. "sales" -means the gross amount of money charged by the named insured or by others trading under his name for all goods and products sold or distributed during the policy period and charged during the policy period for installation, servicing or repair, and includes taxes, other than tuxes which The named insured and such others collect as a separate item and remit directly. to a governmental division;. (Comprehensive General; Completed Operations and Products) 6. "remuneration" means (a) the entire remuneration earned during The policy period by each Class A em- ployee and each Class C employee of the named insured, subject to an average weekly maximum of $100, and Ib) the remuneration of each Class B person aT a fined amount of $2,000 per annum with respect to Dealer Risks (Hazard 1) or $5,200 per annum with respell to Non-Dealer Risks (Hazard 21. "Class A" means all clerical office employees -"Class B" means all proprietors and officers active in the business, and inactive proprietors or officers (other than an inactive proprietor or officer who is a spouse of an active proprietor or officer] who customarily drive an automobile owned by the named insured; .and all salesmen, general managers, service managers and chauffeurs "Class C" means all other employees; (Garage Inwrance) _ 7. A. "cost of hire" means the amount incurred for (a) the hire of automobiles, including the entire remvnera- tion.of each employee of the named insured engaged in the operation of such automobiles subject to -- ~orraverage weekly maximum- remuneration of $100, and for (b) pick-up, transportation or delivery service of property or passengers, other than such services performed by motor carriers which are subject to the security requirements of any motor carrier low or ordinance. The rates for each $100 of "cost of hire" shall be 5 % of the applicable hired automobile rates, provided the owner of such __ hired automobile has purchased automobile Bodily Injury liability and Property Damage Liability .insurance covering_fhe interest of the named insured on a direct primary basis as respects such automobile and submits evidence of such insurance to The named insured; 6.'"'Class l persons" means the following persons, provided their usual :dutiei,7n the business of the named insured include the use of non-owned automobiles: (a) all employees, includ'irig officers, of the named insured compensated for the use of such automobiles by salary, commission, terms of employ- ment, or specific operating allowance of any sort; (b) all direct agents and representatives of the named insured; C. "Class 2 employees" means all employees, including officers, of the named insured, not included in Class 1 persons; , ~. (Comprehensive Automobile Liability) 8. "cusp' means the total cost to any indemnitee with respect to any contract which is insured of all work let ..~ ar sub-let in connection with each specific project, including the cost of all labor, materials ;and equipment ~ ~ furnished, used or delivered for use in the execution of such work, whether furnished by the owner; con- tractor or the subcontractor, including oll fees, allowances, bonuses or commissions made, paid or due. [Contractual Liability Insurance (Designated Contracts Only)] GENERAL LIABILITY WORKSHEET ROYAL-GLOBE INSURANCE COMPANIES HAZARDS 1. PREN1'ISES-OPERATIONS a) Area-per 100 square feet b) Frontage-per linear foot c) Remuneration-per $100. d) Receipts-per $100. e) Admissions-per 100 admissions f) Units-per unit 4. STRUCTURAL ALTERATIONS k) Remuneration-per $100. m) Cost-per $100. 5. PRODUCTS-COMPLETED OPERATIONS n) Sales-per $1000. p) Receipts-per $1000. 2. ESCALATORS g) Number insured-per landing 3. INDEPENDENT CONTRACTORS h) Cost-per $100. 6. CONTRACTUAL q) Number insured-per contract r) Cost-per $100. NAZ- ARD DESCRIPTION OE HAZARD 8 CODE PflEMIUM RATES ADVANCE PREMIUMS , N0. DASES• BI PD 81 PD F I REtJOR.KS EXHIBITIONS SPONSORS 00326 FL CH 75.00 'CODE 8 NUMBER Of UNITS, E.G. 100,000 SD. fT. OF AREA = a100,000 Totals S 75.00 ~ It DOlicy period is mo/e than one year, premium is payable as follo.vs: EFFECTIVE DATE S 1st C.NNIVERSARV I $ 2nd ANNIVERSP.RY Total Advance 5 Premium : 75 .00 .~ o/7u~H Part 3 ~ . Po•(u1-~toBF OWNERS', LANDLORDS' AND TENANTS' LIABILITY INSURANCE•• ROYAL-GLOBE INSURANCE COMPdNIES This coverage PART, the DECLARATIONS and other coverage PART(SI, er endorsements referred to herein, and the GENERAL PRDYISIDNS cetfiplete the rNSUnaxd° contract at insurance. \/a~,; COVERAGE FOR DESIGNATED PREMISES AND RELATED OPERATIONS IN PROGRESS INCLUDING STRUCTURAL ALTERATIONS, NEW CONSTRUCTION AND DEMOLITION I. COVERAGE A-BODILY INJURY LIABILITY COVERAGE B-PROPERTY DAMAGE LIABILITY The company will pay on behalf of the insured all sums which the insured shall become legally obligated to pay as damages because of Coverage A. bodily injury or Coverage B-. property damage to which this insurance applies, caused by an occurence and arising out of the ownership, maintenance or use of the insured premises and all operations necessary or incidental thereto, and the company shall have the right and duty to defend apy suit against the insured seeking damages on ac- count of'such bodily injury or property damage, even if any of the allegations of the suit are groundless, false or fraudu- lent, and may make such investigation and settlement of any claim or suit as it deems expedient, but the company shall not be obligated to pay any claim or judgment or to defend any suit after the applicable limit of the company's liability has been exhausted by payment of judgments or settlements. Exclusions This insurance does not apply: (a) to liability assumed by the insured under any contract or agreement except an incidental contract; but with respect to bodily injury or property damage occurring while work performed by or on behalf of the named insured is in progress, this exclusion does not apply to a warranty that such work will be done in a workman- like manner; (b) to bodily injury or property damage arising out of the ownership, maintenance, operation, use, loading or un- loading of (1) any automobile or aircraft owned or operated by or rented or loaned to any insured, or (2) any other automobile or aircraft operated by any person in the course of his employment by any in- sured; ,but this exclusion does not apply to the parking of an automobile on insured premises, if such automobile is not owned by or rented or loaned to any insured; (c) to bodily injury or Droperty damage arising out of (1) the ownership, maintenance, operation, use, loading or un- loading of any mobile equipment while being used in any prearranged or organized racing, speed or demolition contest or in any stunting activity or in practice or prep- aration for any such contest or activity or (2) the opera- tion or use of any snowmobile or trailer designed for use therewith; (d) to~bodily injury or property damage arising out of and in the course of the transportation of mobile equipment by an automobile owned or operated by or rented or loaned to any insured; (e) to bodily injury or property damage arising out of the ownership, maintenance, operation, use, loading or un- loading of (1) any watercraft owned or operated by or rented or loaned to any insured, or (2) any other watercraft operated by any person in the course of his employment by any insured; but this exclusion does not apply to watercraft while ashore on the insured premises; (f) to bodily injury or property damage arising out of the discharge, dispersal, release or escape of smoke, vapors, soot, fumes, acids, alkalis, toxic chemicals, liquids or gases, waste materials or other irritants, contaminants or pollutants into or upon land, the atmosphere or any water course or body of water; but this exclusion does not apply if such discharge, dispersal, release or escape is sudden and accidental; (g) to bodily injury or property damage due to war, whether or not declared, civil war, insurrection, rebellion or revo- lution or to any act or condition incident to any of the foregoing, with respect to (1) liability assumed by the insured under an incidental contract, or (2) expenses for first aid under the Supplementary Pay- ments provision: (h) to bodily injury or property damage for which the insured or his indemnitee may be held liable (1) as a person or organization engaged in the business of manufacturing, distributing, selling or serving al- coholic beverages, or (2) if not so engaged, as an owner or lessor of premises used for such purposes. if such liability is imposed (i) by, or because of the violation of, any statute, or- dinance or regulation pertaining to the sale, gift, distribution or use of any alcoholic beverage, or (ii) 6y reason of the selling, serving or giving of any alcoholic beverage to a minor or to a person under the influence of alcohol or which causes or contri- butes [o the intoxication of any person; but part (ii) of this exclusion does not apply with respect to liability of the insured or his indemnitee as an owner or lessor described in (2) above; (i) to any obligation for which the insured or any carrier as his insurer may be held liable under any workmen's com- pensation, unemployment compensation or disability benefits law, or under any similar law; (j) to bodily injury to any employee of the insured arising out of and in the course of his employment by the insured or to any obligation of the insured to intlemnify another because of damages arising out of such injury; but this exclusion does not apply to liability assumed by the insured under an incidental contract; (k) to property damage to (ll propertyowned or occupied by or rented to the in- sured, (2) property used by the insured, or (3) property in the care, custody or control of the in- sured or as to which the insured is for any purpose exercising physical control; but parts (2) and (3) of this exclusion do not apply with respect to liability under a written sidetrack agreement and part (3) of this exclusion does not apply with (e- sped to property damage (other than to elevators) aris- ing out of the use of an elevator at the insured premises; (I) [o property damage to premises alienated by the named insured arising out of such premises or any part thereof; (m) to loss of use of tangible property which has not been physically injured or tlestroyed resulting from (U a delay in or lack of performance by or on behalf of the named insured of any contract or agreement, or OLT Ed. 1.1.73 Over cLS~eo~a Continuaf'FromReverseS(de (2) the failure of the named insured's products or work performed by or on behalf of the named Insured to meet the level of performance, quality, fitness or durability warranted or represented by the named Insured; bu[ this exclusion does not apply to loss of use of other tangible property resulting from the sudden and acciden- tal physical injury to or destruction of the named in- sured's products or work performed by or on behalf of the named insured after such products or work have been Put to use by any person or organization other than an insured; (n) to property damage to the named insured's products arising out of such products or any part of such products; (o) to property damage to work performed by or on behalf of the named insured arising out of the work or any por- tion thereof, or out of materials, parts or equipment furnished in connection therewith; (p) to bodily injury or property damage included within the completed operations hazard or the products hazard; (q) to bodily injury or property damage arising out of oper- ations on or from premises (other than the insured premises) owned by, rented to or controlled by the named insured, or to liability assumed by the insured under any contract or agreement relating to such prem- ises. II. PERSONS INSURED Each of the following is an insured under this insurance to the extent set forth below: (a) if the named insured is designated in the declarations as an individual, the person so designated but only with respect to the conduct of a business of which he is the sole proprietor, and the spouse of the named insured with respect to the conduct of such a business; (b) it the named insured is designated in the declarations - as a partnership or joint venture, the partnership or joint venture so designated and any partner or member thereof but only with respect to his liability as such; (c) if the named insured is designated in the declarations as other than an individual, partnership or joint ven- ture,the organization so designated and any executive Officer, director or stockholder thereof while acting within the scope of his duties as such; (d) any person (other than an employee of the named in- sured) or organization while acting as real estate man- ager for the named insured. III. LIMITS OF LIABILITY Regardless of the number of (1) insureds under this ol- icy, (2) persons or organizations who sustain bodily In~ury or property damage, or (3) claims made or suits brought on account of bodily injury or property damage, the company's liability is limited as follows: Coverage A-The total liability of the company for all dam- eBes, including damages for care and Toss of services, because of bodily injury sustained by one or more persons as the re- sult of any one oceurence shall not exceed the limit of bodily injury liability stated in the declarations as applicable to "each occurrence'. Coverage B-The total liability of the company for all dam= ages because of all propertydamage sustained by one or more persons or organizations as the result of any one occurrence shall not exceed the limit of property damage liability stated in the declarations as applicable [o "each oceurence' . Subject to the above provisions respecting "each o~cur- rence,' the total liability of the company for all damages because of all property damage to which this coverage applies and arising out of and occurring in the course of structural alterations which involve changing the size of or moving buildings or other structures, new construction or demolition operations performed by or on behalf of the named insured (including any such property damage for which liability is assumed under any incidental contract relating to such operations) shall not exceed the limit of property damage liability stated in the declarations as aggregate." Coverages A and B-For the purpose of determining the limit of the company's liability, all bodily injury and prop- erty damage arising out of continuous or repeated exposure to substantially the same general conditions shall be cons~d- ered as arising out of one oceurence. IV. ADDITIONAL DEFINITION When used in reference to this insurance (including en- dorsements forming a part of the policy): "Insured promises" means (I) the premises designated in the declarations, (2) premises alienated by the named insured (other than premises constructed for sale by the named Insured), if possession has been relinquished to others, and (3) premises as to which the named insured acquires ownership or control and reports his intention to insure such premises under this policy and no other within 30 days after such acquisition; and includes the ways im- mediately adjoining such premises on land. This insurance does not apply to bodily Injury or Droperty dsmage arising out of the conduct of any partnership or joint venture of which the insured is a partner' or member and which is not designated in this policy as a named Insured. V. POLICY TERRITORY This insurance applies only to bodily Injury or property damage which occurs within the policy territory. - iz CL 6790BA ! , .tl~f~t, - ENDORSEMENT ~ ' plpl,=~~~ Type policy number only, in this section above the heavy I ~` _ aF in policy declarations. ~, Unless otherwise stated, this endorsement forms a part of the policy to which rN,TpRA~y4E attached as of issue, provided such attachment is stated in the policy declarations. ® Otherwise, this endorsement is issued for attachment to and forms a part of the policy numbered below, effective only on the date indicated on this endorsement but at the same time or hour of the day as the policy became effective. ~ ^ Add'I. Named Insured (and address, zip code, when necessary for mailing) AUTHORIZED REPRESENTATIVE $ ~ ~IYLU ~i(7 /, _ Producer Land address, zip code, fcr mailing) r L_ J ~ J THIS POLICY TO COVER FIREWORKS DISPLAY AT LOCATION LISTED IN ITEM #2 ON JULY 4, 1977 OR RAIN DAY JULY 5, 1977. CL 200290-Sets i I Y,, '„1 i .~~; y~ x~.4i sic