DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 05/06/2025
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 have ADDITIONAL INSURED provisions or 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 CONTACT Guilian Lin
NAME:
Maximus Insurance Brokerage LLC PHONE (718) 972-8808 FAX (718) 972-8811
(A/C, No, Ext): (A/C, No):
4315 8th Ave E-MAIL
[email protected] ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
Brooklyn NY 11232 INSURER A : United States Liability Insurance Co 25895
INSURED INSURER B : Knightbrook Insurance Company 13722
Tyson Express Inc INSURER C : Clear Spring Property & Casualty Company 15563
226 Bridge St INSURER D : Travelers Porperty Casualty Co Of America
INSURER E : Upland Specialty Insurance Company
Metuchen NJ 08840 INSURER F :
COVERAGES CERTIFICATE NUMBER: CL255506784 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.
INSR ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED 100,000
CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $
MED EXP (Any one person) $ 5,000
A GL 1094051D 05/06/2025 05/06/2026 PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
PRO- Included
POLICY JECT LOC PRODUCTS - COMP/OP AGG $
OTHER: Blanket AI Including WOS $ 1,000,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
(Ea accident)
ANY AUTO BODILY INJURY (Per person) $
B OWNED SCHEDULED KBQRS0000146-01 05/06/2025 05/06/2026 BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY (Per accident)
Trailer Interchange $ $40,000
UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 500,000
E EXCESS LIAB CLAIMS-MADE XTL061464 05/06/2025 05/06/2026 AGGREGATE $ 500,000
DED RETENTION $ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000
C OFFICER/MEMBER EXCLUDED? Y N/A CSWC03814901 11/05/2024 11/05/2025
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000
Cargo $100,000
Motor Truck Cargo
D 660B1142064 03/25/2025 03/25/2026 Ded $2,500
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Assure Assist ACCORDANCE WITH THE POLICY PROVISIONS.
543 Country Club Dr, Unit B338
AUTHORIZED REPRESENTATIVE
Simi Valley CA 93065
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
