X X X A- LOCKTON COMPANIES, INC. 1185 AVENUE OF THE AMERICAS, STE. 2010, NY, NY 10036 B- AON/ALBERT G. RUBEN & CO., INC. 15303 VENTURA BL., SUITE 1200, SHERMAN OAKS, CA WOODRIDGE PRODUCTIONS, INC. MISC EQUIP/PROPS SETS, WARD/3RD PARTY PROP DMG/VEH PHYS DMG THE BLACKLIST X X CERTIFICATE OF LIABILITY INSURANCE CLL 6404745-02 11/1/2012 11/1/2013 CA 6404746-02 11/1/2012 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: TOKIO MARINE & NICHIDO FIRE INS. CO., LTD INSURER B: FIREMAN S FUND INSURANCE COMPANY 11/1/2013 MPT 07109977 8/1/2012 8/1/2013 1,000,000 LIMIT DATE (MM/DD/YYYY) HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES ELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED EPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. MPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to he terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the ertificate holder in lieu of such endorsement(s). DUCER URED CONTACT NAME PHONE (A/C, No, Ext): E-MAIL ADDRESS: INSURER C: FAX (A/C, No): 10202 W. WASHINGTON BLVD. CULVER CITY, CA. 90232 INSURER D: INSURER E: INSURER F: OVERAGES CERTIFICATE NUMBER: 101642 REVISION NUMBER: HIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS ERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, XCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. GENERAL LIABILITY TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS UMBRELLA LIAB EXCESS LIAB SCHEDULED AUTOS NON-OWNED AUTOS OCCUR CLAIMS-MADE DED RETENTION WORKERS COMPENSATION AND EMPLOYERS LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below ADDL SUBR INSR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) CRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE E CERTIFICATE HOLDER IS ADDED AS AN ADDITIONAL INSURED AND/OR LOSS PAYEE, AS APPLICABLE, BUT ONLY AS SPECTS PREMISES/VEHICLES AND EQUIPMENT LEASED/RENTED BY THE NAMED INSURED IN CONNECTION WITH THE LMING ACTIVITIES OF THE PRODUCTION ENTITLED THE BLACKLIST. LIMITS PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) EACH OCCURRENCE AGGREGATE WC STATU- TORY LIMITS E.L. EACH ACCIDENT OTH- ER E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT 07/17/13 1,000,000 1,000,000 10,000 1,000,000 2,000,000 1,000,000 1,000,000 RTIFICATE HOLDER BUDD LEASING, LTD GRAND CENTRAL STATION BOX 2254! NEW YORK, NY 10163 CANCELLATION 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 ORD 25 (2010/05) 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
Allen, Louise From: Sent: To: Subject: Attachments: Gina Roche [ginajonesroche@yahoo.com] Wednesday, July 17, 2013 5:36 PM Shao, Misara; lgyson@earthlink.net; Au, Aaron; Barnes, Britianey; Doris Jurado; Michael Glees; Luehrs, Dawn; Allen, Louise; Zechowy, Linda The Blacklist- Cert & Contract - Budd Leasing BuddLeasingAgreement.pdf; BuddLeasing-Blacklist.pdf Hi all, Please see the attached fully executed contract and COI for Budd Leasing. Thanks! Gina Roché Asst. Production Coordinator "The Blacklist" Chelsea Piers, Pier 62, Suite 305 New York, NY 10011 646-561-0490 (C) 917-533-6387 ginajonesroche@yahoo.com 1
Allen, Louise From: Sent: To: Subject: Allen, Louise Wednesday, July 17, 2013 11:15 AM 'Gina Roche'; Shao, Misara; Zechowy, Linda; Barnes, Britianey; Luehrs, Dawn; Leslie Gyson RE: Budd Leasing Agreement / "The Blacklist" The blanks in sections 1 to 3 of the agreement still need to be completed. Please send us a copy signed by both parties for our files with all the blanks filled in. You can issue a standard cert. Thanks, Louise From: Gina Roche [mailto:ginajonesroche@yahoo.com] Sent: Tuesday, July 16, 2013 4:33 PM To: Shao, Misara; Allen, Louise; Zechowy, Linda; Barnes, Britianey; Luehrs, Dawn; Leslie Gyson Subject: Re: Budd Leasing Agreement / "The Blacklist" Please see the attached standard form signed by Budd Enterprises. Please let me know that I am OK to issue a COI. Thanks Gina Roché Asst. Production Coordinator "The Blacklist" Chelsea Piers, Pier 62, Suite 305 New York, NY 10011 (C) 917-533-6387 ginajonesroche@yahoo.com From: "Shao, Misara" <Misara_Shao@spe.sony.com> To: "ginajonesroche@yahoo.com" <ginajonesroche@yahoo.com>; "Allen, Louise" <Louise_Allen@spe.sony.com>; "Zechowy, Linda" <Linda_Zechowy@spe.sony.com>; "Barnes, Britianey" <Britianey_Barnes@spe.sony.com>; "Luehrs, Dawn" <Dawn_Luehrs@spe.sony.com>; Leslie Gyson <Lgyson@earthlink.net> Cc: "Shao, Misara" <Misara_Shao@spe.sony.com> Sent: Tuesday, July 16, 2013 2:28 PM Subject: FW: Budd Leasing Agreement / "The Blacklist" Will they sign our form? From: Gina Roche [mailto:ginajonesroche@yahoo.com] Sent: Tuesday, July 16, 2013 11:13 AM To: Shao, Misara Cc: Allen, Louise; Zechowy, Linda; Barnes, Britianey; Luehrs, Dawn; lgyson@earthlink.net Subject: Budd Leasing Agreement / The Blacklist 1
Hi Misara & Risk Group, Please see the attached agreement from Budd Leasing. We will be renting an open top truck with lift gate. Please let me know when it's clear to sign. Thanks and regards, Gina Roché Asst. Production Coordinator "The Blacklist" Chelsea Piers, Pier 62, Suite 305 New York, NY 10011 (C) 917-533-6387 ginajonesroche@yahoo.com 2