EXHIBIT A 

Case 21-14020-RAM Doc 177-1 Filed 01/28/22 Page 1 of 21
Florida Face Page

Insured's Name: Office, The; A&S Entertainment, LLC DBA

Policy Number: Z1JA16388302

UMR Number:

Policy Dates: 11/22/2015 to 11/22/2016

Surplus Lines Agent's Name: Alan S. Goldfarb

Surplus Lines Agent's Address: 510 Vonderburg Drive Suite 214, Brandon, FL 33511

Surplus Lines Agent's License Number: A099212

Producing Agent's Name: Frank Pettineo

Producing Agent's Physical Address: 2430 East Commercial Boulevard Fort Lauderdale, FL 33308

"THIS INSURANCE IS ISSUED PURSUANT TO THE FLORIDA SURPLUS LINES LAW. PERSONS INSURED

BY SURPLUS LINES CARRIERS DO NOT HAVE THE PROTECTION OF THE FLORIDA INSURANCE

GUARANTY ACT TO THE EXTENT OF ANY RIGHT OF RECOVERY FOR THE OBLIGATION OF AN

INSOLVENT UNLICENSED INSURER."

"SURPLUS LINES INSURERS' POLICY RATES AND FORMS ARE NOT

APPROVED BY ANY FLORIDA REGULATORY AGENCY."

Premium: $26,250.00 TRIA/Terrorism: REJECTED

Fees:

Policy Fee $35.00

Taxes:

Surplus Lines Tax $1,314.25

Service Office Fee $46.00

DEM EMPA Surcharge $4.00

Total Cost: $27,649.25

Surplus Lines Agent's Countersignature:

_____ "THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE OR WIND LOSSES, WHICH MAY

RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU."

__x___ "THIS POLICY CONTAINS A CO-PAY PROVISION THAT MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES

TO YOU."

Case 21-14020-RAM Doc 177-1 Filed 01/28/22 Page 2 of 21
COMMERCIAL LINES POLICY

COMMON DECLARATIONS

801-0153 03 14 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 1

Coverage is Provided in the following Company: AIX Specialty Insurance Company

_____________________

Renewal of Number

POLICY NUMBER POLICY PERIOD AGENCY CODE

FROM TO AT 12:01 AM STANDARD TIME AT YOUR 

MAILING ADDRESS SHOWN BELOW

NAMED INSURED AND MAILING ADDRESS

DESCRIPTION OF BUSINESS

Form of Business

Individual Corporation Partnership Limited Liability Company Organization (Other)

Business Description:

IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE 

AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE 

FOLLOWING COVERAGE PART(S) FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO 

ADJUSTMENT.

PREMIUM

$

$

$

Commercial $

$

$

$

Inspection $

PREMIUM

Prepaid The total annual premium of $ is due at inception.

Audit Period: Non-Auditable Unless Indicated by Annual Semi-Annual Quarterly Monthly Other:

THESE DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE PART COVERAGE FORM(S) AND FORMS 

AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY.

5009543

RT Specialty LLC - 5009543

510 Vonderburg Dr, Ste 214

Brandon, FL 33511

11/22/2015 11/22/2016

250 NE MIAMI GARDENS DR

Miami, FL 33179

DBA: THE OFFICE

A & S ENTERTAINMENT LLC

8,250.00

Z1J A163883 02

26,250.00

Z1J A163883 01

15,000.00

3,000.00

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801-0077 06 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 1 

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 

MINIMUM EARNED PREMIUM ENDORSEMENT 

This endorsement modifies insurance provided under the following: 

BUILDING AND PERSONAL PROPERTY COVERAGE FORM 

COMMERCIAL GENERAL LIABILITY COVERAGE PART 

LIQUOR LIABILITY COVERAGE PART 

PRODUCTS/COMPLETED OPERATIONS COVERAGE PART 

SCHEDULE

Minimum Earned Premium $ 

(Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Declarations.) 

If this insurance is cancelled by you or us for any reason, and the actual earned premium as calculated by us is less 

than the sum specified in the Schedule above, we shall retain the amount specified above. 

ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED.

6,563

Case 21-14020-RAM Doc 177-1 Filed 01/28/22 Page 10 of 21
THIS NOTICE IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE

REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT, AS AMENDED. THIS NOTICE DOES NOT 

GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THIS 

POLICY. IF THERE IS A CONFLICT BETWEEN THIS NOTICE AND THE POLICY, THE PROVISIONS OF THE 

POLICY SHALL APPLY.

NOTICE – REJECTION OF TERRORISM COVERAGE AND 

DISCLOSURE OF PREMIUM

Schedule

REJECTION STATEMENT

You have rejected the offer of terrorism coverage. You understand that an exclusion for certain terrorism 

losses will be made part of your policy.

Disclosure of Premium:

Total Terrorism Premium $

Fire Following Premium $

Other than Fire Following Premium $

You have rejected coverage for “acts of terrorism,” as defined in Section 102(1) of the Terrorism Risk Insurance

Act (“Act”) and an exclusion will be included in your policy. You are hereby notified that under the Act, as amended

in 2015, the definition of “act of terrorism” is:

Any act or acts that are certified by the Secretary of the Treasury, in consultation with the 

Secretary of Homeland Security and the Attorney General of the United States, to be an act of 

terrorism; to be a violent act or an act that is dangerous to human life, property, or infrastructure; 

to have resulted in damage within the United States, or outside the United States in the case of 

certain air carriers or vessels or the premises of a United States mission; and to have been 

committed by an individual or individuals as part of an effort to coerce the civilian population of 

the United States or to influence the policy or affect the conduct of the United States government 

by coercion.

Note for Commercial Property or Commercial Inland Marine Policyholders in Standard Fire States:

In your state, a terrorism exclusion makes an exception for (and thereby provides coverage for) fire losses 

resulting from an act of terrorism. Therefore, if you reject the offer of terrorism coverage, that rejection does not

apply to fire losses resulting from an act of terrorism. Coverage for such fire losses will be provided in your policy.

The additional premium just for such fire coverage is described as Fire Following Premium in the Schedule above.

Disclosure of Federal Participation in Payment of Terrorism Losses

The United States government through the Department of the Treasury may pay a share of terrorism losses 

insured under the federal program under a formula set forth in the Act. Under this formula, the United States 

government generally reimburses the following percentage of covered terrorism loss which exceeds the statutorily 

established deductible paid by the insurance company providing the coverage: 85% through 2015; 84% beginning 

on January 1, 2016; 83% beginning on January 1, 2017; 82% beginning on January 1, 2018; 81% beginning on 

January 1, 2019; and 80% beginning on January 1, 2020.

Cap on Insurer Participation in Payment of Terrorism Losses

The Act contains a $100 billion cap that limits the reimbursement by the United States government as well as 

insurers’ liability for losses resulting from certified acts of terrorism. If the aggregate of insured losses attributable 

to terrorist acts certified under the Terrorism Risk Insurance Act exceed $100 billion in a calendar year and we 

have met our insurer deductible under the Act, we will not be liable for the payment of any portion of the amount 

of such losses that exceeds $100 billion. In such case, insured losses up to that amount are subject to pro rata 

allocation in accordance with procedures established by the Secretary of the Treasury.

401-1126 01 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1

0

0

0

Case 21-14020-RAM Doc 177-1 Filed 01/28/22 Page 11 of 21
POLICY NUMBER: COMMERCIAL PROPERTY

CP 04 11 10 12

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

PROTECTIVE SAFEGUARDS

This endorsement modifies insurance provided under the following:

COMMERCIAL PROPERTY COVERAGE PART

STANDARD PROPERTY POLICY

SCHEDULE

Premises Number Building Number

Protective Safeguards

Symbols Applicable

Describe Any "P-9":

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. The following is added to the Commercial Property

Conditions:

Protective Safeguards

1. As a condition of this insurance, you are 

required to maintain the protective devices or 

services listed in the Schedule above. 

2. The protective safeguards to which this 

endorsement applies are identified by the 

following symbols: 

"P-1" Automatic Sprinkler System, including 

related supervisory services. 

Automatic Sprinkler System means: 

a. Any automatic fire protective or 

extinguishing system, including connected: 

(1) Sprinklers and discharge nozzles; 

(2) Ducts, pipes, valves and fittings; 

(3) Tanks, their component parts and 

supports; and 

(4) Pumps and private fire protection mains. 

b. When supplied from an automatic fire 

protective system: 

(1) Non-automatic fire protective systems; 

and

CP 04 11 10 12 © Insurance Services Office, Inc., 2011 Page 1 of 2

Z1J A163883 02

1 1 P-1

Case 21-14020-RAM Doc 177-1 Filed 01/28/22 Page 12 of 21
POLICY NUMBER: COMMERCIAL PROPERTY

CP 12 11 10 00

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CP 12 11 10 00 Copyright, Insurance Services Office, Inc., 1999 Page 1 of 1

BURGLARY AND ROBBERY PROTECTIVE

SAFEGUARDS

This endorsement modifies insurance provided under the following:

COMMERCIAL PROPERTY COVERAGE PART

SCHEDULE*

Premises

No.

Building

No.

Protective Safeguards

Symbols Applicable

Describe any "BR-4":

*Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Declarations.

A. The following is added to the Commercial Property Conditions:

BURGLARY AND ROBBERY PROTECTIVE

SAFEGUARDS

1. As a condition of this insurance, you are required to maintain the protective devices and/or

services listed in the Schedule above.

2. The protective safeguard(s) to which this endorsement applies are identified by the following symbols:

a. "BR-1" Automatic Burglary Alarm, protecting

the entire building, that signals to:

(1) An outside central station; or

(2) A police station.

b. "BR-2" Automatic Burglary Alarm, protecting

the entire building, that has a loud sounding

gong or siren on the outside of the building.

c. "BR-3" Security Service, with a recording

system or watch clock, making hourly

rounds covering the entire building, when

the premises are not in actual operation.

d. "BR-4" The protective safeguard described

in the Schedule.

B. The following is added to the Exclusions section

of the Causes Of Loss  Special Form:

BURGLARY AND ROBBERY PROTECTIVE

SAFEGUARDS

We will not pay for loss or damage caused by or

resulting from theft if, prior to the theft, you:

1. Knew of any suspension or impairment in any

protective safeguard listed in the Schedule

above and failed to notify us of that fact; or

2. Failed to maintain any protective safeguard

listed in the Schedule above, and over which

you had control, in complete working order.

Z1J A163883 02

1 1 BR-1

Case 21-14020-RAM Doc 177-1 Filed 01/28/22 Page 13 of 21
801-0010 06 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 2 

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY 

ASSAULT AND BATTERY LIMITATION – PER OCCURRENCE 

This endorsement modifies insurance provided under the: 

COMMERCIAL GENERAL LIABILITY COVERAGE PART 

LIQUOR LIABILITY COVERAGE PART 

SCHEDULE 

Assault and Battery Each Occurrence Limit: $ 

Assault and Battery Aggregate Limit: $ 

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations 

as applicable to this endorsement.) 

A. The combined Limits of Insurance provided by 

your COMMERCIAL GENERAL LIABILITY 

COVERAGE PART and LIQUOR LIABILITY 

COVERAGE PART for “bodily injury”, “property 

damage”, “personal and advertising injury”, and 

“injury” arising out of “assault and battery” are 

subject to the Assault and Battery Each 

Occurrence Limit and the Assault and Battery 

Aggregate Limit as described in Paragraph B. of 

this endorsement. 

B.

1. The Assault and Battery Each Occurrence 

Limit set forth in the SCHEDULE above is the 

most we will pay under both Coverage Parts to 

which this endorsement applies for the sum of: 

a. All damages under SECTION I –

COVERAGES, COVERAGE A AND 

COVERAGE B. of your Commercial 

General Liability Coverage Form; and 

b. All damages under SECTION I –

COVERAGES, LIQUOR LIABILITY 

COVERAGE because of all “bodily injury”, 

“property damage”, “personal and 

advertising injury” and “injury” arising out 

of any one “occurrence” or “occurrence”

and/or offense of an “assault and battery”. 

Any series of related incidents of “assault and 

battery” such as a battery involving multiple 

blows, an altercation involving multiple 

participants, a battery and false imprisonment, 

or any combination thereof, shall be deemed 

to be a single “occurrence” or “occurrence” for 

purposes of the Assault and Battery Each 

Occurrence Limit, regardless of the number of 

persons that have sustained “injury” or the 

number of persons that have been sold, 

served, or furnished an alcoholic beverage or 

beverages. 

2. The Assault and Battery Aggregate Limit 

shown in the SCHEDULE above of this 

endorsement is the most we will pay under 

both Coverage Parts to which this 

endorsement applies for the sum of: 

a. All damages under SECTION I –

COVERAGES, COVERAGE A. and 

Coverage B.; and 

b. All damages under SECTION I –

COVERAGES, LIQUOR LIABILITY 

COVERAGE arising out of all claims or 

“suits” for “assault and battery”. 

3. Any damages payable under this endorsement 

shall be included within and reduce: 

a. the Each Occurrence Limit or Personal 

and Advertising Injury Limit; and 

b. the General Aggregate or ProductsCompleted Operations Aggregate, of the 

COMMERCIAL GENERAL LIABILITY 

COVERAGE PART, as applicable; or 

c. the Each Common Cause Limit and 

Aggregate Limit of the LIQUOR LIABILITY 

COVERAGE PART. 

C. The following definition is added to SECTION V –

DEFINITIONS: 

“Assault and battery” means: 

a. a threat of bodily violence or harm to a person, 

or an attempt to do such violence or harm; 

b. an uninvited use of any physical force on a 

person including, but not limited to, beating or 

offensive touching; 

c. false arrest, detention or imprisonment; or 

25,000

25,000

Case 21-14020-RAM Doc 177-1 Filed 01/28/22 Page 14 of 21
801-0022 06 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 2 

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY 

LIABILITY INSURANCE DEDUCTIBLE ENDORSEMENT 

This endorsement modifies insurance provided under the following: 

COMMERCIAL GENERAL LIABILITY COVERAGE PART 

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART 

SCHEDULE 

Coverage Amount and Basis of Deductible 

 Per Claim Per Occurrence 

Bodily Injury Liability, or; $ $ 

Property Damage Liability, or; $ $ 

Bodily Injury Liability and/or Property Damage Liability Combined $ $ 

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations 

as applicable to this endorsement.) 

APPLICATION OF ENDORSEMENT (Enter below any limitations on the application of this endorsement. If 

no limitation is entered, the deductibles apply to damages for all "bodily injury" and "property damage", 

however caused):

THE DEDUCTIBLE AMOUNT SHALL ALSO INCLUDE ALL ALLOCATED EXPENSES, INCLUDING 

LEGAL EXPENSES, INCURRED BY THE COMPANY IN THE INVESTIGATION, NEGOTIATION, 

SETTLEMENT AND DEFENSE OF ANY CLAIM OR SUIT SEEKING DAMAGES. 

A. Our obligation under the Bodily Injury Liability and 

Property Damage Liability Coverages to pay 

damages on your behalf applies only to the 

amount of damages in excess of any deductible 

amounts stated in the Schedule above as 

applicable to such coverages. 

B. You may select a deductible amount on either a 

per claim or a per "occurrence" basis. Your 

selected deductible applies to the coverage option 

and to the basis of the deductible indicated by the 

placement of the deductible amount in the 

Schedule above. The deductible amount stated in 

the Schedule above applies as follows: 

1. Per Claim Basis

If the deductible amount indicated in the 

Schedule above is on a per claim basis, that 

deductible applies as follows: 

a. Under Bodily Injury Liability Coverage, to 

all damages sustained by any one person 

because of "bodily injury"; 

b. Under Property Damage Liability 

Coverage, to all damages sustained by 

any one person because of "property 

damage"; or 

c. Under Bodily Injury Liability and/or 

Property Damage Liability Coverage 

Combined, to all damages sustained by 

any one person because of: 

(1) "Bodily injury"; 

(2) "Property damage"; or 

(3) "Bodily injury" and "property damage" 

combined 

as the result of any one "occurrence”. 

If damages are claimed for care, loss of 

services or death resulting at any time 

from "bodily injury", a separate deductible 

amount will be applied to each person 

making a claim for such damages. 

With respect to "property damage", person 

includes an organization. 

2. Per Occurrence Basis

2,500

Case 21-14020-RAM Doc 177-1 Filed 01/28/22 Page 15 of 21
801-0161 05 14 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 

DEDUCTIBLE LIABILITY INSURANCE 

This endorsement modifies insurance provided under the following:

LIQUOR LIABILITY COVERAGE PART 

SCHEDULE

Location: 

Coverage Amount and Basis of Deductible 

 Per Claim Per Common Cause 

Liquor Liability $ $ 

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations 

as applicable to this endorsement.) 

APPLICATION OF ENDORSEMENT (Enter below any limitations on the application of this endorsement. If no 

limitation is entered, the deductibles apply to damages for "injury", however caused): 

THE DEDUCTIBLE AMOUNT SHALL ALSO INCLUDE ALL ALLOCATED EXPENSES, INCLUDING LEGAL 

EXPENSES, INCURRED BY THE COMPANY IN THE INVESTIGATION, NEGOTIATION, SETTLEMENT 

AND DEFENSE OF ANY CLAIM OR SUIT SEEKING DAMAGES.

A. Our obligation under the Liquor Liability Coverage 

to pay damages on your behalf applies only to the 

amount of damages in excess of any deductible 

amount stated in the Schedule above.

B. You may select a deductible amount on either a 

per claim or a per common cause basis. Your 

selected deductible applies to the Liquor Liability 

Coverage and to the basis of the deductible 

indicated by the placement of the deductible 

amount in the Schedule above. The deductible 

amount stated in the Schedule above applies as 

follows: 

1. Per Claim Basis. If the deductible amount 

indicated in the Schedule above is on a per 

claim basis, that deductible applies under 

Liquor Liability Coverage, to all "injuries" 

sustained by any one person or organization.

2. Per Common Cause Basis. If the deductible 

amount indicated in the Schedule above is on 

a per common cause basis, that deductible 

amount applies under Liquor Liability 

Coverage to all damages because of "injury" 

as the result of the selling, serving or 

furnishing of any alcoholic beverage to any 

one person, regardless of the number of 

persons or organizations who sustain 

damages.

C. The terms of this insurance, including those with 

respect to: 

1. Our right and duty to defend the insured 

against any "suit" seeking those damages; 

and

2. Your duties in the event of an "injury”, claim or 

"suit" 

apply irrespective of the application of the 

deductible amount.

D. We may pay any part or all of the deductible 

amount to effect settlement of any claims or "suit" 

and, upon notification of the action taken, you shall 

promptly reimburse us for such part of the 

deductible amount as has been paid by us.

ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. 

2,500

250 NE Miami Gardens Dr., Miami, FL 33179

Case 21-14020-RAM Doc 177-1 Filed 01/28/22 Page 16 of 21
POLICY NUMBER: COMMERCIAL GENERAL LIABILITY

CG 20 13 04 13

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 

CG 20 13 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1

ADDITIONAL INSURED – STATE

OR GOVERNMENTAL AGENCY OR SUBDIVISION

OR POLITICAL SUBDIVISION – PERMITS

OR AUTHORIZATIONS RELATING TO PREMISES 

This endorsement modifies insurance provided under the following: 

COMMERCIAL GENERAL LIABILITY COVERAGE PART 

SCHEDULE 

State Or Governmental Agency Or Subdivision Or Political Subdivision:

Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 

A. Section II – Who Is An Insured is amended to 

include as an additional insured any state or 

governmental agency or subdivision or political 

subdivision shown in the Schedule, subject to the 

following additional provision: 

This insurance applies only with respect to the 

following hazards for which the state or 

governmental agency or subdivision or political 

subdivision has issued a permit or authorization in 

connection with premises you own, rent or control 

and to which this insurance applies: 

 1. The existence, maintenance, repair, 

construction, erection or removal of advertising 

signs, awnings, canopies, cellar entrances, 

coal holes, driveways, manholes, marquees, 

hoist away openings, sidewalk vaults, street 

banners or decorations and similar exposures; 

or 

2. The construction, erection or removal of 

elevators; or 

3. The ownership, maintenance or use of any 

elevators covered by this insurance. 

However: 

 1. The insurance afforded to such additional 

insured only applies to the extent permitted by 

law; and

 2. If coverage provided to the additional insured is 

required by a contract or agreement, the 

insurance afforded to such additional insured

will not be broader than that which you are 

required by the contract or agreement to 

provide for such additional insured.

B. With respect to the insurance afforded to these 

additional insureds, the following is added to 

Section III – Limits Of Insurance: 

If coverage provided to the additional insured is 

required by a contract or agreement, the most we 

will pay on behalf of the additional insured is the 

amount of insurance: 

 1. Required by the contract or agreement; or 

 2. Available under the applicable Limits of 

Insurance shown in the Declarations;

whichever is less. 

This endorsement shall not increase the 

applicable Limits of Insurance shown in the 

Declarations. 

Z1J A163883 02

City of Jacksonville

Case 21-14020-RAM Doc 177-1 Filed 01/28/22 Page 17 of 21
POLICY NUMBER: COMMERCIAL GENERAL LIABILITY

CG 21 44 07 98

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CG 21 44 07 98 Copyright, Insurance Services Office, Inc., 1997 Page 1 of 1 o

LIMITATION OF COVERAGE TO DESIGNATED

PREMISES OR PROJECT

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Premises:

Project:

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations

as applicable to this endorsement.)

This insurance applies only to "bodily injury", "property damage", "personal and advertising injury" and medical

expenses arising out of:

1. The ownership, maintenance or use of the premises shown in the Schedule and operations necessary or

incidental to those premises; or

2. The project shown in the Schedule.

Z1J A163883 02

250 NE Miami Gardens Drive, Miami FL 33179

Case 21-14020-RAM Doc 177-1 Filed 01/28/22 Page 18 of 21
POLICY NUMBER: COMMERCIAL GENERAL LIABILITY

CG 21 53 01 96

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CG 21 53 01 96 Copyright, Insurance Services Office, Inc., 1994 Page 1 of 1 o

EXCLUSION – DESIGNATED ONGOING OPERATIONS

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Description of Designated Ongoing Operation(s):

Specified Location (If Applicable):

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations

as applicable to this endorsement.)

The following exclusion is added to paragraph 2.,

Exclusions of COVERAGE A – BODILY INJURY

AND PROPERTY DAMAGE LIABILITY (Section I –

Coverages):

This insurance does not apply to "bodily injury" or

"property damage" arising out of the ongoing operations described in the Schedule of this endorsement,

regardless of whether such operations are conducted

by you or on your behalf or whether the operations

are conducted for yourself or for others.

Unless a "location" is specified in the Schedule, this

exclusion applies regardless of where such operations are conducted by you or on your behalf. If a

specific "location" is designated in the Schedule of

this endorsement, this exclusion applies only to the

described ongoing operations conducted at that

"location".

For the purpose of this endorsement, "location"

means premises involving the same or connecting

lots, or premises whose connection is interrupted only

by a street, roadway, waterway or right-of-way of a

railroad.

Z1J A163883 02

Mechanical Bull

Case 21-14020-RAM Doc 177-1 Filed 01/28/22 Page 19 of 21
POLICY NUMBER: COMMERCIAL GENERAL LIABILITY

CG 28 06 01 96

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CG 28 06 01 96 Copyright, Insurance Services Office, Inc., 1994 Page 1 of 1 o

LIMITATION OF COVERAGE TO INSURED PREMISES

This endorsement modifies insurance provided under the following:

LIQUOR LIABILITY COVERAGE PART

SCHEDULE

Description and Location of "Insured Premises":

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations

as applicable to this endorsement.)

A. This insurance only applies to damages arising out of your "insured premises".

B. The following definition is added to the DEFINITIONS Section:

"Insured premises" means:

1. The premises shown in the Schedule; and

2. Any premises you acquire during the policy period for use in manufacturing, distributing, selling, serving or

furnishing alcoholic beverages if:

a. You notify us within 30 days after the acquisition, and

b. You have no other valid and collectible insurance applicable to the loss.

Z1J A163883 02

Cabaret

250 NE Miami Gardens Drive

Miami, FL 33179

Case 21-14020-RAM Doc 177-1 Filed 01/28/22 Page 20 of 21
AIL00160613

In Witness Whereof, Aix Specialty Insurance Company has executed and attested 

these presents, and where required by law, has caused this Policy to be 

countersigned by its duly authorized Representative.

Charles Frederick Cronin Frederick H. Eppinger

Corporate Secretary President

Page 1 of 1

Case 21-14020-RAM Doc 177-1 Filed 01/28/22 Page 21 of 21