®
ACORD
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CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDAYYYY)
5/21/2020
REPRESENTATIVE OR PRODUCER,
, AND THE CERTIFICATE HOLDER.
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
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(tes) must 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 Haver Donna Bickford
THE ROWLEY AGENCY INC. PHONE (603) 224-2562 ANG, Noy: {602)226-8012
45 Constitution Avenue EMAL... dbickford@rowlayagency, com
P.O. Box 511 INSURER{S} AFFORDING COVERAGE NAIC #
Concord NH 03302-0511 INSURERA: Fixemen's Ins Co of Wash. DC 21784
INSURED INSURERB: Acadia Insurance Company 31325
Weaver Brothers Construction Co., Inc. INSURER C:
1629 Rte. 3A INSURER D:
INSURER E:
Bow NH 03304 INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT FHE 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 1S SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ADDL [SUaR c
tie TYPE OF INSURANCE Ns [wun POLICY NUMBER (MMIOBIVTY) | (MINDDIVYYYS Limits
X | COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE TU RENTED
A CLAIMS-MADE OGCUR PREMISES (E@ occurrence} 3 300,000
CPAL50086030 4/1/2020 4/1/2023 MED EXP (Any one person) $ 10,000
PERSONAL & ADV INJURY $ 1,000,000
| GEN LAGSRERATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
poucy LX] eer Loc PRODUCTS -COMP/OPAGG | $ 2,000,000
OTHER: $
AUTOMOBILE LIABILITY feaeenderty Noe MIT 8 1,000,000
a” X | any auto BODILY INJURY (Per person} 7 $
ALL OWNED [| SGHEDULED CAAL 50086130 4/1/2020 | 4/1/2021 | BODILY INJURY (Per accident) | $
xX x NON-OWNED PROPERTY DAMAGE $
HIRED AUTOS (Per accident)
$
% | UMBRELLA LIAB =X | occur EACH OCCURRENCE $ 10,000,000
B EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000
beo | x | RETENTION $ 0 cUA014456025 4/1/2020 4/1/2021 s
WORKERS COMPENSATION x | PER OTR:
AND EMPLOYERS’ LIABILITY YIN sare | | ER
ANY PROPRIEFOR/PARTNER/EXECUTIVE WRAL50086329 E.L. EACH ACCIDENT $ 500,000
OFFICER/MEMBER EXCLUDED? [i | NIA
AL | (Mandatory In NH} 3A STATES: NH 4/1/2020 4/1/2021 | EL. DISEASE -EAEMPLOYEE | § 500,000
IF yes, describ
DESCRIPTION Ore OPERATIONS below NO EXCLUDED OFFICERS E.L. DISEASE - POLICY LIMIT_| $ 500,000
B | LEASED/RENTED EQUIPMENT CM00 6660629 4/1/2020 4/1/2021 | LIMIT4$1,000 DEDUCTIBLE): $525,000
MOTOR TRUCK CARGO LIMIT ($1,000 DEDUCTIBLE): $250,000
installation of barriexs on
Main St for outdoor dining.
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 161, Additional Remarks Schedule, may be attached If more space is required)
The certificate holder is included es an additional insured on all liability policies except workers comp
on a primary non-contributory basis when required by written contract with the named insured.
CERTIFICATE HOLDER
CANCELLATION
City of Nashua
Nashua, NH 03060
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
AGCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Donna Bickford/DTB
Lrinee Leeda?
ACORD 25 (2014/01)
INSO25 (201401)
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