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CERTIFICATE OF LIABILITY INSURANCE
ENGISER-CL
PATRA2
DATE (MMIDDIVYYY)
12/1/2021
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 endorsementi(s).
PRODUCER
Smith Brothers Insurance, LLC.
68 National Drive
Glastonbury, CT 06033
gauract Kristen D. Kane
(AiG, No, Ext): (B60) 430-3258 (AIG, No):
| EMA ss, kkane@SmithBrothersUSA.com
INSURER(S) AFFORDING COVERAGE NAIC #
InsuRER A: Phoenix Insurance Company 25623
INSURED iNsuRER B: Charter Oak Fire Insurance Co 25615
Clear Span Fabric Structures International, Inc. INSURER C: Travelers Property Casualty Co of Amer 25674
1395 John Fitch Boulevard INSURER D:
South Windsor, CT 06074-1029
INSURER E:
INSURER F :
COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE Ape |suBR POLICY NUMBER Mab Oey) | dieeo ey) LIMITS
A | X ] COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
| crams-maoe | X ] occur x | [6308P621994 6/1/2021 | 6/1/2022 | DAMAGE TO RENTED 5 500,000
|__} MED EXP (Any one person) $ 15,000
|__J PERSONAL & ADVINJURY _| $ 1,000,000
| GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 2,000,000
POLICY Sect Loc PRODUCTS - COMP/OP AGG | $ 2,000,000
OTHER: 5
B | AUTOMOBILE LIABILITY | FE QMBINED SINGLE LIMIT $ 1,000,000
| X | ANY AUTO 810-8P624290 6/1/2021 6/1/2022 | BooiLy INJURY (Per person) | $
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY (Per accident) | $
PROPERTY DAMAGE
|__| AUER ONLY AgtS veNii (Per accident) $
$
C |X| umerevtavias | X| occur EACH OCCURRENCE $ 10,000,000
EXCESS LIAB CLAIMS-MADE CUP8P720634 6/1/2021 6/1/2022 | .ccreGate 5 10,000,000
peo |X| retentions 10,000 5
WORKERS COMPENSATION PER OTH-
8 AND EMPLOYERS ABILITY YIN X {Eure | 1 OF
ANY PROPRIETOR/PARTNER/EXECUTIVE UB8P646780 6/1/2021 | 6/1/2022 | c cacH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? NIA 7,000,000
{Mandatory in NH) E.L. DISEASE - EA EMPLOYEE! § 00;
If yes, describe under 7,000,000
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT | $ us
Re: Q #1035248, City of Nashua.
DCSCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additlonal Remarks Schedule, may be attached If more space Is required)
CERTIFICATE HOLDER
CANCELLATION
Four Hills Landfill
840 West Hollis Street
Nashua, NH 03062
|
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
Ciel Koma
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
