ACCORD DATE (MMIDONVYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/23/2021
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 be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certaln policies may require an endorsement. A statement on this cartificate does not confer rights to the
certificate holder In llau of such endorsemant(s).
PRODUCER CONTACT Karen Stapley
THE ROWLEY AGENCY INC. PHONE — .. (603) 224-2562 LEAe, Noy. (6039224-8012
45 Conatitution Avanue eee kstapley@ rowleyagency. com
P.O. Box 511 INSURER(S) AFFORDING COVERAGE NAIC
Concord NA 03302-0511 INSURERA: Union Insurance Company 25844
py INsURERG :Acadia Insurance Company 31325
Material Handling Sales, Inc. INSURERG:Maine Employers Mutual Ins Co 11149
20 Downeast Dr INSURER D;
INSURER E:
Yarmouth ME 04096 INSURER F :
COVERAGES CERTIFICATE NUMBER: - REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEO 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,
&XCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR JADOL [SUaR POLICYEFF | POLIC
on TYPE OF INSURANCE wp POLICY NUMBER cambonern UimiTs
X | COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A ] CLAIMS-MADE [x | OCCUR PREMISES (E6 popurenca) $ 300,000
CPAS101636 12/31/2021 | 12/31/2022 | MED EXP (Any one p $ 5,000
+ PERSONAL & ADV INJURY | $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
POLICY BRS [] Loc PRODUCTS -GOMP/OPAGG | $ 2,000,000
QTHER: §
AUTOMOBILE LIABILITY fe es sea ga ro $ 1,000,000
B XE ANYAUTO BODILY JURY (Per person) | $
ALL Gwen rin CAA5101637 12/31/2021 | 12/31/2022 | BODILY INJURY (Per sccident) | $
; | NON-OWNED ROPERTY DAMAGE
HIRED AUTOS AUTOS fe eocdent) G $
$
| x | UMBRELLA LIAB | | occur CUAS101633 | EACH OCCURRENCE bj 5,000,000
EXCESS LIAB CLAIMS-MADE Per Project Aggregate AGGREGATE $ 5,000,000
B ‘
DED | RETENTION $ capped at $10,000,000 12/31/2021 | 12/31/2022 $
WORKERS COMPENSATION 3A States: ME,WH,CT,MA,VZ,NY, x [eee ure mre
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE nT 5101600377 E.L. EACH ACCIDENT $ 1,000,000
OFFIGEFUMEMBER EXCLUDED? NIA
C [iMandatory in NH) EXCLUDED : WILLIAM 12/31/2021 | 12/31/2022 | E.. DISEASE - EAEMPLOYEE | $ 1,000,000
H yas, describe under
ORSCRIPTION F OPERATIONS below CLIFFORD, ERIC PETERSON E.L. DISEASE -POLICYLIMIT | § 1,000,000
A | Leased/Rented Equip CPAS101636 12/31/2021 | 12/31/2022 | Limit $25,000 9500 Ded
Inetallation Floater Limit: $165,000 $500 Ded
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additiona! Remarks Schedule, may be atteched if more space Is required)
Covering operations of the insured during the policy period.
CERTIFICATE HOLDER CANCELLATION
SHOULO ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEO BEFORE
1 l THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
EIR SoD aL Se ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Karen Stapley/KS K anert hel
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INS025 (201401)
