®
ACORD
(—
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
05/03/2021
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 endorsement(s).
PRODUCER BONTACT Patricia LeBlanc
; PHONE - FAX -
Brown & Brown of New Hampshire (AIG. No, Ext): (603) 424-9901 (AIC, No}: (866) 848-1223
309 Daniel Webster Highway EMAL ss: pleblanc@bbnhins.com
INSURER(S) AFFORDING COVERAGE NAIC #
Merrimack NH 03054 INSURERA: /he Travelers Indemnity Company of Connecticut 25682
INSURED INSURERB: /he Phoenix Insurance Company 25623
Flow Assessment Services LLC INSURERC: |ravelers Property Casualty Company of America 25674
72 Priscilla Ln. INSURER D: Admiral Insurance Company 24856
INSURER E :
Auburn NH 03032 INSURER F:
COVERAGES CERTIFICATE NUMBER: 2021 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 ADDL|SUBR POLICY EFF | POLICY EXP
LTR TYPE OF INSURANCE INSD | wvD POLICY NUMBER (MM/DD/YYYY) | (MM/DD/YYYY) LIMITS
x< COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED
| CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ 300,000
MED EXP (Any one person) $ 5,000
A Y P-660-7R164868-TCT-21 01/01/2021 | 01/01/2022 | LeRconal a ADV INJURY g 1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE g_ 2,000,000
><) powicy [| aE [| Loc propucts-compiopace | 5 2:000,000
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $s 1,000,000
(Ea accident)
><| any Auto BODILY INJURY (Per person) | $
OWNED SCHEDULED - -21-43- i
B OU Tas ONLY ress Y BA-7R164217-21-43-G 01/01/2021 | 01/01/2022 | BODILY INJURY (Per accident) | $
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY (Per accident)
$
><) UMBRELLA LIAB ><! occur EACH OCCURRENCE g 9,000,000
Cc EXCESS LIAB CLAIMS-MADE CUP-7R165472-21-43 01/01/2021 | 01/01/2022 | , carecate g 2,000,000
DED | | RETENTION g 10,000 $
WORKERS COMPENSATION | PER Ix OTH-
AND EMPLOYERS' LIABILITY YIN STATUTE ER 7000000
CO CROC NIBEN ONC URED OO TVE NIA UB-18084133 03/18/2021 | 03/18/2022 LEL.EACHACCIDENT §
(Mandatory in NH) E.L. DISEASE -EA EMPLOYEE | ¢ 1,000,000
If yes, describe under 1.000.000
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT | $ [mY *?
; Aggregate $5,000,000
Contractors Pollution and ;
D | Professional Liability FEI-ECC-28148-00 01/01/2021 | 01/01/2022 | Each Claim $5,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The City of Nashua is listed as additional insured for ongoing and completed operations when required by written contract or agreement.
Workers Compensation 3A States: CT, DE, MA, MD, ME, NH, NJ, NY, PA, RI, VA, VT
CERTIFICATE HOLDER
CANCELLATION
The City of Nashua
229 Main Street
City Hall
Nashua NH 03060
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
Pataca Le Ateme
ACORD 25 (2016/03)
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