—_)
(a
CERTIFICATE OF LIABILITY INSURANCE
EXHIBIT C
KSHAUGH
DATE (MM/DDIYYYY)
7/1/2021
EASTHEA-01
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
The Davis Agency, LLC
28 Commercial Street
Suite 5
CONTACT Karen Shaughnessy
(Ale. No, Ext); (603) 856-8104 | FAX o).(603) 715-1911
F MAL... karen@thedavisagency.com
Concord, NH 03301
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A: Hanover Insurance Companies
INSURED INSURER B :
Eastern Heat Pump & Mechanical LLC INSURER C :
724 E. Industrial Park Drive Unit 1 INSURER D:
Manchester, NH 03109
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 ADDL SUBR POLICY NUMBER HOA) | CIR ay) LIMITS
A | X | COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 1,000,000
CLAIMS-MADE OCCUR X ZBVH411125 10/26/2020 | 10/26/2021 | BAMEBE TO RENTED ce) | 8 100,000
— MED EXP (Any one person) $ 10,000
CP PERSONAL & ADVINJURY | $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 2,000,000
POLICY SECT Loc PRODUCTS - COMP/OP AGG | $ 2,000,000
OTHER: $
A | AUTOMOBILE LIABILITY & a eoden) LIMIT $ 1,000,000
X | any auto [AWVH410784 10/26/2020 | 10/26/2021 | sopiLy INJURY Per person) | §
OWNED [| SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY (Per accident) | $
X | HIRED X | NON-OWNED PROPERTY DAMAGE
| & | AUTOS ONLY AUTOS ONLY (Per accident) $
$
A | X | umBreLLa LiaB X | occur EACH OCCURRENCE $ 1,000,000
EXCESS LIAB CLAIMS-MADE UHVH411529 10/26/2020 | 10/26/2021 AGGREGATE 5 1,000,000
DED | | RETENTION $ $
A. |WORKERS COMPENSATION PER OTH-
AND EMPLOYERS’ LIABILITY YIN X | stature | ER
ANY PROPRIETORIPARTNERIEXECUTIVE WDVH410863 40/26/2020 | 10/26/2021 | =) acy acciDENT 5 500,000
QFFICER/MEMBER EXCLUDED? N/A 500.000
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE! $ ,
If yes, describe under 500.000
DESGRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT | $ ’
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
** Workers Compensation ** 3A State(s): NH. Excluded Officer(s)/Member(s): Robert Fichera
RE: Various work throughout the policy term. It is agreed and understood that the City of Nashua NH is included as additional insured on a primary and
non-contributory basis on General Liability for ongoing operations when required by written contract.
CERTIFICATE HOLDER
CANCELLATION
City of Nashua NH
Division of Public Works
229 Main Street
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
|
ACORD 25 (2016/03)
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