®
ACORD
_
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDIYYYY)
05/11/2021
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 RONTACT Megan Feehan
PHONE FAX -
RSC Insurance Brokerage, Inc. PHONE. (617) 330-5700 FAX won: (617) 439-3752
160 Federal St. EMAIL
ADDRESS:
4th Floor INSURER(S) AFFORDING COVERAGE NAIC #
Boston MA 02110 INSURERA: ©larr Surplus Lines Insurance Company
INSURED INSURERB: Starr Indemnity & Liability Company
Windfield Alloy, Inc. INSURER Cc: Liberty Mutual Insurance
#2 Route 111 INSURERD: CM Vantage Specialty Insurance Co.
INSURER E:
Atkinson NH 03811 INSURER F:
COVERAGES CERTIFICATE NUMBER: _CL207666716 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 ADDLISUBR POLICY EFF | POLICY EXP
LTR TYPE OF INSURANCE INSD | wvD POLICY NUMBER (MM/DDIYYYY) | (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) $ 25,000
A Y 1000067027201 07/01/2020 | 07/01/2021 | peRsonal & ADV INJURY g 1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE g_ 2,000,000
><} poticy aes Loc propucts-compiopace | s 2:000,000
OTHER: $
COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY a accident) $ 1,000,000
><} ANY AUTO BODILY INJURY (Per person) | $
OWNED SCHEDULED :
B AUTOS ONLY SuTos Y 1000626090201 07/01/2020 | 07/01/2021 | BODILY INJURY (Per accident) | $
HIRED NON-OWNED PROPERTY DAMAGE $
|__| AUTOS ONLY AUTOS ONLY | (Per accident)
$
><} UMBRELLA LIAB ><} occur EACH OCCURRENCE g_3,000,000
A EXCESS LIAB CLAIMS-MADE 1000337350201 07/01/2020 | 07/01/2021 | pgorecatE g 3,000,000
DED | | RETENTION $ $
WORKERS COMPENSATION PER | OTH-
AND EMPLOYERS' LIABILITY YIN STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? [| NIA
(Mandatory in NH) E.L. DISEASE - EAEMPLOYEE | $
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LimiT_| $
Property ;
D | Contractors Equipment CMV-PRP-0014657-02 07/01/2020 | 07/01/2021 | Insured Value Listed Below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Re: Scrap Metal Recycling Program Contract
City of Nashua is included as Additional Insured as required by written contract.
written contract.
Policies are on a primary and non-contributory basis where required by
CERTIFICATE HOLDER
CANCELLATION
City of Nashua-Division of Public Works
Solid Waste Department
840 West Hollis Street
Nashua
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
NH 03062
AUTHORIZED REPRESENTATIVE
POA AF C Hed EZ,
ACORD 25 (2016/03)
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