oe
» ACORD
* ee
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDIYYYY)
5/3/2021
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
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
certificate holder in lieu of such endorsement(s).
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, certain polictas may require an endorsement. A statement on this certificate does not confer rights to the
PRODUCER
CONTACT Jennifer Letendre
THE ROWLEY AGENCY INC. | PHONE: (603) 224-2562 at No}: (503)224-8012
45 Constitution Avenue Paaeeeee jletendre@rowleyagency.com
P.O. Box 511 INSURER(S) AFFOROING COVERAGE NAIC #
Concord NH 03302-0511 INSURERA: Firemen's Ins Co of Wash. DC 21784
INSURED INSURER@: Acadia Insurance Company 31325
Harvey Construction Corporation INSURERC: Liberty Insurance Underwriters, Inc 19917
10 Harvey Road INSURER D :
INSURER E :
Bedford NH 03110 INSURER F:
COVERAGES CERTIFICATE NUMBER:19/20 CERT w/20/21 WC REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN !SSUED 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.
ADDL |SUBR
Te TYPE OF INSURANCE LWyD_ POLICY NUMBER MMIDDIYYY (MMIDOIYYY) LIMITS
X | COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
[DAMAGE TO RENTED
A CLAIMS-MADE [x] OccUR pReMices (Ea occurrence) _| $ 300,000
CPAO184919-23 7/01/2019 | 7/01/2020 | MED EXP (Any one person) | $ 5,000
| PERSONAL & ADV INJURY | $ 1,000,000
| GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000, 000
POLICY BRO. Loc PRODUCTS - COMP/OPAGG | $ 2,000,000
OTHER: Employee Benefits $ 1,000,000
COMBINED SINGLE LIMIT
| AUTOMOBILE LIABILITY tia soodent) $ 1,000,000
a LL] anvauto BODILY INJURY (Per person) | $
x | ALL OWNED AUTOS CAA0184920-23 7/01/2019 | 7/01/2020 | BODILY INJURY (Per accident) | $
7 NON-OWNED PROPERTY DAMAGE
X | niReo autos AUTOS (Per accident) $
Uninsured motorist B-single limit | $ 1,000,000
UMBRELLA LIAB X | occur CUAS402622-10 EACH OCCURRENCE $ 10,000,000
B LX EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000
DEO | x | RETENTION $ 0 7/01/2019 | 7/01/2020 $
WORKERS COMPENSATION . PER OTH-
AND EMPLOYERS' LIABILITY VIN Beet 3h: NH,MA;VT.ME x | Srarure | [eR
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 500,000
OFFICER/IMEMBER EXCLUDED? [1 | NIA
A | (Mandatory In NH} WPA0242726-22 3/01/2020 | 3/01/2021 | EL. DISEASE -EAEMPLOYEE | $ 500,000
Wf yes, describe under
CESCRIPTION OF OPERATIONS betow, E.L. DISEASE - POLICY LIMIT | $ $00,000
C | EXCESS Liability 1000307631-01 7/01/2019 | 7/01/2020 | EXCESS tablity AGG 15,000,000
general liability when required by written contract.
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
Project: New D.P.W. Administration office Building, Four Hills Landfill, 840 W Hollis Street, Nashua NH
03062. The City of Nashua and HKT Architects and their consultants are additional insureds w/respects to
CERTIFICATE HOLDER
CANCELLATION
City of Nashua
229 Main St
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
LCE
Robert Simpson/JLP
ACORD 25 (2014/01)
INSO285 (201401)
© 1988-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
