. ACORD® DATE paOONT)
CERTIFICATE OF LIABILITY INSURANCE
* Mc 5/3/2021
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: I[f 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
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT Jennifer Letendre
THE ROWLEY AGENCY INC. pone (603) 224-2562 iS No}: (503)224-8012
45 Constitution Avenue aan 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 INSURERB: 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 we REVISION NUMBER:
THIS 1S 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 PAIO CLAIMS.
ADDL [SUB
ie TYPE OF INSURANCE 1 inl POLICY NUMBER MMOD IVY | MaMioner) LIMITS
X | COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
[DAMAGE TORENTED
A CLAIMS-MADE [x] OCCUR PReMices (Ga occurence, | $ 300,000
CPA0184919-23 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
| AUTOMOBILE LIABILITY é OMBINED SINGLE LIMIT $ 1,000,000
a LX J anvauto BODILY INJURY (Per person) | $
x | ALL OWNED SCHEDULED CAA0184920-23 7/01/2019 | 7/01/2020 | BODILY INJURY (Per accident) | $
ra NON-OWNED PE
| X | Hineo autos AUTOS PROPERTY DAMAGE ;:
Uninsured motorist Bi-single limit | $ 1,000,000
|} UMBRELLALIAB =| X | occur CUAS402622-10 EACH OCCURRENCE s 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 Sect 3A: NH,YA;VT/ME x | Srarure | [eR
ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 500,000
OFFICER/MEMBER EXCLUDED? [a | NIA
A | (Mandatory In NH} WPA0242726-22 3/01/2020 | 3/01/2021 | EL DISEASE -EAEMPLOYEE | $ 500,000
Wf yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE -PoLicyumiT | $ $00,000
C | Excess Liability 1000307631-01 7/01/2019 | 7/01/2020 | EXCESS fablity 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
LCG
Robert Simpson/JLP
ACORD 25 (2014/01)
INSO285 (201401)
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