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CERTIFICATE OF LIABILITY INSURANCE
MELPENT-01
JMEIERDIRK
DATE (MMIDD/YYYY)
5/10/2021
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 License # AGR8150
Clark Insurance
One Sundial Ave Suite 302N
Manchester, NH 03103
CONTACT ficate
fale No, Ext: (603) 622-2855
| FAX no).(603) 622-2854
EMAL... info@clarkinsurance.com
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A: The Hanover Insurance Company 22292
INSURED INSURER B:Allmerica Financial Benefit 41840
Melport Enterprises LLC dba Chemserve insuRER c: Berkley Design Prof Und
317 Elm St INSURER D :
Milford, NH 03055
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.
ee TYPE OF INSURANCE HO ae POLICY NUMBER HO HAY) | (HIRI Ar) LIMITS
A | X | COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 1,000,000
CLAIMS-MADE OCCUR ZBVH384246 9/25/2020 | 9/25/2021 | DAMAGE TORENTED ce) | 8 300,000
| MED EXP (Any one person) $ 5,000
|_| PERSONAL & ADVINJURY | $ 1,000,000
| GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
POLICY ject Loc PRODUCTS - COMP/OP AGG | $ 2,000,000
OTHER: $
B | AUTOMOBILE LIABILITY & a aeoden) LIMIT $ 1,000,000
X | ANY AUTO AAWVH383943 9/25/2020 | 9/25/2021 | BopiLy INJURY (Per person) | $
[| OWNED SCHEDULED
|__| AUTOS ONLY AUTOS BODILY INJURY (Per accident) | $
HIRED NON-QWNED PROPERTY DAMAGE
|__| AUTOS ONLY AUTOS ONLY (Per accident) $
$
A | X | UMBRELLA LIAB =| X | occur EACH OCCURRENCE $ 1,000,000
EXCESS LIAB CLAIMS-MADE UHVH384381 9/25/2020 | 9/25/2021 AGGREGATE 5 1,000,000
DED | X | RETENTION $ 0 $
PER OTH-
A WESSON vy X [Sifne |_18R
ANY PROPRIETOR/PARTNER/EXECUTIVE WHVH383946 9/25/2020 | 9/25/2021 | =) cacy accIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE] $ 1,000,000
If yes, describe under 1,000,000
DESGRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT | $ wom
C |Errors & Omissions BDP0417001 9/15/2020 | 9/30/2021 |Occurrence 1,000,000
C |Pollution BDP0417001 9/15/2020 | 9/30/2021 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER
CANCELLATION
City of Nashua
City Hall
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
fy Goh
|
ACORD 25 (2016/03)
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