NYC 9/11 Public Portal Document
SUPPLY and SERVICE CONTRACT Page 2 of 4
GENERAL CONDITIONS
SCHEDULE A
endorsements must be sent
Insurance indicated by (X) will be required under this contract. Insurance certificates, policies, and
Chief Contracting Officer,
to the New York City Department of Environmental Protection, Agency
New York 11368.
ATTN: Contract Management Office (INSURANCE), 17th Floor, 59-17 Junction Boulevard, Corona,
Article 6 of Agreement Insurance
Section Statutury per New York State Law without regard to jurisdiction
(x) Workers Compensation:
II B $ 1,000,000 each accident
(x) Employers Liability: Section
II.D
() Jones Act:* Section
II.E
() U.S. Harbor Workers & Lotigshoremans
Compensation Act:* Section
it G
As respects use of tugs, uaryes or uutel rnahne opelatiuns under In's
contract.
(X) Commercial General Liability CG 00 01 (ed.10/93) or $_5,000,000 per occurrence:
equivalent. Combined Single Limit-Bodily Injury and $ 5,000,000 products/completed operations aggregate
Property Damage: $ 5,000,000 personal injury
Section $ 50,000,000 general aggregate
II.A $ 10,000 per claim maximum deductible, except as
approved by the CONTRACT MANAGEMENT OFFICE
() Others to be added as additional insureds: Additional Named Additional Insureds
insured status using ISO endorsement CG 20 10.
Section _United States of America
II A.3 _State of New York
$ 2,000,000 Each Occurrence
(x) Business Auto Covera.e: CA 00 01 (ed. 06/92) or
equivalent Combined Single Limit - Bodily Injury and
Property Damage
(x) Owned (x) Hired (x) Non-Owned
Inc toiluwiny coverage must be provided:
()Business Auto Coverage Form: Section II I
() Marine Protection and Indemnity, SP-23 or equivalent: $ per occurrence
• Section $ aggregate per year
II.F $ max deductible
' As lespccts JC ul luyJ LulyCJ ul utr1CI Irwl lie upciat~wns
under this contract.
# City as insured by endorsement to each relevant policy
DEP Form SCHED A SUPPLY & SERVICE: August 21, 2002 (PIN#826WTC03UCCL)
NYC-WTC 000107845
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