NYC 9/11 Public Portal Document
Page 2 of 4
SUPPLY and SERVICE CONTRACT
GENERAL CONDITIONS
SCHEDULE A
Insurance indicated by (X) will be required under this contract. Insurance certificates, policies, and endorsements must be sent
to the New York City Department of Environmental Protection, Agency Chief Contracting Officer,
ATTN: Contract Management Office (INSURANCE), 17th Floor, 59-17 Junction Boulevard, Corona, New York 11368.
Article 6 of Agreement Insurance
(x) Workers Compensation: Section Statutory per New York State Law without regard to jurisdiction
II B $_1000000 each accident
(x) Employers Liability: Section
II.D
() Jones Act" Section
II.E
() U.S. Harbor Workers & Longshoremans
Compensation Act:* Section
As respects use of tugs, barges or otner marine operations under this
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 Coverage: CA 00 01 (ed. 06/92) or
equivalent Combined Single Limit - Bodily Injury and
Property Damage
(x) Owned (x) Hired (x) Non-Owned
The following coverage must be provided:
() Business Auto Coverage Form: Section 11.1
() Marine Protection and Indemnity, SP-23 or equivalent: $ per occurrence
* Section $ aggregate per year
II.F $ max deductible
" As respects ,:se ut Luys, oaiyes ur utner rnine uperati,r,s
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 000108835
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