NYC 9/11 Public Portal Document
Page 2 of 4
nsurance indicated by (X) will be required under this contract. Insurance certificates, policies, and endorsements must be sent
o the New York City Department of Environmental Protection, Agency Chief Contracting Officer,
kTTN: Contract Management Office (INSURANCE), 17th Floor, 59-17 Junction Boulevard, Corona, New York 11368.
Article 6 of Agreement Insurance
(x) Workers Compensation: Section Stabito y per New York State taw without regar aiadtcnon
II.B $ each accident
(x) Employers Liability: Section
II.D
().Jones Act: Section
ILE
( ) U.S. Harbor Workers & Longshoreman .
Compensation Act:` Section
113
• As respects use of tugs. barges or other marine operstians under this
Contract.
(X) Commercial General Liability CG 00 01 (ed.10/93) or $,900 0; 000 per occurrence:
equivalent. Combined Single Limit-Bodily Injury and $ 5 000. 000 products/completed operations aggregate
Property Damage: Section II.A $' S 0.0, 000 personal injury
0 000 00 general aggregate
$ 25,000 per claim maximum deductible, except as
approved by the CONTRACT MANAGEMENT OFFICE
Others to be added as additional insureds: Additional . Named Additional Insureds
s red status using ISO endorsement CG 2010.
Section flashers of .Builds s nn Whieh Work'2a• 'Pn
_. ~.
II: Be Done
3l_ .,A ! F
133 •- V ZLU~Z.V , ` 1 L.5_ . ... .
$ 1.000.000 Each Occurrence
(x) 8BusfnessAuto 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 .
DEP Form SCHED A SUPPLY & SERVICE: March 28, 2002 (PINif826WTCROOF1)
2T'd 8092 S6S 8TL flat Qti31'HSu WHNtjt3 d3a3AN 90:TT Z0OZ-ST-100
NYC-WTC 000110582
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