NYC 9/11 Public Portal Document
Page 2 of 4
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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,
VTTN: 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 wtaaut regeI to f.atadtcnon
II.B $ t000 0Q0 each accident
(x) Employers Liability: Section
11.D
().Jones Act:' Section
ILE
() U.S. Harbor Workers & Longshoreman
Compensation Act:` Section
II.G
• As respect use of to. barges or other marine operattans under this
conaact.
(X) Commercial General Liability CG 00 01 (ed.10/93) or $j59QO0; 000 per occurrence:
equivalent. Combined Single LimitBodily Injury and $ 5 000. 000 products/completed operations aggregate
Property Damage: Section II.A $.j 0.90, 000 personal injury
0 000 00 general aggregate
$ 25,000 per claim maximum deductible, except as
approved by the Co.rw►cT MANAGEMENT OFFICE
hlb(Others to be added as additional insureds: Additional . Named Additional Insureds
s red status using ISO endorsement CG 20 10.
Section Aaianrs of .Bui]dI, s on WhInh Work'2a• Tn
II:A`3. Be Done
+iiiL l I( '' .
MTh.
ii_ 7 'ATE l 'i :-. L
• $ 1.000.000 Each Occurrence
(x) BusinessAuto 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 (PINf826WTCROOF1)
£T'd 8t'92 S6S 8TL nbl cI 31i8SU WHNUE d3a3AN 9t':TT ZOOZ—ST-100
NYC-WTC 000110582
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