NYC 9/11 Public Portal Document
OCT-04-2002 FRI 04:32 P11 FAX NC. P. 14/31
Poo• 2 of 4
SUPPLY and SERVICE CONTRACt
GENERAL COPDITIONS
SCHEDULEA
must be sent
indicated by (X) will be required under this contract. Insurance certificates, policies, and
nsurance
Environmental Protection, Agency Chef Contracting Officer,
a the New York City Department of Floor, 59.17 Junction Boulevard, Corona, New Yak 11368.
1TFN: Contract Management Office (INSURANCE), 17th
Insurance
Article 6 of Agreement
. Section Sab.rery par New Yarn Stab Mawr w cut. ri w to Jandieson
(x) Workers Compensation: $ each accident
II.B
(x) Employers Liability: section
iI.D -
Section
() Jones Act:•
II.E
() U.S. Harbor Workers & Longshoremans Section
Compensation Act'
IG
order V&
• As rsepscts use of ttras, birpas or Other rnufna aperatione
or 000..per 0=11 rte:
(X) Commercial General Liability CG 00 01 (ed.10/93) $; S,O0O.0 prodUCt$/GompleUrd operations aggregate
equivalent. Combined Single Limit-Bodily Injury and
Property Damage: Section ILA I 5 5 • 020 .Qo personal injury
S'01.00 000 general aggregator
except as
$ 25.000 per claim maximum deductible,
Named Additional Insureds
th to be added as additional insureds: Additional
&~—Stsws using ISO endorsement CO 2010. ! L7nrk 1s Tn
Section .rrw
ll1-'S Be Dobe
$ 1.000.000 _ Each Docu. Tense
(x) pusiness Auto CcvfiraQe: CA 00 01 (ad. 061'92) or
equivalent Combined Single Limit - Bodily Injury end.
Property Damage
(x) Owned (x) Hired (x) None Jwned
The following coverage must be provided:
() Business Auto Coverage Form: Section Il.l
(PI 6WTCROOF1)
DEP Form SCHED A SUPPLY i SERVICE: Msrch 25, 2002
NYC-WTC 000113558
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