NYC 9/11 Public Portal Document
•Ii , i
1 - .a
t D
nsurance Indicated by (X) will be required under this contract. insurance certificates, policies, and*ndorsements must be sent
o the New York City Department of Environmental Protection, Agency Chief Contracting Officer,
VrTN: 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 won
118 $1.000.000 each accident
(x) Employers Liability: Section
II.D
()Jones Act* Section
II.E
() U.S. Harbor Workers & Longshoreman
Compensation Act:* Section
Il.G
• As respects use of tugs, barges or other marine operations under this
contract
(X) Commercial General Liability CG 00 01 (ed.10/93) or $5, 00; 000 per occurrence:
equivalent. Combined Single Limit-Bodily Injury and $-' 5 ~ 000,000 products/completed operations aggregate
Property Damage: Section IIA $ 5, 0- Q0, 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
red status using ISO endorsement CG 2010.
Section 0 rs of .Buildings on Whieh Wo k • Tc •. To
. .... .. •...
Be Done
.
$ 1.000.000 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
DEP Form SCHED A SUPPLY & SERVICE: March 28, 2002 (PI SWTCROOFI)
NYC-WTC 000115486
OCR can misread numbers and units. Confirm readings against the page image before using them.