NYC 9/11 Public Portal Document
NOV.13.20@2 4:2SPM ROSS & HPiRDIES NO.979 P.15
SOPPILY dSRQE CORAT Page ot4
nswtence Indloeltad by CX) will be required under this 'contract. Insurance arttflgtes, policies, and endorsements must be sent
a the New York City Deportment of Envlronmentdl Protoetloyi, Agency Chlof Connb ttng Omost.
~►TTNi Confect Management Office (INSURANCE), t7th Floor, 89-fl Junction Bduievard, Corona, New York 11368.
Amble 6 of Agreement Insurance
{x) Workers Compensstlon: Section sh_nr t_ __ Yortc 81110 v WOW caul b .
1t.s ~- affi-M esah s~ldant
{x). Employers Liability: Section
{ } ;tunes Act' Salon
11.5
} U.S. Harbor Workers & Lonpshorernanot
Conlpense Act' Section
• As raped oee of 1upe, sires cc oilier n the opereIons cider this
(*) Commercial General f-tebility CO 00 01 (ed.10t93) or $;, per
equivalent. Combined Single Umf-Bodlly Injury end $ 'y,S; 000 g ,Q, pmdutWaampIeted operations aggregate
• Property Damage: Secti•on II.A $' apt}„
personae ate
• $ t2$QQ..per oisltm ntoadnrturn deductible, except as
a qte cs
tktters to by added as sddltional insureds: Additional . Named*Addltonal Insureds
s t us usf g ISO endorsement CG 2010, . •
Section • ~rg_at . B4 ; d{~
, as Wnr
.-a•.•• .• •.dr., ... :.
. • • • • , ..
fLam• . . •W 1 •
• Y -
.
. .
k ,
VS
x_ Each O nrosnae
(*) 3lnes l d ' u ,e: CA 00, 01 (ed. 0812) or ''®~`"~
equivalent Combined Singie I.bnit - Bodily Injury end, •
Property Damage
(x) O ed ' (x) Hired (x) Nn-Owned
The following caysregq must be provided: •
O Buetrteu Auto Comwe Form: Section 11.1. V
DRIP Fora $CHED A SUPPLY & BERVICS: March 25. 2002 {PIN*5W Cf Fi)
NYC-WTC 000115614
OCR can misread numbers and units. Confirm readings against the page image before using them.