NYC 9/11 Public Portal Document
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nsurance indicated by (X) will be required under this contract. Insurance certificates, policies, and~erdarsements must be sent
o the New York City Department of Environmental Protection, Agency Chief Contracting Officer, ~r
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 without regard to jurisdiction
II.B $ 1.000.000 each accident
(x) Employers Liability: Section
ll.D
( )• Jones Act:* Section
ILE
() U.S. Harbor Workers & Longshoremans
Compensation Act:* Section
' di:G
• As respects use of tugs, urges or other marine operations under this
contract
(X) Commercial General Liability CG 00 01 (ed.10/93) or $5 ; QO0; 000 per occurrence:
equivalent Combined Single Limit-Bodily Injury and $ ;000, 000 products/completed operations aggregate
Property Damage: Section IIA $ 5, 0. QO, 00 personal injury
0-00,000 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 0w~ rs of . Buildings on Which We Tea Tn
• P&'\. ?a W t. U1 , : ILA3, • Be Done
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$ 1.000.000 Each Occurrence
(x)Business Auto Coverage: CA 00 01 (ed. 06192) 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 (Pimaim CROOFI)
NYC-WTC 000115783
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