Asbestos inspection form for 65 Beaver Street

NYC 9/11 Public Portal Document

1 e.

Page 2 of 4

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 without regard to jurisdiction 11.8 $ 1.000.000 each accident (x). Employers Liability: Section • II.D O Jones Act:' Section 11.E () U.S. Harbor Workers & Longshoremans Compensation Act:' Section II.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 $j,000 000 per occurrence: equivalent. Combined Single Limit-Bodily Injury and $; 5 %000, 000 products/completed operations aggregate Property Damage: Section II.A $;S, 0Q0, 000 personal injury 50,000,Q00 general aggregate $ 25, 000 per claim maximum deductible, except as approved by the CONTRACT MANAGEMENT OFFI .E

Others to be added as additional insureds: Additional . Named Additional Insureds s red status using ISO endorsement CG 20 10. Section Work' T.c . Tn 0w1iers of Buildings on Which .. . _ it.A:3 Be Done'

$ 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 (PIN#826WTCROOFI)

NYC-WTC 000118985