NYC 9/11 Public Portal Document
Ei!J.. . . • - Page 2 of 4
• 14L.i!1
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
II.B $1.000,000 each accident
(x) Employers Liability: Section
II.D
Q. Jones Act:* Section
ILE
( ) 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 $ ,. 00 00 per occurrence:
equivalent. Combined Single Limit-Bodily Injury and $, 5,000,000 products/completed operations aggregate
Property Damage: Section ILA $ 5,000,000 personal injury
0 000 000 general aggregate
$ 25,000 per claim maximum deductible, except as
approved by the CONTRACT MANAGEMENT OFFICE
4 Others to be added as additional insureds: Additional
h red status using ISO endorsement CG 20 10.
Section
II.A3
Named Additional Insureds
Owners of .Buildings on Which Work Is Ti
Be Done
$ 1.000.000 Each Occurrence
(x) Business pr o
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 Iii
DEP Fonn SCHED A SUPPLY & SERVICE: March 28, 2002 (PIN#826WTCROOFI)
NYC-WTC 000119314
OCR can misread numbers and units. Confirm readings against the page image before using them.