NYC 9/11 Public Portal Document
OCT-24-2002 09 17 NYCDEP BRNHM ASE/LEAD TRU 718 595 3648 P.12
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and ot~dar~t~nts must be sent
isurat<ct: indicated by (7Q will be required under e contact. Insurance oertiflcetes, ,' r.
Contracting
the New York City Department at En ranmentat Proton, Agency Chief 8cwiortar Corolla, New York 11388.
TIN: Contract Management Office (INSURANCE), 17th Floor, 69.17 Junction
Ardc:le 6 of Agreement Insurance
Sfe owy pw Nest* York tote ~.au►wNhottt ts~ eo a►
(x) Workers Compensation: Section
si o.000__ each accident
(x) Employers Uabaiwy: liD
Section
{ }Jones Act:* Section
li.E
(} t~ohcers & Longshoremans $
Compensation eedon
• As respect sea or1 a , bjegos or other opai*lIol under ttl
(X) Commerc=ial General Liability CO 00 01 (ed.1tom) or $jojqço per o oe:
equivalent. Combined Single iamit-Bodily injury and $j 0O0. 000 productslcamplsted operations aggregate
Property Damage: Section HA $' 05 0Q, personal purr
o,00q.00O geierl.aggteagate
$ 25,0QQ per claim maximum deductible. except as
approved by the CONTMCT MANAGEMENT OFFICE
Others to by added as additional Insureds: Mdltionsl Named Addis rnau eds
iced status using i$0 endorsement CG 2010. .
Mark
n 3. Q B3i'~$'A~■ Viii
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x) u&nass Auto Comca: CA 0001 (ad. ) or
tqulvsient Combined Single Limit. Bodily Injury and.
Damage
(x) Owned (x) Hired (x) Non-Owned
1,e mowing coverage must be proceed:
) Business Auto Coverage Form: but Jill
DEP Penn SCHED A SUPPLY a 5aRVI0E: Me h 2% am (PIN SMYTCROOF1)
NYC-WTC 000128461
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