NYC 9/11 Public Portal Document
Page 2 of 4
• Moll el
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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,
ITT N: Contract Management Office (INSURANCE),17th Floor, 59-17 Junction Boulevard, Corona, New York 11368.
Article S of Agreement Insurance
(x) Workers Compensation: Section Statutory per New York State La without regard to jurisdiction
11.8 $1-000.000 each accident
(x) Employers Liabilty - Section
• IID
O Jones Act:' Section
11.E
() U.S. Harbor Workers & Longshoreman
Compensation Act• Section
.ILG
• As respects use of tugs, barges or other marine operations under this
contract.
(X) Commercial General Liability CG 00 01 (ed.10193) or $'S;QO0 ;000 per occurrence:
equivalent. Combined Single Limit-Bodily injury and $. 5 , 000,000 products/completed operations aggregate
Property Damage: Section iIA $' 5 0 ,0,QOO personal injury
• 0,000,000 general aggregate
$ 25,000 per claim maximum deductible, except as •
• approved by the CONTRACT MANAGEMENT OFFICE
added as additional Insureds: Additional Named Additional Insureds
XZ=4nsing ISO endorsement CG 2010.
Section of Buildings nn Which Work Tc Tn
.. .. .
t3wters
lLA3 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 000134493
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