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Home My WebLink AboutBuilding Permit #073 - 1600 OSGOOD STREET 8/4/2006 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION o`pORTh tt,.6o 0 6tq�o 6 0� Q o Permit NO: 4. 73 Date Received pgococ.xawe..K P` Date Issued: S 'CHUS IMPORTANT: Applicant must complete all items on this page LOCATION 1600 OS&Mb SW'6't, Ng-krif A-A3 6av6k rUA— 010K Print PROPERTY OWNER , Print MAP NO.: 3 4 PARCEL: l ZONING DISTRICT: 12-- TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building ❑One family ❑Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑Repair, replacement ❑ Assessory Bldg VCommercial ❑Demolition ❑Moving(relocation) ❑Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED CoA)5(.2.cc cto Two Fro+��i2 R�u,cS int fre.ST -FLaok /NSTA-wA-'cU?,J cT A160 14vkC E40lPM/:6/,J-" A-7VA P�o74,6P.r Identification Please Type or Print Clearly) OWNER: Name: 07-Z-1 MCKP-TttS 110C. Phone: 9-I$"6$f Address: 11bo0 OS&006 McVr, NO-UH .,61,J1D D0,60L , P.A . 0182f CONTRACTOR Name: Ci�,Lttc,416IArl CzP0SJkAkf%JJ'(U4 co. Phone: °Q�-(0 Address: f C0�.0 S�I✓�% �' P.O.IDX 220 WkrI4 k-6kA11J C-r MA 01%tb Supervisor's Construction License: CS 0(0J o A y Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/E EER GSA &SoG tkTOS Name: Phone: io wiw S-'. v ILaw(.,o Address: NoK-TN A-I}pov.EL 1 AAA-- DIWSI Reg. No. 8b$% (a6&oty Sat,c!rFi FEE SCHEDULE:BULDING PER IT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost S //bg, x12.00=FEE:$ v V6 Check No.: 9 ,5141-10 Receipt No.: Page 1 of 4 TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ 11Tanning/Massage/Body Art ❑ g Public Sewer Well Tobacco Sales ❑ Food Packaging/Sales [I❑ ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner1�,! Signature of contractor Plans Submitted ❑ Pl Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-'U FORM DATE REJECTED DATE APPROVED PLANNING& DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ COMMENTS i DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments ' Conservation Decision: Comments Water&Sewer connection/Si nature&Date fDrivewav Pe rraw Temp Dumpster on site yes—no— Fire Department signature/date i I Building Setback (ft.) Front Yard Side Yard Rear Yard j Required j Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area,sq. ft.: I NOTES and DATA—(For department use) j Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Pa-P.4 of 4 Location / � � No. 7--.3 � Date "`y o, NORTp TOWN OF NORTH ANDOVER F S oighat Certificate of Occupancy $ MUS<� Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # l Building Inspector' ELECTRICAL AFFIDAVIT Commonwealth of Massachusetts County of Middlesex Sct. On this 315` day of January,2007 before me, Cheryl Lynn Casey,a Notary Public duly commissioned and qualified for the Commonwealth of Massachusetts,personally appeared Raymond J.Walsh Jr.,PE. No.45241 who,being duly sworn,on behalf of B20 Associates deposes and states that electrical work constructed to date on the 1st floor of 1600 Osgood St Massachusetts were inspected on 1/30/07,and that to the best of his knowledge,information,and belief,there are no apparent violations of applicable laws or codes of the Commonwealth of Massachusetts,or the Town of North Andover,MA or any other regulatory agencies having jurisdiction. Based on his review on the above date,the project is built in conformance with the plans and specifications,and meets the requirements of all applicable codes and conforms to generally accepted engineering practices. Therefore,I request that the Town of North Andover issue a Certificate of Occupancy for: Project Title: Osgood Landing Boiler Replacement Project Location: 1600 Osgood Street Andover,MA Name of Building: Ozzy Properties—BLDG.30 Nature of Project: Boiler and low pressure steam plant Name of PE: Raymond J.Walsh Jr. Title: Electrical Engineer �A OF Firm Name: 132Q Associates,Inc. ast;,P sqo e� RAYtI100 J. '6- VVALSH JR. Firm Address: 5 Arrowhead Ln. o ELECTR;CAL No.4.5241 Beverly,MA 01915 Telephone: (978)969-3747 S�ONAL EN Mass PE eal an Signa Subscribed and Sworn to before me this 2M day of 7 CHERYL LYNN CASEY Notary Publi eal and ignature Notry aPublic calm a Num �,.�-�... �'1 , r10 ►1 *C�an�iOnE>�Oa27.2011 My Commission Expires PLUMBING AFFIDAVIT Commonwealth of Massachusetts On this DAY 01/30/07 before me, &Ocry/6 L1C1a Notary Public duly commissioned and qualified for the Commonwealth of Massachusetts,personally appeared Rand Refrigeri,PE. No.30394 who, being duly sworn,on behalf of B2Q Associates Inc. states that Mechanical work constructed to date on the 1st floor of 1600 Osgood Street Massachusetts were inspected on 01/24/07,and that to the best of his knowledge,information,and belief,there are no apparent violations of applicable laws or codes of the Commonwealth of Massachusetts, or the Town of North Andover,MA or any other regulatory agencies having jurisdiction. Based on his review on the above date,the project is built in conformance with the plans and specifications,and meets the requirements of all applicable codes and conforms to generally accepted engineering practices. Therefore,I request that the Town of North Andover issue a Certificate of Occupancy for: Project Title: Osgood Landing Boiler Replacement Project Location: 1600 Osgood Street North Andover MA OF MgSs9cyG Name of Building: BLDNG 30 � RAND JOHN �P zREFRIGERI in-4Nature of Project: Boiler and low pressure steam plant MECHANICAL c' No.30394�Q �Q Name of PE: Rand Refrigeri F A�oFFSS�/SAIENG\�� Title: Plumbing Engineer N Firm Name: B2Q Associates Inc. Firm Address: 5 Arrowhead Lane Beverly,MA 01915 Telepho e: 9789693747 Mass W§ealand e Subscribed and Swom to before me this day of l( 2007 41 yxe Notary ublic Seal and ignature My Commission Expires FIRE PROTECTION AFFIDAVIT Commonwealth of Massachusetts On this DAY 01/30/07 before me, &W a Notary Public duly commissioned and qualified for the Commonwealth of Massachusetts,personally appeared Rand Refrig_eri,PE. No. 38694 who, being duly sworn,on behalf of B2Q Associates Inc. states that Mechanical work constructed to date on the 1st floor of 1600 Osgood Street Massachusetts were inspected on 01/24/07,and that to the best of his knowledge,information,and belief,there are no apparent violations of applicable laws or codes of the Commonwealth of Massachusetts,or the Town of North Andover,MA or any other regulatory agencies having jurisdiction. Based on his review on the above date,the project is built in conformance with the plans and specifications,and meets the requirements of all applicable codes and conforms to generally accepted engineering practices. Therefore,I request that the Town of North Andover issue a Certificate of Occupancy for: Project Title: Osgood Landing Boiler Replacement Project Location: 1600 Osgood Street North Andover MA Name of Building: BLDNG 30 OF MAS,qC Nature of Project: Boiler and low pressure steam plant RAND JOHN yGs�, REFRIGERI � Name of PE: Rand Refrigeri � FIRE PRvTEC¶ON N 140.38694 Q Title: Fire Protection Engineer ,o '9FGISZEQ�`' 9�FF4I0NAI Firm Name: B2Q Associates Inc. Firm Address: 5 Arrowhead Lane Beverly,MA 01915 Tele hone: 9789693747 MassTE Seal and i e Subscribed and Sworn to before me this �} �T day o lLh 2007 No ry Public Seal and Signature `17- '2,�/7 My Commission Expires MECHANICAL AFFIDAVIT Commonwealth of Massachusetts On this DAY 01/30/07 before medam/&i+ g-,2 ,,a Notary Public duly commissioned and qualified for the Commonwealth of Massachusetts,personally appeared Paul Banks,PE. No.33669 who,being duly sworn,on behalf of B20 Associates Inc. states that Mechanical work constructed to date on the 1 st floor of 1600 Osgood Street Massachusetts were inspected on 01/30/07,and that to the best of his knowledge, information,and belief,there are no apparent violations of applicable laws or codes of the Commonwealth of Massachusetts, or the Town of North Andover,MA or any other regulatory agencies having jurisdiction. Based on his review on the above date,the project is built in conformance with the plans and specifications,and meets the requirements of all applicable codes and conforms to generally accepted engineering practices. Therefore,I request that the Town of North Andover issue a Certificate of Occupancy for: Project Title: Osgood Landing Boiler Replacement Project Project Location: 1600 Osgood Street North Andover MA Name of Building: BLDNG 30 Nature of Project: Bolier and low pressure steam plant Name of PE: Paul Banks ZN 4F Title: Mechanical Engineer PAt1L J. �G ' HANKS Firm Name: B2Q Associates Inc. MECHAN}i,4AL N Na X3669 'A Firm Address: 5 Arrowhead Lane 7rZ Beverly,MA 01915 Telephone: 9789693747 pec"Ct Q P�Qz—u �4 � Mass PE Seal and Signature Subscribed and Sworn to before me this3o day of ,2007 Notary Public Seal and Signature y ow ZO My Com ission Expires TOWN OF NORTH ANDOVER Final Design Affidavit Project Number: 0605046 Project Title: Boiler Replacement Project—Boiler Plant Project Location 1600 Osgood St. 1st floor Building 30 North &South Side Name of Building: 1600 Osgood St. — Osgood Landing Nature of Project: Replacement of central boiler plant building with smaller more efficient boilers inside of the main building In accordance with Section 116.0 Registered Architectural and Professional Engineering Services-Construction Control of the Massachusetts State Building Code, I, Gregory P. Smith Registration No. 8688 being a Registered Pre€essiefial En#veeF/Architect, HEREBY CERTIFY that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Architectural X)= Structural Mechanical Fire Protection Electrical Other (specify) FOR THE ABOVE-NAMED PROJECT, AND THAT SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE 780 CMR MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRACTICES AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER-CERTIFY THAT I HAVE PERFORMED THE NECESSARY PROFESSIONAL SERVICES AND EITHER MY REPRESENTATIVE OR I HAVE BEEN PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK HAS PROCEEDED IN ACCORDANCE WITH THE DOCUMENTS SUBMITTED FOR THE BUILDING PERMIT, AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2 1. Review for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the state of construction to become generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. I AM SUBMITTING THIS FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. Signature and Stamp(no facsimile) ArA AR P.S s Ile. 8688 s vJp#WDDERRV. aw SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF UZU 2007 MY COMMISS p NOTARY PUBLIC' � DONNA .WEDGE {� NOTARY PUBLIC COMMONWEALTH OF MASSACHUSETTS My Comm.Expires Aug.7,2009 FINAL CONSTRUCTION CONTROL COMPLETION PROJECT LOCATION: 1600 Osgood Street North Andover MA NAME OF PROJECT: Boiler Plants-North and South PROJECT NO: D1609 SCOPE OF PROJECT: Design of stack and pipe supports and floor trench I Robert K.Dai ]g e,P.E. of Daigle Engineers,Inc. submit that our office has performed the following professional ser- vices, as specified in Massachusetts State Building Code Section 116.2.2 and as related to the structural portions of the work: 1. Reviewed for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Reviewed and approved the quality control procedures for all code-required controlled materials. 3. Been present at intervals appropriate to the stage of construction,and complexity of the project,to become generally familiar with the progress and quality of the work, and determine to the extent practical and pos- sible the work was being performed in a manner consistent with the structural construction documents. To the best of our information,knowledge,and belief,the structural work has been satisfactorily completed in substan- tial compliance with the intent of the construction documents. Signature: 2 2 Q Massachusetts Registration No. 8583 Our observations during site visits do not relieve the Contractor or its subcontractors of their responsibilities and obligations for qual- ity control of the work,for any design work which is included in their scope of services(i.e.design delegation),and for full compli- ance with the requirements of the Construction Documents and applicable building codes. Furthermore,the detection of,or the fail- ure to detect,deficiencies or defects in the work during our site visits does not relieve the Contractor or their subcontractors of their responsibility to correct all deficiencies or defects,whether detected or undetected, in all parts of the work,and to otherwise comply with all requirements of the Construction Documents. NOTARY STATEMENT: Subscribed and swom to before me this day of NOTARY PUBLIC MY COMMISSION EXPIRES ON D1609 CCA 070129.doc The Commonwealth of Massachusetts Department of Fire Services Office of the State Fire Marshal P.O.Box 1025 State Road,Stow,MA 01775 PERMIT Date: North Andover permit No Dig Safe Num er (City of Town) (If Applicable) In accordance with the provisions of M.G.L.14 8 CChhaptt+er1()_as provided in section 5?7 f'M R 34 Start Date This Permit is granted to: %/�7�c3'7< J U It-, '1`-0---,r Full name of person,Firm or Corporation Peraiissionto locate dumpster for construction/renovation/demolition of building Comments: dumpster must be 25 ' from structure if unable to place with required Restrictions: clearance dumpster must be covered Yith plywood or tarp end of work day at (Give location by street and n ., r describe in such as to provied adequate identification of I tion) Fee Paid$ 50 .00 f� (/ / Fire Chief This Permit will expire /L% -6` Signature of or al grant g permit) Offical.granting permit (Title) m==♦ TW1.cZ PI=RMIT MI ICT F2F ('_(1NCPiri inn ICI v Pr1CTi=n I IPr M TW9= PRFMICFC �� t NORTH Town of No. 7 - _ A o dover, Mass., AP 44%06 COCMICFIEWICK A0RATED S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System (54 * BUILDING INSPECTOR THIS CERTIFIES THAT.............. ....... Foundation has permission to erect......................6'....... ..... buildings on f d Rough .......................... . ................ .......... to be occupied as.......... ... . �.... ...�!f V...... .�.... ! �.... A� Chimney provided that the person accepting this permit shall in every respect conform to the terms of t app tion on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration an Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough a rep PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTI START ELECTRICAL INSPEC'T'OR Rough ................. ... .......4UILDSIWN�Gft�k;i6k Service Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner FlRE DEPARTMENT Street No. SEE REVERSE SIDE Smoke Det. TOWN OF NORTH ANDOVER Construction Control Affidavit Project Number: 0605046 Project Title: Boiler Replacement Project— Building 30 Project Location: 1600 Osgood Street, Building 30, First Floor Name of Building: Osgood Landing Nature of Project: New low pressure boilers to replace high pressure central plant boilers. In accordance with Section 116.0 Registered Architectural and Professional Engineering Services-Construction Control of the Massachusetts State Building Code, I, Gregory P. Smith, AIA Registration No. 8688 being a Registered Prefessienal /Architect, HEREBY CERTIFY that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Architectural _XXXX_Structural Mechanical Fire Protection Electrical Other (specify) FOR THE ABOVE-NAMED PROJECT AND THAT SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE 780 CMR MASSACHUSETTS STATE BUILDING CODE. ALL ACCEPTABLE ENGINEERING PRACTICES AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the state of construction to become, generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. UNDER SECTION 116.4, I SHALL PERIODICALLY SUBMIT A PROGRESS REPORT, TOGETHER WITH PERTINENT COMMENTS,TO THE BUILDING INSPECTOR UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMP. READINESS OF THE PROJECT FOR OCCUPANCY. Signature and Stamp (no facsimile) Na8688 IW AMM � 41 OF SUBSCRIBEND SW RN E MET IS AY OF 2006 MY COMMISSION E IRES NOTARY PU �� j AUG-03-2006 11:27 From:OZZY PROPERTIES 19784754638 To:19786641965 P.1/1 • � r August:1, 2006 1.'crry(-)'Sullivan Columbia Construction C'nmpa.ny 58 Concord Strect PO Box 220 North Reading,MA 01864-0220 RG: Boiler Project 1600 Useood Street,North Andover,Massstchusetts Dear Terry, Ozzy Properties has selected your firm to undertake dic new Boiler Project at 1600 Osgood Street. The work shal I consist of the items described in your proposal dated July 26,2006 in the sum of $(,699,000(tine million six hundred eighty-nine thousand dollars). Receipt ul'tlus letter Shall constitute authority for you to begin permitting, mubilizing the necessary staff and begin work on this project. Formol contracts arc currently heing drafted and shall be issued to you for signing shortly. We arc pleased to have Columbia Construetinn Company as part ol'our team fur this project. Sincerely, k,llen .Keller Vice President Commercial Real EXtate 3 Dundee Park Andover, MA 01810 Phone: (978) 475-4569 • rax: (978) 475-4638 www.ozryproperties.eom 6 �pCpC E S BOARD OF BUILDING REGULATIONS ,License: CONSTRUCTION SUPERVISOR Number CS 067042 Birthdate:08/26/1968 I , Expires,: 08/26/2007 Tr. no: 3352.0 I'I estricted: .00 THOMAS E BERTHIAUME I685 WEST LOWELL AVE �j— HAVERHILL, MA 01832' Commissioner -------------------------- j 0 { E s r rHur- UZI ri[ 19BE Y) %,M CERTIFICATE OF LIABILITY INSURANCE ,00UCER THB CEFMFICATE IS ISSLED ASA MATTEROF II FORMATION T.►inbrovk Insurance Brokerage ONLY AND CONFIERS NO RIGHTS UPONTHECERTIFIC 400A Franklin Street HOLDER 11IISCEtiTIFICATEDO®Nat AM9ND,EXTE ALTER THE COVERAGE AFFORDED13YTHE POLICII3 nraintree, MA 02184 — — —'— —— — INSLgFA AFFORDING COVERAGE --—— _.Columbia Con9truCtivn ComF8nx INSURER — P0 Bolt. 220 INSURER C: .— S9 Concord Street INSURERO: Tschno10 In2ur&AcQ CO North Reading, MA 01864-022 — "x INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PCRTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.IfE IOUCYMBER ' POt1GY FEC VE L1GY PI N LIMITS NU OENPRALLIABILITY I I EACH OCCURRENCE — COMMERCIAL GENERAL LIABILITY PREMISES( — CLAMSMroE I_ OCCUR MEJ]EXP(Aryaln`penon) —. ..— PERSONAL ADV INJURY 1 _ —. GENERAL AGGREGATE $ l DEM L AOGREGATE LIMIT APPLIES PER: PRODUCTS•CDMProv AGG POLICY jE 17 LOC AUTOMOBILE LIABILITY I COMBINED SINGLi LIMIT ANY AUTO (E��eeldwlO — ALLOVMEDAUTOS I BODILY INJURY (Pw SCHfiOuLED AUTOS HIRE�NONDAUTOS OWNEOAUTOS I BDOILYMJURY (Parwcleerq PROPERTY DAMAGE (Par cclOwd) GARAGE LIABILITY AUTO ONLY•EAACCIDENT ANYAUTO OTHER THAN EAACG AUTO ONLY: AGG f ECESSNMBRELI.ALIABILITY I I EACH OCCURRENCE i OCCUR CIANSMADE AGGREGATE ! _ 3 DEDUCTIBLE I L RETENTION 11 I = WORKERS COMPENSATION MIDX RYLIVEs E TIZI— [1 EMPLOYER7S'LIAR TNC3108d63 7/1 06 1/07 E.L.EACH ACCIDENT $ 1,000,000 IANY PROPRIETORIPARTNEAIEcECUTIW 1-000-000 OFFICERNIVIDEREXCLUDEDT E.LDISEASE-GAEMPLOYEE 4 ItA ewdmvaw EL DISEA9E•POUCYUMIT i 1,000,000 SA AI PROVISION S blbw OTHER D f5C RIPTIO N OF 0 RzRATIONS I LOCATIONS I VEH CLES 1 EXCLUSIONS ADDEO BY END ORSEMETNT I SPECIAL PROVISIONS CERT IFIC ATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED PDLICIES BE CANCELLED BEFORE THE EXPIR ATION DATETNEREOF,THE 163UING INSURER WILL V40EAVOR TO MNL 3_0 DAIS W RITWH NOTIC ETO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO D 0 90 SHALL IMI06NNOOBLIG •ITSAGENTSOR REPREtENTARIVES. AUTHORIZED REPRE ACORD 25(2001108) 0 AC CORPORATION 1968