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HomeMy WebLinkAboutBuilding Permit #180 - 45 BEECHWOOD DRIVE 9/6/2007 �►ORTH BUILDING PERMIT o`�t�`° 'e,94'o TOWN OF NORTH ANDOVER 0 i A APPLICATION FOR PLAN EXAMINATION 4 ; Permit NO: Date Received SACH�15 Date Issued: IMPORTANT Applicant must complete all items on this page . � x� � ;yam t LOCATION d p ! rLnt 7 PRO1 e OW Nb ia& = �� i & j. Print M PAfiRCIZC3IINC L}ISTIC Hi00orfc Des#nct� � dyes Nlac �nSloplllage TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition 11 Two or more family El Industrial ❑ Alteration No. of units: xCommercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other 0 Septic C 1Ne�f41 Flc®dplaan iWat ltetlancts,J? t . ersl"kcitnct = k otterlSLAI ewe(, w . .^DESCRIPTION OF WORK TO BE PREFORMED: -.e`er- llTr7�D L?'� '41 �r St Identif tion Please Type or Print early) OWNER: Name: / a 4d Phone: r_4li�3G Address �I Ply©rie CON CTOR N ie _ ` s 141 Superuis� s gins rp tion Licenses Exp m rovementL�cense. Exp .Date Horn"A � < , ARCHITECT/ENGINEER�n rt, �c�G� - Phone: Z.-0 374- go�,� Address:?/A�t�illI&/ &W_442 - "Z1 �� Reg. No. M-4 ��/ Z� FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ *4 FEE: $ j, 3 O �z d Check No.: 31116 Receipt No.: © !;r;r& NOTE: Persons contrac ' with a registered contractors do not have access to tl guaranty fund Signature of Agent(C)wSignature of contractor j lov Location �•• �i� Date O 7 No. .- t - NORTN TOWN OF NORTH ANDOVER 3? ° • 0 AL F 2 _ Certificate of Occupancy $ �'�s''•° Eta' Building/Frame Permit Fee $ ��Z T�GNus • Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 20560 Building Inspector Plans Submitted ® Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ i i Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING &-DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ . ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS ❑ r. Zonirt.glt3oard of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: . Comments Conservation Decision: Comments Water& Sewer Connection/Signature & Date Driveway Permit Located at 384 Osgood Street FIRE DEP ARTMENT, -Temp Dumpstei�on site9 =jr s Located at 124 IVlain:Street. nO F Fire 1)epartmer'it sig(inatureldate.t ' ., :: -a. •+ice'^.-,. �CTVMMEN�S x ? Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use ❑ Notified for pickup - Date _............................... ... ...................... ........................................................_....................................................................................................._... Doc.Building Permit Revised 2007 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 o Workers Comp Affidavit a Photo Copy Of H.I.C. And/Or C.S.L. Licenses a Copy of Contract - • Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Li Mass check Energy Compliance Report (If Applicable) u Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) L, Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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 i Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 NORTH Town of �_ - VO No. O =_ 000* 0 - LAK O dover, Mas . I� COCMICHEWICK ORATED PP�,`�5 7 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.......... ......x.....66110............................. ................... .............. �aO ........ • Foundation ` ................... has permission to erect........................................ buildings on . ..�G .................. .. .......................... Rough T �� Chimney to be occupied as...................... .G4 ............ .... ... ......... ............... ...... ....R?qoit ................................ provided that the person accep ing this permit shall in every respect confo m to te arms oe application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final 5101 -- PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC >)*400�B STARTS Rough .... Service LD SPECTOR 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 FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. OFFICE OF BUILDING INSPECTOR �+ TOWN OF NORTH ANDOVER '•�," ` :. CONSTRUCTION CONTROL PROJECT NUMBER: PROJECT TITLE: ,L GON! 4�i�is PROJECT LOCATION: �� BE�GN G!/OO fI 027 NAME OF BUILDING: L C-OM NATURE OF PROJECT: ReNOVATion/y IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, I, RoN,4` d Aj5AI Ri REGISTRATION NO. 4G,2 7 BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT 0 ARCHITECTURAL 9 STRUCTURAL 0 MECHANICAL 0 FIRE PROTECTION 0 ELECTRICAL 0 OTHER(SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 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 stage of construction to become, generally familiar with6the 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. PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY , A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. SIGNATURE SUBSCRIBED AND SWORN TO BEFORE ME THIS 5 DAY OF 16 zoo SUSAN J. MATSON NOTARY PUBLIC NOTARY PUB MY COMMISSION EXPIRES_111atef N oew Hampshire y Commission Expires May 2,2012 Dutton & Garfield, Inc. CONTRACTORS 08/16/07 LETTER OF INTENT TO CONTRACT for L-COM CONNECTIVITY PRODUCTS, INC at 45 Beechwood Drive, North Andover, MA 01845 To Whom It May Concern: It is the intent of L-Com Connectivity Products, Inc. to contract with Dutton & Garfield, Inc. for interoffice renovations as depicted on the plans dated 01/23/07 at the Corporate Headquarters located at 45 Beechwood Drive, North Andover, MA. The current project budget is $360,928.00, which includes the items of work as defined by the Preliminary Project Scope of Work dated 08/15/07, copy attached. Allowances and exclusions to the contract are noted. A mutually agreeable lump sum AGC contract document is to be drafted and executed by the respective parties within the next two to three weeks. Should work be stopped for any reason, Dutton& Garfield is entitled to recover expenses in connection with this work at cost plus 5% for overhead, and 5% for contractor's fee. It is the intent of the parties to this contract to work in a cooperative and team like manner in order to provide cost effective and functional site work changes in a timely manner for L-Com Connectivity Products, Inc. Dutton & Garfield, Inc. is to provide a project schedule and coordinate commencement of this project as soon as.possible as directed by the designated L-Com representative. Certificates of insurance are to be provided prior to commencement of construction. AGREED AND ACCEPTED: L-Co Fine ivity oducts, Inc. Dutton & Garfield, Inc. B . wa.L �. Ca s c(��-► By: Stephen E. Foster, V.P. Date: Date: BUTLER BUILDER 43 Gigante Drive-Hampstead,NH 03841 www.duttongarfiield.com Tel:(60 3) 329-5300 Fax:(603) 329-5368 _ � ✓die-�o�.7mea.��.un�i a�/ oluaelta BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 029376 3irthdate 02/28/1953 Expires 02/28/2008 Tr.no: 17954 `•;� estricted. 00: rOSTER 48 MEADOW LN N ANDOVER, MA 01845 Commissioner The Commonwealth of Massachusetts t Department of Industrial Accidents Office of Investigations 600 Washington Street '.� Boston, MA 02111 �i 1 www.mass.gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):__�(,l,—+Q(-\ & 621 Address: L ► `\\)e- City/State/Zip:City/State/Zip: Ma&_d, JJ}' Q Phone# toU3� 3 02 q Are you an employer?Check the appropriate bo Type of project(required): 1.❑ I am a employer with 4, 1 am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.1 7• Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity, workers' comp. insurance. 9. Building addition [No workers'comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL t I. Plumbing repairs or additions myself,[No workers'comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.]t employees. [No workers' comp. insurance required.] 13.❑Other Any applicant that checks box i I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: �C 'GL sur ace- Co. Policy#or Self-ins. Lie.#: WC P10p5'7 �a\ Expiration Date: ] 1 O t Q Job Site Address: UUt e, City/State/Zip: Q�Apf," (�'l fl Ul QjyS Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required.under Section 25A of MGL c. 152 cari tead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: it Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees, Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed.to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),ad-dress(es)and phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to cavy workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permidlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense applications in any given year,need.only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or pennit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-7227-7749 Revised 5-26-OS www.mass.gov/dia 08/30/2007 09:30 FAX 6036696831 0 001/002 DATE(MM1VD/YYYY) AC= CERTIFICATE OF LIABILITY INSURANCE 08/30/2007 PRODUCER (603)669-0704 FAX (603)669-6831 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Infanti ne Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND,OR P.O. Box 5125 ALTER THE COVERAGE AFFORDED BY THE POLICIES BE-OW. Manchester, NH 03108 Danielle West INSURERS AFFORDING COVERAGE NAIC III INSURED Dutton & Garfield, Inc. INSURERA: Acadia Insurance Co. 43 Gigante Drive INSURER B: Hampstead NH 03841 INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDIN, ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,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. INSR DDATE(MMIDDfM DATE(MMIDDI'M D' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS ILTR GENERAL LIABILITY CPAOOS7S2015 11/01/2006 11/01/2007 EACH OCCURRENCE $ 1,)00,00 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ Z50,OO CLAIMS MADE a OCCUR MED EXP(Any one person) $ 5,OO A PERSONAL S ADV INJURY $ 11 01001000 GENERAL AGGREGATE $ 2,300,000 rGENL�AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,300,OOCY X J � X LOC AUTOMOBILE LIABILITY CAA020073210 11/01/2006 11/01/2007 COMBINED SINGLE LIMIT (Ea accident) $ X ANY AUTO 11300,000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ A HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) b PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ HAUTO ONLY: AGG $ EXCESSIUMBRELLALIABILITY CUAO05754115 11/01/2006 11/01/2007 EACH OCCURRENCE $ S,DOO,00 -5q OCCUR F]CLAIMS MADE AGGREGATE $ 51300,000 A $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WCAOOS753215 11/01/2006 11/01/2007 X I WCSTATU- I JOTH- ER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 500,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE $ S00,000 If yes xn,cleseriDe under SAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,000 ER CPA00S752015 11/01/2006 11/01/2007 Leased limit $100,000 LeaOTHsed Equipment DESCRIPTION OF OPERATIONS!LOCATIONS 1 VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT f SPECIAL PROVISIONS Various work throughout the policy term. -Com Connectivity Products, Inc. to be named as additional insured for General Liability and mbrella as respects this work. ax: Betsy Shull 329-S368 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL j 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, L-Com Connectivity Products, Inc. BUT FAILURE TO MAILH MCE SMALL IMPOSE NO OBLIGATION OR LIABQTY 45 Beechwood Drive OF ANY KIND UPON Tli ITS AGEWS OPfRqPRESENTATMS. North Andover, MA 01845 AUTHORIZED REPRESS ACORD 25(2001108) ©ACORD C ORA"ION 19814 08/30/2007 09:31 FAX 6036696831 Z002/002 IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s),authorized representative or producer,and the certificate holder,nor does it affirmatively or negatively amend,extend or alter the coverage afforded by the policies listed thereon. ACORD 25(2001/08) From:Paula Hall At:Hub International New England LLC FaAD:HUB International Ne To:Dutton&Garfield Date:8/28/2007 05:23 PM Page:1 of 2 OP ID P DATE(MMIDD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE IANNA-1 08/29/07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HUB International New England HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 299 Ballardvale St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Wilmington MA 01887 Phone: 978-657-5100 Fax:978-988-0038 INSURERS AFFORDING COVERAGE NAIC9 INSURED INSURER A: Peerless insurance Company INSURER B: Atlantic Charter Insurance Co. William J. Iannazzi, Inc INSURER Netherlands Insurance Co. 191 Chandler Road INSURER D: Andover MA 01810 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 PERTAIN,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. LTR NSRC TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MMIDDIYY) LIMBS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CCP8192739 10/01/06 10/01/07 PREMISES(Eaoccurenca) $ 300,000 CLAIMS MADEX❑OCCUR MED EXP(Any one person) $ 5,000 X Blanket Al ti>NeN REq'D BY CONTRACT PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PEC LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT C ANY AUTO BAS192539 10/01/06 10/01/07 (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $5,000,OOO A X OCCUR ❑CLAIMS MADE CU8192939 10/01/06 10/01/07 AGGREGATE $5,000,000 DEDUCTIBLE $ X RETENTION $10,000 $ WORKERS COMPENSATION AND TORY LIMITS ER B EMPLOYERS'LIABILITY WCI00054900 10/01/06 10/01/07 E.L.EACH ACCIDENT $ 1000000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYEE $1000000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 1$1000000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS re: L-Com Connectivity Products Inc. Dutton & Garfield, Inc. and L-Com Connectivity Products Inc. are hereby named as additional insured as required by written contract CERTIFICATE HOLDER CANCELLATION DUTTON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Dutton & Garfield IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 43 Giganti Drive REPRESENTATIVES. Hampstead NH 03841 A D R RE TATI ACORD 25(2001/08) ©ACORD CORPORATION 1988 From:Paula Hall At:Hub International New England LLC FaxlD:HUB International Ne To:Dutton&Garfield Date:8/28/2007 05:23 PM Page:2 of 2 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25(2001/08) 08/27!2007 11:57 16034345812 HORIZON PAGE 02 ACORD CERTIFICATE OF LIABILITY INSURANCE p)8f27/2007�"'' PRODUCaR J,E.Schlndler Ins,Agy'Inc THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION One Wall ONLY AND CONFER$ NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 5th Floor ALTER THE;COVERAGE AFFORlZ SE D BY THE POLICIES BELOW. Burlington MA 018030009 ....... . - .... ..... .... . (7$1)272.7505 INSURERS AFFORI)ING COVER F F„ NAIC 0 INSURED INSURE -The Hrd artfo _ Hodson Motais,Inc, rNBug£R a: 2 Windham Depot Road INSURER C: Derry NH 03038-0000 INSURER D' INDURER COVERAGES - THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS ZERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLU:WNS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR7X( OmMALUARILITY ICY NUMBER POLICY EFFECTIVE P061CY EXi'IRATtON A OB SBA UP4435 12/31/2006 12/31/2007 EACH 0c01 RRENCE 1,000,000 DAMAimmGEcTTO RENTED 300000 MERCIALGENERAI tA91UTY CLAIMS MADE, OCCUR _mf t�°x• Pro fty on Paesen s 51000 PERSONAL&ADV I1,000,000 GMATE IS 2,000,000 z,O00,000 N'L AGGREG 61Mrr APPLIES PER: PRODU,TQ• / X P A AUTOMOBILE UA9U.IT( 08 MCC W1 8400 12131 J2008 12/31/2007 COMBINED 6114GLE LIMIT S 1,000,000 c A ANY AUTO 08 UEC AB0333 12/31/2006 12/31/2007 Jae sccklam ALL OWNED AUTOS BODILY[NJ KY S 'X SCHEDULED AUTOS X HIRED AUTOS 800MY INJ 1RY E X NON•OWNEDAUTOS Iparweddrvl' PROPERTY DAMAGE (Pwr aucltlet I) GARAGE LtAWLITY AUTO ONLY-EAACCM T ANY AUTO OTHER THE N -E�A.AOS•.. AUTO ONLY. Ago It A EXCESWUMBRFLLA LIAatuTY OB$ISA UP4435 12/31/2006 12131/2007 EACttLX0lIRRE 5 000 000 X CLAIMS MADE OCCUR ❑ AOl3F{ECi47E 5,000, 0 DEDUCTIBLE $ RETENTION ' WC S-'ATU- bTH- WORK ERS COMPENSAPOR AND 11,, EMPLOYERS'LIAMUTY C.L EACH!CCIDENT ANY FROMICTORIPARTNORIEXECUTIVE OMCF,RIMEM9ER EXCLUDED? E.L.DISEA:E•EA EMPLOYE Wad a daxa111 -d& F,L,131315AE ,POLICY LIMIT S A OTHER OB SBA UP4435 12/31/2005 12/31/2007 Contrac.Equip 10,000 j A ProInland Marine erty 08 SBA UP4435 12/31/2006 12/31/2007 ¢ereanel Prop(NH) 275,000 Personal Prop(MA) 25,000 DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT!SPCCtAL PROVISIONS j RE:I-com Connectivity Products,Inc. Add'I Insured:Dutton&Garfield:!-com Connectivity Products,Inc. i 1 CERTIFICATE HOLDER.-----. CANCELLATION AI 000178 SHOULD ANY OF THE ABOVE DESCRIBED BE OANCBLLED 9EFORE THE W"A11ON OAT6 THEREOP,TNF 1S9UING INSURER WILL UtlEAVOR TO MAIL 30 DAYS WRITTEN Dutton&Gartleld NOTICE TO THE CERTIFICATE 14OLMR NAMED TO THE LEFT,19UT FAILURE TO DO 90 SMALL 43 Gigante Drive IMPOSP NO 09LIOATION OR LIAWLITY OF ANY K'NO UPON THE INSURER,ITS AGENTS OR Hempsfead NH 03841- 9 I!FRC3LWTA ea AUTHORIZED REPRESENTATIVE W. ACORD 25(2001/08) Fax:( ) - p ACORD CORPORATION 1988 08/27/2007 11:57 16034345812 HORIZON PAIGE 03 OP ID p�3 DATE(MM/OD MI ACORD CERTIFICATE OF LIABILITY INSURANCE HORIZ-5 08127 07 PROOUCBR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TF.E CERTIFICATE TD Banknorth Ins AgCX Inc (SF) HOLDER.THIS CERTIFICATE DOES NOT ADENO,EXTEND OR P.O. BOX 9040 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Sprizlg£feld M 01141-9040 Phone:413-781-5940 P'ax:413-7337722 INSURERS AFFORDING COVERAGE # INSURED INSURER A. ABc m!e mr-IIpnm uaw INSURER 8: Horizon Metals Inc INSLRERC' 2 Windham Depot Rd INSURER D: Derry NH 03038 INSURER E. COVERAGES THE POLICIES OF INSURANCE,'LISTED 13CLOW HAVE BEEN 155UF_0 10 THE INSURED NAMED ABOVE FOR TF£PMICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPF('T TO WHICH THIS CERTIFICATE MAYBE 1RRL1E0 OR MAY PERTAIN,THE INSURANCE AFFORPFD BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,AGGREGATE LIMBS SHOWN MAY HAVE 9C2N REDUCED BY PAID CLAIMS. LTR NSR TYPE OF TNSURANCB POLICY NUMBER DATE MMIODNY) DATE(MMA)1) LIMITS GENERAL LIABILITY EACH OCCURREN:E B COMMERCIAL OENERAI,IJAGILITY PREMISES REB oovence) CLAIM$MADE E:1 OCCUR MEI)FRCP(Any ON-person) $ PERSONAL 3 ADV INJURY GrNERALA.GGRE'sATE E G t AGGREGATE LIMIT APPLIES PER: PRODUCTS-CObPfOP AGG $ POLICY CECT LOC AUTOMOBILE LIABILITY COMBINED SINGL?LIMIT ANY AUTO (Eo nocldon') ALL OWWO AUTOS BODILY INJURY � SCHEDULED AUTOS HIRED AUTOS 900(LY INJURY $ (Per occldent) NON-OWNED ALITOv PROPERTY OAMA X g (Pw nccidmt) GARAGE LIABIIJTY AUTO ONLY-EA i CCIOENT S ANY AUTO OTHER THAN FA ACC S AUTO ONLY. AGG $ EXCESSAJI 13ft-LLA LIA91LffY EACH OCCIJRRD CE t OCCI,IR CLAIMG MADE AGGREGATE S CEOUCT191-2 $ RETENTION $ $ .._.., YYORN@i3 CDMPBNSATION AND XI MIT TORY LIMITS I I FR EMPLOY2RS'LIABILITY ANY PROPRIETORIPARTNERIEXECU'nVF. ABti00501207 01/01/07 0101/08 E.L.EACH ACCIOENT $1Ca0000 OFFICER/MEWER EXC1-IJOFD9 E.L.DISEASE-El,EMPLOYEE R X,000 0 0 0 Ifyt�t doceribeumdee SPECIALPROVISIONSbeow E.L.OISFA5F_-P11,iCYI'mit $1000000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/EXCLUSIONS ADDED 19Y ENDORSEMENT I SPECIAL PROVISIONS Job: i-Caen Connectivity Products, Inc. CERTIFICATE HOLDER CANCELLATION YStMTG&R SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE C WMLLED WORE THE EXPIRATION DATE THEREOF,THE 14=tMG INSURER WILL ENDRAVOP TO MAC, 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE Ll IFT,BUT FAILURE TO 00 SO SHALL Dutton and ear£ield IMPOSE NO OBLIGATION OR UABBJTY OF ANY KIND UPOI4 THE INSURER,ITB AQENTS OR 43 Gigante Drive Hampstead MR 03941 REPRESENTATRVES. AUTHOK1 SE NTATIVE Joe Blanche _ ACORII 25(2001/08) 6I ACORP CORPORATION 1988 08/27/2007 11:57 16034345812 HORIZON PAGE 04 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(!* must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemerd(s), If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain inlicies may require an endorsement. A statement on this certificate does not confer rights to the oertificate holder in lieu of such endorsement($). pISCLAiMSR The Certificate of insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, ncr does It affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORO 25(x001/08) 06/27/'2007 12:33 FAX 9786926482 DURKIN8HEVRIES a 001/001 AW-RQ CERTIFICATE OF LIABILITY INSURANCE 08/27/20o PRODUCER (783)894,8500 FAX (978)692-6482 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Durkin & DeVries Ins. Agcy, LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDEFL THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 131 Middlesex Turnpike ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Burlington, MA 01803 g��-;„ , s Patricia Capadanno RECEI I ,.:. INSURERS AFFORDING COVERAGE NAIC S INSURED Artec Sprinkler Corp INSURERA: Travelers Insurance Company 545 Broadway =,I , INsuRERe: Scottsdale Insurance Company Lowell, MA 01854 INSURERC: Associates Employers Insurance- Dutton Garfield INSURER D. Dt & Garfiel INsuRER S. 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 PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN iS SUBJECT TO AIL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR DD' TYpE OF INSURANCE POLICY NUMBER P Y F CTIVE POLICY EXPIRATION LIMITS GENERAL Lu9LITY CO-46400191-06 09/01/2006 09/01/2007 EACH OCCURRENCE 3 1 000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,000 CLAIMS MADE a OCCUR MED EXP(Any one person) S 5,00 A PERSONAL&ADV INJURY $ 1.0001000 GENERAL AGGREGATE 3 2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OP AOG S 2,000,000 POLICY X jECT f7 LOC AUTOMOBILE LIABILITY 810-46400209-06 09/01/2006 09/01/2007 COMBINED SINGLE LIMIT 3 ANY AUTO (Ea w=anq 1,000,0() ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) S A X HIRED AUTOS BODILY INJURY 3 X NON-OWNED AUTOS (Per Aeddern) PROPERTY DAMAGE 3 (P.ricodonp GARAGE LIABILITY AUTO ONLY•EA ACCIDENT S ANY AUTO OTHER THAN ,EA ACC S AUTO ONLY: AGO 3 EXCESSIUMBREULA LIABILITY UMS0020236 09/01/2006 09/01/2007 EACH OCCURRENCE $ 51 000,000 X OCCUR Flcomms MADE AGGREGATE s 5.000,000 B 3 DEDUCABLE S RETENTION S 3 v wORKERS COMPENSATION AND TBD 08/01/2007 08/01/2008 X WcsTAru- DTH. EMPLOYERS'LIABILITY C ANY PROPRIETORIPARTNERJEXECUTIVE E L EACH ACCIDENT S J-00110-00 OFFICER(MEMBEREXCLUDEW E.LDISEASE-EAEMPLOYE S S00,000 If yo d4surlin undor SPECIAL PROVISIONS Delon E L DISEASE-POLICY LIMIT 3 $00,000 OTHER DEWRIPYION 0 0�E NS RATI I LOCAnPNF I VEHICLES I EXCLUSIONS ADDS]ISY ENDO EMENT I SPECIAL PROVISIONS Project: -Com gonnectivity Products, Inc., N.An over MA Additional Insured: Dutton & Garfield, Inc,; L-Com Connectivity Products, Inc. as required by written contract, for this project only. CERTIFICATE HOLDERCA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLER BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER OLL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT Dutton & Garfield, Inc. BUT FAILURE TOMKLSUCH NOTICE SHALL IMPOSE NO08UGATIONORLIABILITY 43 Gigante Drive OF ANY IONIC UPON THE INSURER,119 AGENTS OR RWRESENTATVEI Hampstead, NN 03841 AUTHORIZED REPRESENTATXVE [John DeVries/TIM ACORD 26(2001!08) FAX: (603)329-5368 ®ACORD CORPORATION 1998 Date: 8/27/2007 Time: 5 :44 PM To : @ 329-5368 Page: 001-002 A DjF CERTIFICATE OF LIABILITY INSURANCE osiz%z 0 PRODUCER (603)432-3666 FAX (603)432-6076 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Lakeside Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE One Wall Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Windham, NH 03087 Rta.—C Iyp� d"-������ �D INSURERS AFFORDING COVERAGE NAIC# INSURED Wall-Tech Systems Inc INSURERA. Central Insurance Companies 20230 94 River Road INSURER B: Hudson, NH 03051 INSURER C: Duttor 6�p Garfield INSURER 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 PERTAIN,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. INSR ADID'L TYPE OF INSURANCE POLICY NUMBER PEFFECTNE POLICY EXPIRATION LIMITS LT NSR DOLICYTE MMIDD DATE MMIDD GENERAL LIABILITY CLP8123453 03/11/2007 03/11/2008 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,000 CLAIMS MADE a OCCUR MED EXP(Arty one person) $ 5,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPIOP AGG $ 2,000,000 POLICY PRO JECT LOC AUTOMOBILE LIABILITY BAP8122994 03/11/2007 03/11/2008 COMBINED SINGLE LIMIT $ X ANY AUTO (Ea accident) 1,000,000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ A HIRED AUTOS BODILY INJURY $ N04OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY. AGG $ EXCESSAIMBRELLALIABILITY CXS8123454 03/11/2007 03/11/2008 EACH OCCURRENCE $ 51000,000 X OCCUR F7 CLAIMSMADE AGGREGATE $ 5,000,000 A $ _. DEDUCTIBLE $ RETENTION $ O $ WORKERS COMPENSATION AND WC8123455 03/11/2007 03/11/2008 X TORYLIMITS DER EMPLOYERS'LIABILITY A ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFRCER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under SPECIAL PROVISIONS befow E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS f VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS overing work performed by the insured during the policy period. roject: L-Com, 45 Beechwood Dr. , Andover, MA _-Com Connectivity Products Inc and Dutton & Garfield Inc are named as Additional Insureds per writte ontract but only with respect to Insureds work and with the exception of the Workers Compensation olicy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL Dutton & Garfield Inc 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ATTN: Steve Foster BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 43 Gigante Drive OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Hampstead, NH 03841 AUTHORIZED REPRESENTATIVE Edwin Duvall/PROPA 11 ACORD 25(2001108) FAX: (603)329-5368 ©ACORD CORPORATION 1988 Date: 8/27/2007 Time: 5 :44 PM To: @ 329-5368 Page: 002-002 IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer,and the certificate holder, nor does it affirmatively or negatively amend,extend or alter the coverage afforded by the policies listed thereon. ACORD 25(2001108) 08/27/2007 MON 17:39 FAX001/002 ACO-RD„ CERTIFICATE OF LIABILITY INSURANCE 08/27/2007' PRODUCER (603)669-0704 FAX (603)669-6831 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Infantine Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 5125 Rt D C ENV 3.,.om% ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Manchester, NH 03108 ..�FEN Danielle West INSURERS AFFORDING COVERAGE NAIC# INSURED ;y�( ,� wsURERA: Acadia Insurance Co. A&E Flooring, Inc. INSURERS: Technology Insurance through OH 59 Londonderry Turnpike Dutton & G2171eld INSURER C: Hooksett, NH 03106 INSURER D: 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 PERTAIN,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. INSR DO' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY CPA001298022 01/30/2007 01/30/2008 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 250,000 CLAIMS MADE a OCCUR MED EXP(Any one penton) $ 5,000 A PERSONAL&AOV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMP/OP AGG $ 2,000,000 POLICYX PROEGT XLOC J AUTOMOBILE LIABILITY CAA001297822 01/30/2007 01/30/2008 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) 1,000,000 1,000,000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ A X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY CUA001298122 01/30/2007 01/30/2008 EACH OCCURRENCE $ 5,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 5,000,000 A $ DEDUCTIBLE $ nX RETENTION $ 0 $ WORKERS COMPENSATION AND TWC3128697 01/30/2007 01/30/2008 X I T CYrATu- oTH- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 500,000 B ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEd$ 500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT I$ 500,000 OTHER DESCRIPTION OF OPERATIONS]LOCATIONS I VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS E: L-Com Connectivity Products, Inc, No. Andover MA, -Com Connectivity Products, Inc. and Dutton & Garfield to be named as additional insured for eneral Liability and Umbrella as respects this work. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Dutton 8, Garfield BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 43 Gigante Drive OF ANY KIND UPON THE INSUR AGENTS OR REPRESENTATIVES. Hampstead, NH 03841 AUTHORIZED REPRESENTATIVE ACORD 25(2001/08) ©ACORDCORP TION 1988 08/27/2007 MON 17:40 FAX 002/002 IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed..A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer,and the certificate holder, nor does it affirmatively or negatively amend,extend or alter the coverage afforded by the policies listed thereon. ACORD 26(2001108) LNNECTIVITYCO CO PRODUCTS Factory Direct Cables and Supplies Since 1982 September 4, 2007 Town of North Andover Gerald Brown Inspector of Buildings 1600 Osgood Street North Andover, MA 01845 This letter is the estimation of the costs for the new cubicles for the business L-com @ 45 Beechwood Drive since no contractor has been awarded as of yet. The estimation is $73,235.05. v t Timothy May Asst. Operations Manager L-COM,INC. 45 BEECHWOOD DRIVE NORTH ANDOVER,MA 01845 WWW.L-COM.COM E-MAIL:SALES@L-COM.COM PHONE:1-800-343-1455 FAX:1-978-689-9484