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HomeMy WebLinkAboutBuilding Permit #767 - 67 SHERWOOD DRIVE 5/22/2007BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: q � Date Received Date Issued: 61, 2Z- bq-- DESCRIPTION OF WORK TO BE PREFORMED: ►C ena tr- i.",CL VQ Ir AC, VY) 4-,.P OWNER: Name:, Please Ty a or Print Clearly) )roc, nv(�,,. Phone: ARCHITECT/ENGINEER --' Phone: Address: �— Reg. No. FEE SCHEDULE: BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ FEE: $_ Check No.: � Receipt No.:,:-- -2L� 3� NOTE: Persons contracting with unregiste d contractors do not have access to the guaranty fund Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ 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 .a Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/S Located at 384 Osgood Street Dimension Number of Stories: Total land area, sq. ft.: Total square feet of floor area, based on Exterior dimensions. ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes 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 No 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 ❑ Engineering Affidavits for Engineered products NOTE:r All dumpster_perm permits. sign�of _f rp Fire, Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan L, Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) o 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 �..�_� .��❑...Certi�ed�-opese � v,.a. a,n_..__ . _�. r,,. �z�.v __.__.__..r.. _.__.. _ _. __ .__._._ _ . w _. � _. __ Li 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 Li 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 Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 Locationn7�o . 1L �Ae1-1wapw No. / (, -�' Date 5 2 -Z �- �aRTM TOWN OF NORTH ANDOVER 3?i._ •SOL F : 9 Certificate of Occupancy $ '��s'••'° • ttt' swCH Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $` TOTAL $ �7 Check # 20263 Building Inspector RED APPLE RENOVATIONS jr..onte -rez wdelin.g Pr-oJ�,ss on.-,- is Construction Contract 10,6, COPY This construction contract (the "Contract"), dated May 17, 2007 is by and between the following homeowner(s) and contractor: Homeowner(s): Property address City., State, Zip Contractor: Representative: Street Telephone Federal Identification Number: Massachusetts License Numbers: Construction Supervisor Home Improvement Bill and Ronna Duffy 67 Sherwood Drive North Andover, MA 01845 Red Apple Renovations, Inc. Chris Matey, President 9 Bartlet Street, #332 Andover, MA 01810 978.409.1293 56-2309042 CS 083511 138132 L GENERAL r- In consideration of the mutual promises contained herein, Contractor agrees to perform the following work: furnish all labor, materials, tools, equipment, and supervision to construct or renovate the Homeowner's residence according to this Contract and the following documents (collectively with this Contract, the "Contract Documents"). The project, is generally described as repair front wall (the "Project"). The Contract consists of this document, Exhibit I - General Conditions, and Exhibit II - the Project. Change orders and modifications_ shall be in writing and shall become part of this Contract. 2. PRICE The total projected price for the work agreed upon based on a time and materials rate of $70 per hours for labor plus materials and ancillary charges at Red Apple's cost plus 25%. Payment terms are set out below in Paragraph 6. 3. STARTING AND SUBSTANTIAL COMPLETION PROVISIONS The work will begin on or about May 1, 2007 The work will be substantially completed on or about July 1, 2007 This project, once construction starts, is estimated to take 2 -3 months to complete (exclusive of any punch list items). This time estimate, as well as the projected start date, is dependent upon some or all of the following variables: • Weather • Delays in the availability of materials required for the project. • Condition of .materials once delivered to worksite. • Unforeseen conditions arising in the course of the project • Other delays as outlined in Section 3 Exhibit I of the contract. 4. SPECIFIC REQUIREMENTS FOR MATERIALS AND WORKMANSHIP a. This Contract will be completed by the Contractor in a good and workmanlike manner, using good quality materials. b. If applicable, the Contract price includes the allowances listed in the Contract Details Section. S. EXPIRATI6N OF THIS CONTRACT This Contract will expire thirty (30) days after the date first written above if not accepted in writing by Homeowner and returned to Contractor within that time. 6. PAYMENT a. Timely payment by. the Homeowner of all sums due under this Contract is of the essence io this Contract. The parties agree to the following schedule of payments: 1. Progress payments: The Homeowner will be billed weekly for the work completed through the end of that week. The Contractor shall provide the Homeowner with his own waiver or cumulative subcontractors' waivers equal to the amount paid for any progress payment. b. The billing schedule is for the convenience of the homeowner and does not reflect the percentage of effort or actual work expended at the time of the payment. If for any reason the project should be discontinued during the construction process, the client will be for the actual work completed to date. c. The Contractor may cease operations if the Homeowner as required herein does not make any progress payment, and proceed to collect any balance due with any legal remedy. Alternatively, the Contractor may continue operations, as set forth in the attached, 7. SIGNATURE Attached hereto as EXHIBIT I are General Conditions governing the rights and obligations of the parties to this Contract. The parties are further subject to the laws of Massachusetts governing contracts and mechanics' liens, and acknowledge the right of the Contractor to place a lien or security interest on the property of the Homeowner. IN WITNESS WHE EOF, we have hereunto set our hands and seals this �1a day of e , 20C�-J . DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Homeowners contractor 2 Homeowners) The Homeowner may cancel this Contract if it has been signed by the Homeowner at a place other than the office of the Contract -or, provided that -the Homeowner notifies the Contractor in writing at the Contractor's office by ordinary mail, telegram or personal delivery, not later than the midnight of the third business day following the signing of the Contract. See attached Notice of Cancellation for further explanation of this right. 3 EXHIBIT I GENERAL CONDITIONS These General Conditions are part of the Contract between Bill and Ronna Duffy ("Homeowner") and Red Apple Renovations, Inc. ("Contractor") for work at 67 Sherwood Drive, North Andover, MA 01845, dated May 17, 2007. 1. CONTRACTOR'S DUTIES — GENERAL a. To direct and control the work contracted for in accordance with the terms of this Contract and all applicable codes, laws, and regulations, and as the building permits, if any, issued for this project require. b. To inspect the site, examine the pians and specifications, if any, and supervise all of Contractor's employees, and to direct the work of ail subcontractors selected by Contractor. c. To maintain the work site in a safe and clean condition, to the extent consistent with the Contrach The worksite will be left in a "broom clean" condition. d. To advise the Homeowner promptly if concealed conditions are ascertained which require additional or different work, and to proceed in such event in accordance with this agreement. 2. HOMEOWNER'S DUTIES — GENERAL a. To provide adequate utilities for the work agreed upon. b. To advise the Contractor of any condition of the property which affects Contractor's ability to perform. c. To provide secure storage areas for materials delivered to the work site. d. To execute in a timely manner all permit applications and other documents necessary for the work to proceed. e. To perform no work on the project without a written agreement with the Contractor. f. To avoid interfering with workers. g. To make no agreements with any tradesperson, subcontractor, or Contractor's employee outside the scope of this Contract without the written consent of the Contractor. h. Homeowner shall notify his insurance agent of the execution of this Contract and obtain any necessary Riders to his current coverage or any locally customary forms of coverage, such as Builder's Risk, to cover Homeowner's interests and liabilities during the construction process. 3. DELAY Contractor shall not be responsible for delays caused by events beyond the control of the Contractor, including but not limited to: strikes, war, acts of Gad, riots, governmental regulations and restrictions. Delays caused by Homeowner's failure to make allowance materials' selections or caused by the performance by Contractor of additional or necessary work shall likewise be excusable delays. 4 4. PERMITS The contract will obtain the following permits: Town of North Andover Building Permit It is the obligation of the Contractor to secure such _permits as the Homeowner's agent. Note: if the Homeowner secures its own permits or deals with unregistered contractors, the Homeowner is excluded from the Guaranty Fund provisions of MGL c. 142A. S. PREFERRED VENDOR CLAUSE Except where expressly permitted, all material and fixtures will be purchased by Red Apple Renovations. This is done to ensure that all materials are of the highest quality and that the vendors offer good customer support. If, for some reason, materials for the project are not purchased by Red Apple Renovations, the following conditions apply: a. Red Apple may at its discretion charge a handling fee to supervise the installation and coordination of these materials. b. Any and , all materials not purchased by Red Apple are excluded from the project warrantyL 6. INSURANCE Contractor agrees to maintain all necessary forms of insurance to protect the Homeowner from liability for any occurrence arising from the performance of this Contract. Contractor agrees that he shall cover his own employees for worker's compensation and carry general liability, and that all forms of insurance carried hereunder shall be with reputable companies licensed to do business in this state. Homeowner agrees to carry full coverage on the subject property covering Homeowner's risk of loss during the construction period, together with all special forms required by reason of the performance of this Contract. Specifically, Homeowner shall contact Homeowner's insurance agent and secure any necessary Builder's risk coverage prior to the commencement of the work. 7. HIDDEN, CONCEALED and UNFORESEEABLE CONDITIONS The parties agree that in the event Contractor discovers a condition requiring an extra cost that they shall proceed as follows: The Contractor shall notify the Homeowner verbally at once to expedite agreement as to the charge to correct or cure such condition, and provide a written estimate as soon as practicable. The parties must agree to such extra charges, or agree to a resolution method, or this Contract may be canceled by either of them. For purposes of this section, a "hidden, concealed and unforeseeable condition" shall mean a condition not readily observable to a prudent contractor Inspecting the subject property for the purpose of performing this Contract. 8. WASTE REMOVAL CONTAINERS The project may require a dumpster to be located on the property. It is the owner's responsibility to provide a location and adequate access for a dumpster location. In some cases, a dumpster can damage the surface it is placed on. Dumpsters are generally placed on boards to minimize surface damage. Every effort is made to minimize any damage as a result of dumpster presence. The types of damage possible may include, but are not limited to, dead grass, gouges in the soil and scrapes or chips on asphalt or pavement. Unless expressly included in this contract, Red Apple is not responsible for the repair of this damage. 5 9. ADDITIONAL WORK Any additional work or materials desired by the Homeowner shall be agreed upon -in writing and such extras shall become a part of this Contract. Unless otherwise agreed, any additional work shall be paid for as performed. Failure of the Homeowner to sign a change order shall not preclude recovery for same by Contractor, and acceptance of said additional.Work or materials shall be presumed, unless there is written notice to the contrary. Contractor shall advise Homeowner at the time of agreement on any additional work as to any additional time required to -perform this Contract. 10. TERMINATION and CANCELLATION Contractor shall have the right to stop all work on the project and keep the job idle if payments are not made to Contractor in accordance with the payment schedule set forth above, or if Homeowner repeatedly fails or refuses to furnish Contractor with access to the job.site or product selections or information necessary for the advancement of the work. Simultaneous with stopping work on- the project, Contractor shall give Homeowner written notice of the nature of Homeowner's default. If work Is stopped due to any of the above reasons (or for any other material breach of Contract by Homeowner) for a period of seven (7) days after notice, and the Homeowner has failed to cure the default, then Contractor may, without prejudicing any other remedies Contractor may have, give written notice of termination of the Contract to Homeowner and demand payment for all completed work and materials ordered through the date -of work stoppage, -and any other loss sustained by Contractor, including the balance of the Contract. Thereafter, Contractor is relieved from all other contractual duties. Upon such termination, the Contractor shall have all remedies provided by law, including such lien rights as then apply. The Homeowner may terminate this Contract upon the following conditions: a. Any other failure to perform this Contract required by the terms of this Contract. b. No termination shall be effective unless 10 days notice of Homeowner's intent are given as provided below, during which time the default may be cured by the Contractor. 11. DISPUTE RESOLUTION AND ATTORNEYS' FEES a. Dispute kesolution. The Contractor and the Homeowner hereby mutually agree in advance that in the event that the Contractor has a dispute concerning this contract, the Contractor may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided in M.G.L. C. 142A. i Contractor: Homeowner: L^_3_ SSI/. Homeowner: NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the Contractor. The Homeowner may initiate alternative dispute resolution even where this section is not signed separately by the parties. b. Small Claims Court. Any controversy or claim arising out of or related to this Contract involving an amount of less than $2,500.00 (or the maximum limit of the 2 court) must be heard in the Small Claims Division of the District Court in Essex County. c. Attorneys' Fees. In the event of any litigation between the parties relating to this Contract, the parry against whom any adverse final judgment is entered (as specifically determined by the Court), following the expiration or exhaustion of all appeals, shall reimburse the other parry for such party's costs and expenses (including, without limitation, all reasonable attorneys' fees, expenses and disbursements) of such litigation. d. Inquiries Regarding Contractor. All home improvement contractors and subcontractors shall be registered and that any inquiries regarding a contractor or subcontractor relating to a registration should be directed to: Registration Division, Program Coordinator One Ashburton Place, Room 1301 Boston, MA 02108 Tei: (617) 727-3000 ext. 25239 12. WARRANTIES a. The work of the Contractor, including materials and labor, shall be guaranteed for a period of two (2) years during which period Contractor shall at its own expense correct any defect arising from its work unless Paragraph 7 of these General Conditions applies. This provision is in lieu of all other warranties, express or implied, and Homeowner has no action at law or in equity against the Homeowner after said date. b. Any and all warranties for appliances or mechanical systems shall be delivered to Homeowner when Contractor's final payment is received. c. Notwithstanding any manufacturer's warranty of any component, appliance, or system, no action may be brought against the Contractor on this contract, for the performance of this work, except as provided above. 13. NOTICES Notices may be sent to either party at the addresses shown above, or mailed by certified or registered mail. Any mailed notice shall be deemed given as of the date of mailing. 14. SEVERABILITY If any portion of this agreement is found invalid or unenforceable by any court, the remaining provisions shall remain in force between the parties. 15. ENTIRE AGREEMENT This Contract consists of the documents defined above, and constitutes the entire agreement of the parties. It can be modified only by a written document. 7 NOTICE OF CANCELLATION You may cancel this Contract, without penalty or obligation, within three (3) business days from the date this Contract is'fuliy executed. If you cancel, any property traded in, any payments made by you under the Contract, and any negotiable instruments executed by you will be returned within ten (10) business days following receipt by the Contractor of your Cancellation Notice, and any security interest arising out of the Contract will be cancelled. If you cancel,. you must make available to the Contractor at your residence, In substantially as good condition as when received, any goods delivered to you under this Contract; or you may, if you wish, .comply with the instructions of the Contractor regarding the return shipment of the goods at the Contractor's expense and risk. If you do make the goods available to the Contractor and the Contractor does not pick them up within twenty (20) days of the date of Cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the Contractor, or if you agree to return the goods to the Contractor and fail to do so, then you remain liable for performance of all obligations of the Contract. To cancel the Contract, mail or deliver a signed or dated copy of this Cancellation Notice or any other written notice, or send a telegram to RED APPLE RENOVATIONS at 9 BARTLET STREET, #332, ANDOVER, MASSACHUSETTS 01810 not later than midnight of the third (3rd) business day after the execution of the Contract. I HEREBY CANCEL THIS CONTRACT. Date: Homeowner: Note: Massachusetts State Law requires that all construction contracts include two copies of a cancellation notice. 11 NOTICE OF CANCELLATION You may cancel This Contract, without penalty or obligation, within three (3) business days from the date this Contract is fully executed. If you cancel, any property traded in, any payments made by you under the Contract, and any negotiable instruments executed by you will be returned within ten (10) business days following receipt by the Contractor of your Cancellation Notice, and any security interest arising out of the Contract will be cancelled. If you cancel, you must make available to the Contractor at your residence, in substantially as good condition as when received, any goods delivered to you under this Contract; or you may, if you wish, comply with the instructions of the Contractor regarding the return shipment of the goods at the Contractor's expense and risk. If you do make the goods available to the Contractor and the Contractor does not pick them up within twenty (20) days of the date of Cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the Contractor, or if you agree to return the goods to the Contractor and fail to do so, then you remain liable for performance of all obligations of the Contract. To cancel the Contract, mail or delivery signed or dated copy of this Cancellation Notice or any other written notice, or send a telegram to RED APPLE RENOVATIONS at 9 BARTLET STREET, #332, ANDOVER, MASSACHUSETTS 01810 not later than midnight of the third (3rd) business day after the execution of the Contract. I HEREBY CANCEL THIS CONTRACT. Date: Homeowner: (Vote: Massachusetts State Law requires that all construction contracts include two copies of a cancellation notice. �7 KED APPLE. RENOVATIONS 1 omw - --e 'a.r_�deh`ng p-ofessimmils Exhibit II - The Project Repair Front Wall The work would include the following: 1P The synthetic stone will be removed from the front wall of the house to expose all water damaged areas. V The siding will be removed from the adjacent wail to expose any water damage on that area. The water damaged areas will be repaired. The repairs will include removing and replacing all damaged plywood, framing and insulation. Additional, due to the nature of the repair, some damage to the interior surface of the wall may also occur. This will be patched and painted as part of the project once the work on the exterior is complete. New gutters will be installed on the second floor roof in the area over the damaged corner of the front wall. Once the repair is complete, the wall will be prepared for the installation of new windows and installing new windows and new stone on the front of the house. This proposal does not include the installation of new windows or new stone. �� Bill are sent to the client weekly on Friday and payment is due the following Monday. Notes: 1) An allowance is an amount set aside in the contract for a specific item. The final cost will be determined by the fixtures determined. by the homeowner. 2) Paint grade means 4iial ded tobe painted rather than stained. Homeowners Homeowner(s) Date 6 - a D- d? Date 9 Bartlet Street #332, Andover, MA 01810 tel: 978.409.1293 fax: 978.945.2446 J fir. ^. ..a x. 'fes•*°:.. 'v r= -JON a t O ay nm sC �tg Y o Y t . 4�1 ' JJ r "w . h d a t O ay nm sC �tg Y o Y t The Commonwealth of Massachusetts Department of Industrial Accidents Ogee of Investigations 600 Washington Street Boston, MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers licant Information Name (Business/Organization/Individual): Address: a Ae h City/State/Zip: 4hc Oc 'e Phone #: C� 4 �- , 40, . 1 a� Are you an employer? Check the appropriate box: 1. I am a employer with 4. ❑ Y— I am a general contractor and I 2. ❑employees (full and/or part-time).* 1 am a sole proprietor or have hired the sub -contractors listed partner- ship and have no employees on the attached sheet. t These sub -contractors have working for me in any capacity. [No workers' comp. insurance workers' comp, insurance. 5. ❑ We are a corporation 3. ❑required.] I am a homeowner doing all and its officers have exercised their work myself. [No workers' comp. right of exemption per MGL c. 152, § 1(4), and we have insurance required.] t no employees. [No workers' com insu Type of project (required): 6. ❑ New construction 7. [`] Remodeling S. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs P rance required.] 13r7l Other "Any applicant that checks box #I must also fill out the section below If their workers' In 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. {Contractor: that check this box must attached an additional sheet showing the name of the sub contn,cr�ro a.,,r -- 1"113P. poncy Information. information. am an employer that is Providing workers, comp ensation insurance for my employees. Below is the policy and job site Insurance Company Name: � �:h Policy # or Self -ins. Lic. #: W C �- -7 4G ( R- e- Expiration Date: (� (�-�G� Job Site Address:�� 5���� P s.�� City/State/Zip: �jof�h f �Er, U�l� 0j14� _ Attach acopy of the workers' compensation policy declaration a e showing the policy number and expiration date). P. g ( --r•— Failure to secure coverage as required under Section 25A of MGL c. 152 can lead 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 may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. a -7 tains and penalties of perjury that the information provided above is true and correct U0,, Q C, Official use only. Do not write in this area, to be completed by city or town gJj`iciaL City or Town: I Permit/License # ssufng Authority (circle one): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: CORD AA�TId. CERTIFICATE OF LIABILITY INSURANCE I*TE(MMnX YYr 03/21/2007 PRODUCER PNS (9 CE AG fart (978) a75.2i71 THIS CERT94CATE IS ISSUED AS A MATTER OF INFIORMATION THE Hr; HA INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON TME CER71FICATE d PUNGFIARD AVE H009R, THIS CERTIFICATE OQMSI NOT AMEND, Ei(TEND OR ANDOVER MA 01810 AI TFR TUU r'ttv=uAlSC Aeenener, — —V — I--- — ,.... INSURED RED APPLE RENOVATIONS INC 32 WASHINGTON AVENUE ANDOVER MA 01810 INSURERS AFFORDING COVERAGE NAIL # INSURER & Commerce Insurance Co INSURER B: National Grange Mutual INSURER C: Commer*v Insurance Co INSURER D: COMMerce Insurance CO VY a,Y14f11GY. I D l�IP1Yr1111 ANY REQUIREMENT, TERM OR CONDITION OF ANY CONri;ACr ER OR OTHDOCUMENT VVITI� RESPECT ro WHICH THIS C€aTIF1CATE MAY BE ISSUED OR MAY PERTAIN, TKE INSURANCE AFFOADED BY THE POLICIES DESCR18ED HEREIN IS SUOMT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLIGIF,S, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAVA N9A ADM TYPE OF INSURANCE POLICY NUNSER Patlrr UFWTIVE ROLW OFFAMN LTR -- GENERALr MrNLrlY X COMMERCIAL UNFRAL LIABILITY CLAM MADE ❑X OCCUR B GEML AGGREGATE LIMIT APPLIES Pat POLrCY p PRO- tOc AUTOMOBILE LIAWTY ANY AUTO ALL OWNED AMS. D 71 SC44MULED AUTOS X HIRED AUTOS -- �C NO"WNED AUT94 GARAGELWBIUTY ANY AUTO i exam I UMBRELL.Ii LwKrrY OCCUR [] OLAIMS MADE DEDUCrkg RETENTION a WORKERS CAMPBMMMN AND EMPLOYERS" IJAMUTY E �i4ERcunvE SPBCcIAL PRQVMM brew DESCRIPTION QF FOR RECORD PURPOSES Attention: ACORD 25 (2001108) MMHHH724 1 10m3w 1 1ol1= VYC""1so J 05 M06 1 061M7 ulalrs CH CURRENCE S Fre _`000,00 500,000 NFD. EXP (Any one panwq S 10,000 PERSONAL s aper INJURY s 9,000,000 GENERALAGGREGA-M s 2,000,000 PRODUCTS-COMPW ACG. S 2,000,000 t� -44wtSINGLf LIMIT 250,000 1300ILV INJURY (Pwpmm) s 250,000 BODILY INJURY (F9r e4Gdanr) 5 500,000 PROPERTY OAMAAGE Par ac;WenO AUTO ONLY -EAACCID s 100,000 $ OTHER THAN EA ACC AUTO ONLY. AGO EACH OCCURRENCE $ $ $ AGGREGATE b S 5 T WGSiA TARII UMrTS OhiER $ E.L. EACH ACCIDENT s 100,000 E,L,OISfASE-EAEMPLOYEE : 100,00Q ELOISEASE-POUCYLUT $ 500,000 I ADDED BY ENDORSEMENT/ SPECIAL. PROVISIONS 9 CANCELLATION SHOULD ANY Of THE ASQVE DESCRIBED POUCIH$ BE CANCELLED BEFORE THE EXP'RATx* DATE THEREOF, TME ISSUING INSURm WILL FNUEAVOR TO HAIL 10 DAYS To Do 0 SK&LL IMPOSE NO 10CBC GATION OR LIAWV Y OF ANY KIND UPON THE w$URER IrG AGENTS OR REPRESENTATr ss. Diane M. Newton 00 # 2902 0 ACORD CORPORATION 1988 \ 00 lam -/o z 0` u F3 \<£:# i �v CO. \: . LL }.ƒ7> < Iwo «, zci. 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