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HomeMy WebLinkAboutBuilding Permit # 6/9/2015 i TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 0� Permit NO: 1d Date Received *A A Date Issued: IMPORTANT:Applicant must com lete all items on this page LOCATION /°"% t f " PROPERTY OWNER 1` a int �)) A) Print (i MAP NO.: PARCEL. �`" ZONING DISTRICT: MAP NO.& TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential New Building ❑gne family LY Addition Vrwo or more family ❑Industrial ❑Alteration No. of units: 2. G Repair,replacement ❑Assessory Bldg ❑ Commercial ❑Demolition Moving relocation ❑Other L I Others: Foundation only D SCRIPTION OF WORK TO BE PREFORMED Ar Identification Please Type or Print Clearly) OWNER: Name: xyd/v voxm�. 110 41 .. Phone: Address: I�L2 °'w ) CONTRACTOR Name: .- / ; ,., A� �„ � �� Phone: Address: 5 4L 4,AJPad&--)1--4 Supervisor's Construction License: ..n ` Exp. Date: �w p b l r� Exp. Date: Home Improvement License: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING A7ERMIT.•$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ F, n ,. ro x12.00=FEE:$ w} Check No.: l � Receipt No.: Page lof4 III pit 'No. Y h ver, Mass ��;)aCD coc"Ict4mcK AD4ATED APa;�'65 S u BOARD OF HEALTH PERMIT T Food/Kitchen Septic System THIS CERTIFIES THAT BUILDING INSPECTOR I �, Foundation has permission to erect .......................... buildings on ..� . .. .......w..4 ..............5. ............. Rough tobe occupied as ...........Iz .-P . ....-01.4 ............................................................................. Chimney provided that the person acceptin is permit shall in every respect conform to the terms of the application Final on file in 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI TS Rough S Service ................................................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. Ywo,: 4 valeon TURNKEY CONTRACT This TURNKEY CONTRACT is made this 14t' day of May, 2015 (the"EFFECTIVE DATE") by and between: "ITC" Invaleon Technologies Corporation ATTN: Tom Wu 451 Andover Street Suite 330 North Andover,MA 01845 P: (978)-794-1724 AND "CLIENT" (Name) YuanYong Zhang (Address) 172/174 Water Street North Andover, MA 01845 (Phone) 781-324-8883 ITC desires to provide Solar Installation services to the CLIENT and the CLIENT desires to obtain such services from the ITC. THEREFORE, in consideration of the mutual promises set forth below, the parties agree as follows: 1. PROJECT MANAGER. Tom Wu is an employee of Invaleon Technologies Corporation, and will act as the PROJECT MANAGER and representative for ITC. 2. PROJECT LOCATION: 172/174 Water St, North Andover, MA 01845 3. CONTRACT PRICE: $6,000.00 4. SOLAR SYSTEM SPECIFICATIONS. ITC will install one layer of Owens Corning Hallow Fox Grey Architectural Shingles on the roof of the Project Location. The installation of the "ENTIRE SYSTEM" shall hereinafter be referred to as the "WORK". 5. INSTALLER WARRANTY. The ENTIRE SYSTEM will have a minimum 5 year labor warranty provided by the ITC to protect the CLIENT against defective workmanship. The Page 1 of 9 A��Ktl01ugj � �0 ��VV�f&41µ valeon warranty will cover the ENTIRE PROJECT, including shingles, and provide for no-cost repair or replacement of the PV project or system components, including any associated labor during the warranty period. SECTION 6. (Omitted) 7. PLANS, SPECIFICATIONS AND CONSTRUCTION DOCUMENTS. The CLIENT will make available to ITC all plans, specifications, drawings, blueprints, and similar construction documents necessary for ITC to provide the Services described herein. Any such materials shall remain the property of the CLIENT. ITC will promptly return all such materials to the CLIENT upon completion of the WORK. $. REQUIRED PERMITS. The following building permits are required and will be secured by ITC as the CLIENT 's agent: • Building Permit from the Town of North Andover 9. PAYMENT SCHEDULE. The following schedule will be adhered to unless circumstances beyond ITC`s control arise Payments will be made according to the following schedule: $2,000 for material procurement. (**) $2,000.00 upon commencement of construction. $2,000.00 upon completion of this contract NOTES: (**) Law requires that any deposit or down-payment required by the Primary Installer/Integrator before work begins may not exceed the greater of(a) one-third of the total contract price or(b) the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule. 10. SUBCONTRACTORS. ITC shall have the right, at its sole discretion, to perform all or any part of the work through subcontractors and sub-subcontractors. ITC shall be responsible for any work performed by subcontractors and sub-subcontractors as if it has performed such work through its own forces. ITC shall not be obligated to obtain the CLIENT 's prior consent to the use of any subcontractor(s) or sub-subcontractor(s). The CLIENT shall not communicate directly with any subcontractor(s) or sub-subcontractor(s), all communications, changes, instructions, or orders regarding the WORK shall be communicated directly to ITC by the CLIENT . The CLIENT recognizes that unauthorized communications with ITC's subcontractors may result in changes to the WORK, for which the CLIENT shall compensate ITC in accordance with the provisions of Section 9 above. Page 2 of 9 a���O�IuCu� VMD hvakon� 11. CHANGE ORDER. The CLIENT may make changes to the scope of the work from time to time during the term of this TURNKEY CONTRACT. However, any such change or modification shall only be made in a written "CHANGE ORDER" which is signed and dated by both parties. Such CHANGE ORDER's shall become part of this TURNKEY CONTRACT. The CLIENT agrees to pay any increase in the cost of the WORK as a result of any written, dated and signed CHANGE ORDER. In the event the cost of a CHANGE ORDER is not known at the time a CHANGE ORDER is executed, ITC shall estimate the cost thereof and the CLIENT shall pay the actual cost whether or not this cost is in excess of the estimated cost. 12. CONFIDENTIALITY. ITC and its employees, agents, or representatives will not at any time or in any manner, either directly or indirectly, use for the personal benefit of ITC, or divulge, disclose, or communicate in any manner, any information that is proprietary to the CLIENT . ITC and its employees, agents, and representatives will protect such information and treat it as strictly confidential. This provision will continue to be effective after the termination of this TURNKEY CONTRACT. Upon termination of this TURNKEY CONTRACT, ITC will return to the CLIENT all records, notes, documentation and other items that were used, created, or controlled by ITC during the term of this TURNKEY CONTRACT. 13. INSTALLATION WARRANTY. ITC shall provide its services and meet its obligations under this TURNKEY CONTRACT in a timely and workmanlike manner, using knowledge and recommendations for performing the services which meet generally acceptable standards in ITC's community and region, and will provide a standard of care equal to, or superior to, care used by service providers similar to ITC on similar projects. ITC shall perform the WORK in conformance with the plans, and specifications signed by ITC and the CLIENT . In addition to any additional warranties agreed to by the parties, the ITC warrants that the work will be free from faulty materials; constructed according to the standards of the building code applicable for this location; constructed in a skillful manner and fit for habitation or appropriate use. The warranty rights and remedies set forth in the Massachusetts Uniform Commercial Code apply to this contract. 14. FREE ACCESS TO WORKSITE. The CLIENT will allow free access to work areas for workers and vehicles and will allow areas for the storage of materials and debris. Driveways will be kept clear for the movement of vehicles during work hours. ITC will make reasonable efforts to protect driveways, lawns, shrubs, and other vegetation. ITC also agrees to keep the SITE clean and orderly and to remove all debris as needed during the hours of work in order to maintain work conditions which do not cause health or safety hazards. Page 3 of 9 valeon 15. UTILITIES. The CLIENT shall provide and maintain water and electrical service, connect permanent electrical service, gas service or oil service, whichever is applicable, and tanks and lines to the building constructed under this TURNKEY CONTRACT after an acceptable cover inspection has been completed, and prior to the installation of any inside wall cover. The CLIENT shall permit ITC to use, at no cost, any electrical power and water use necessary to carry out and complete the work. 16. INSPECTION. The CLIENT shall have the right to inspect all work performed under this TURNKEY CONTRACT. All work that needs to be inspected or tested and certified by an engineer as a condition of any government departments or other state agency, or inspected and certified by the local health officer, shall be done at each necessary stage of construction and before further construction can continue. All inspection and certification will be done at the CLIENT 's expense. 17. DEFAULT. The occurrence of any of the following shall constitute a material default under this TURNKEY CONTRACT: a.The failure of the CLIENT to make a required payment when due. b.The insolvency of either party or if either party shall, either voluntarily or involuntarily, become a debtor of or seek protection under Title 11 of the United States Bankruptcy Code, c.A lawsuit is brought on any claim, seizure, lien or levy for labor performed or materials used on or furnished to the project by either party, or there is a general assignment for the benefit of creditors, application or sale for or by any creditor or government agency brought against either party. d.The failure of the CLIENT to make the building site available or the failure of ITC to deliver the Services in the time and manner provided for in this Contract. 18. REMEDIES. In addition to any and all other rights a party may have available according to law of the State of Massachusetts, if a party defaults by failing to substantially perform any provision,term or condition of this TURNKEY CONTRACT (including without limitation the failure to make a monetary payment when due),the other party may terminate the TURNKEY CONTRACT by providing written notice to the defaulting party. This notice shall describe with sufficient detail the nature of the default. The party receiving said notice shall have 90 days from Page 4 of 9 �;rrwr�au� ro WF h vale on hu the effective date of said notice to cure the default(s). Unless waived by a party providing notice, the failure to cure the default(s) within such time period shall result in the automatic termination of this TURNKEY CONTRACT. 19. FORCE MAJEURE. If performance of this TURNKEY CONTRACT or any obligation under this TURNKEY CONTRACT is prevented, restricted, or interfered with by causes beyond either party's reasonable control ("FORCE MAJEURE"), and if the party unable to carry out its obligations gives the other party prompt written notice of such event,then the obligations of the party invoking this provision shall be suspended to the extent necessary by such event. The term FORCE MAJEURE shall include, without limitation, acts of God, fire, explosion,vandalism, storm, casualty, illness, injury, general unavailability of materials or other similar occurrence, orders or acts of military or civil authority, or by national emergencies, insurrections, riots, or wars, or strikes, lock-outs,work stoppages, or other labor disputes, or supplier failures. The excused party shall use reasonable efforts under the circumstances to avoid or remove such causes of non-performance and shall proceed to perform with reasonable dispatch whenever such causes are removed or ceased. An act or omission shall be deemed within the reasonable control of a party if committed, omitted, or caused by such party, or its employees, officers, agents, or affiliates. 20. CONTRACT ARBITRATION. ITC and the CLIENT hereby mutually agree in advance that in the event the ITC has a dispute concerning this contract, ITC may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations and the CLIENT shall be required to submit to such arbitration as provided in Massachusetts General Laws. CLIENT Signature: ITC's PROJECT MANAGER's Signature: NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by ITC. The CLIENT may initiate alternative dispute resolution even where this section is no separately signed by the parties. 21. Indemnification and Limitation of Liability To the fullest extent permitted by law ITC will indemnify and hold harmless the CLIENT and its employees from and against claims, damages, losses and expenses, including but not limited to reasonable attorneys' fees arising out of or resulting from performance of the WORK, Page 5 of 9 looirhvaleon provided that such claim, damage, loss or expense is attributable to bodily injury, sickness, disease or death, or to injury to or destruction of tangible property,but only to the extent caused by the negligent acts of omissions of ITC or its subcontractor or anyone directly or indirectly employed by them. Nothing contained in this TURNKEY CONTRACT shall be construed as creating any personal liability on the part of any officer, director, owner, employee,manager, member or agent of ITC. Notwithstanding any other provision to the contrary in this TURNKEY CONTRACT, and to the fullest extent permitted by law, ITC's liability under this TURNKEY CONTRACT, shall be limited to the sums recovered by ITC under insurance policies taken out by ITC or ITC's subcontractors in respect to the WORK. ITC shall not be liable to the CLIENT for damages incurred by the CLIENT as a result of a failure to obtain Utility Interconnect approval. Notwithstanding any other provision in this Agreement, under no circumstances shall. ITC be responsible for or be under an obligation to compensate the CLIENT for lost energy sales, regardless of the reasons for such lost sales. 22. Taxes The CONTRACT PRICE includes all sales, consumer, use, and other similar taxes on materials provided by ITC, which are legally enacted by the governing authority in the area where the installation is located. 23. Miscellaneous This TURNKEY CONTRACT represents the entire and integrated agreement between the CLIENT and ITC with respect to the WORK and supersedes all prior negotiations, representations or agreements, either written or oral. This TURNKEY CONTRACT may be amended only by written instruments signed by both the CLIENT and ITC. Any oral representation of modification concerning this TURNKEY CONTRACT shall be of no force or effect. This TURNKEY CONTRACT shall be executed in two counterparts, both of which taken together shall constitute one and the same instrument. The undersigned individual(s) represent that they are fully authorized to bind their respective entities. The CLIENT acknowledges that it has carefully read this TURNKEY CONTRACT and understands the contents thereof, that it has had the opportunity to consult with its own attorney(s) in respect to the terms and conditions set out herein and it has agreed to the provisions hereof without reliance on any representation or promise by ITC or anyone acting on behalf of ITC. Page 6 of 9 "',41 IlVill""'nvaleon Solar The invalidity or unenforceability of any particular provision of this TURNKEY CONTRACT shall not affect the other provisions, and this TURNKEY CONTRACT shall be construed in all respects as if any invalid or unenforceable provision were omitted. Nothing in this TURNKEY CONTRACT shall be construed or deemed to create a contractual relationship between ITC and any third party; a cause of action in favor of a third party against ITC; or create any third party beneficiary rights of any kind. ITC and the CLIENT waive all claims against each other for consequential damages arising out of or relating to this TURNKEY CONTRACT. This mutual waiver applies, without limitation to all consequential damages which arise as a result of either party's termination of this TURNKEY CONTRACT. 24. GOVERNING LAW. This TURNKEY CONTRACT shall be construed in accordance with, and governed by the laws of the State of Massachusetts, regardless of the choice of law provisions of Massachusetts or any other jurisdiction. 25.ASSIGNMENT.Neither party may assign or transfer this TURKNEY CONTRACT without the prior written consent of the non-assigning party, which approval shall not be unreasonably withheld. 26. CONTRACT ACCEPTANCE. Upon signing, this document becomes a binding contract under law. Unless otherwise noted within this document, the contract shall not imply that any lien or other security interest has been placed on the property. Review the following cautions and notices carefully before signing this contract. Page 7 of 9 nva iol eon "A �/�,ori .u:Jt',„dl p`�:"a'r'1C'iJl.ut,Mda•"':::r IN WITNESS WHEREOF,the undersigned have duly executed and delivered this TURNKEY CONTRACT as of the day and year first above written. DO NOT SIGN THIS TURNKEY CONTRACT IF THERE ARE ANY BLANK SPACES. No work shall begin prior to the signing of the TURNKEY CONTRACT and transmittal to the CLIENT of a copy of such contract. ITC Name: t Title: Signature: w. Date: CLIENT Name: .G � r Signature: f Date: Page 8 of 9 1 H Nd nvaleon NOTICE OF CANCELLATION YOU MAY CANCEL THIS TRANSACTION, WITHOUT PENALTY OR OBLIGATION, WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE. IF YOU CANCEL, ANY PROPERTY TRADED IN,ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OR SALE, AND ANY NEGOTIABLE INSTRUMENTS EXECUTED BY YOU WILL BE RETURNED WITHIN TEN BUSINESS DAYS FOLLOWING RECEIPT BY THE SELLER OF YOU CANCELLATION NOTICE, AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED IF YOU CANCEL, YOU MUST MAKE AVAILABLE TO THE SELLER AT YOUR RESIDENCE,THE SUBSTANTIALLY AS GOOD CONDITION AS WHEN RECEIVED, ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT OR SALE; OR YOU MAY, IF YOU WISH, COMPLY WITH THE INSTRUCTIONS OF THE SELLER REGARDING THE RETURN SHIPMENT OF THE GOODS AT THE SELLER'S EXPENSE AND RISK. IF YOU MAKE THE GOODS AVAILABLE TO THE SELLER AND THE SELLER DOES NOT PICK THEM UP WITHIN TWENTY DAYS OF THE DATE OF CANCELLATION, YOU MAY RETAIN OR DESPOSE OF THE GOODS WITHOUT ANY FURTHER OBLIGATION. IF YOU FAIL TO MAKE THE GOODS AVAILABLE TO THE SELLER, OR IF YOU AGREE TO RETURN THE GOODS TO THE SELLER AND FAIL TO DO SO, THEN YOU REMAIN LIABLE FOR PERFORMANCE OF ALL OBLIGATIONS UNDER THE CONTRACT. TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE, OR SEND A TELEGRAM TO INVALEON TECHNOLOGIES CORPORATION,AT 451 ANDOVER STREET SUITE 330,NORTH ANDOVER, MASSACHUSETTS, 01845 NOT LATER THAN MIDNIGHT OF I HEREBY CANCEL THIS TRANSACTION. DATE: BUYER'S SIGNATURE:. Page 9 of 9 The Commonwealth of'Mitvvachasetty Deportment of 111d virial Aeeklents (Yfrce of lit vestiiAptiotrs 6#0 Washington Street Boston, AIA 02111' wfvtv.rnass.gov/dltt Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Illlumbers ADMicant Information 'lease Print Le rib/ Name(J3usincs /t)r anicatinn%Jtulividual}: VTT T Address:—451 �o0 r12T 5( City/State 1'./1b -4pbLo2- M4 Q(,F (.' Phone p' Arc you an employer?Check the appropriate hux: �1. lam a general contractor and 1 Type of rojeet(required): I, ]am a employer svit]a_� � L employees(ha]]and/or part-time),* have hired the sub-contractors 6. New constroctiola 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. [] Remodeling ship and have,no enaployces l,hesv sub-contractors have 8. El Demolition working for nae in any capacity. employees and have workers' [No workers' comp, insurance* comp. insurance.» 9. ❑ Building addition required.] 5. F-1 We are a corporation and its 10.❑Electrical repairs or additions 3.0 1 am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. (No workers' comp. right of exemption per MGL 12.F] Roof repairs insurance required,] t C. 152, y 1(4),and we have no employees. [leo workers' 13-❑Other comp, itastnalace requirad,] 'riny applicant tbat ehccks box 01 must ulso till Uut tlu suction below showote,alt>ir workers'compensation Irolicy mthrntatitnt. f liontuowvten svho submit flit.atttd;rvit itutictrinu tltcy are doing oil work and then hire outside contractors must submit a new a813dtrvit intticaung Such 4<:onlractors that check Itis box bust anached all additional shcel showing the nuruc orthe sub-eontraclors and steno whether of not those entities have employees, Iftho sub•contracims bme employees,they must pros idc their workers`comp policy number. !not fur eucpinJ�er Hurt is prove"rlin tvorkcrrs'c"onrpenstttiutr h►srtrarrce fear rttp employees. Belt.)w r`s the rya/lcy rrudjob site lief"ornnttfatr. Insurance Company Name:_. �, Policy y Lie.4: V .. '' cp C 1.3 Eixpiration Date: � t` 1'otic, it or Self-ins. � .—.. Job te ?41 Attach ttdt at t��„ ter ' copy he workers' compensation policy declaration page(showrng the policy number and expiration date), Failure to secure coverage as requires~;under Section 25,A of MGL c. 152 can lead to the imposition of criminal penalties of a Sine alp to M,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 it copy ofthis statement may be fiorwarded to the Office of Investigations ofthe DI for insurance coverage verification. /do iterebj,certify cure I the palprs it cd pemtllies of perftu t'that the iuforturttion provider/rr ove is trite and correct. Snatureit � Ph ne ., .. Gfftcittl use only, Do not write in this arert,to be completed Gv ciry or tower official. City or Town: Permit/License# Issuing Authority(circle one,): 1.Board of Health 2. Building 0eparnuent 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector ti. Other Contact Person: _ Phone M A� CERTIFICATE OF LIABILITY INSURANCE 3Ai10Mi2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les) must be endorsed. 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). PRODUCER CONEACT Lisa London MTM Insurance Associates PHONE (g'JB)681-5700 FAXAIC Nol.(978)6e1-5777 1320 Osgood Street 'MAILADpgESS.lisal@mtminsure.com INSURERS AFFORDING COVERAGE NAIC N North Andover MA 01845 INSURERAAtain Specialty Ins Co INSURED INSURERB:National Union Fire Ins Cc of Invaleon Technologies, Corp. INSURERC:Travelers Insurance Group 451 Andover Street INSURER D: Suite 330 INSURER E: North Andover MA 01845 INSURER F: COVERAGES CERTIFICATE NUMBER:15-16 Master List REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILSR TYPE OF INSURANCE ADDL SUBR VJVn POLICY NUMBER POLICY EFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 }� COMMERCIAL GENERAL LIABILITY DAMAGE T REN E occurrence)PREMISES(Ea $ 100,000 A CLAIMS-MADE OCCUR CIP229969 /2/2015 /2/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM P/OPAGG $ 2,000,000 X1 POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident _ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS e e $ X UMBRELLA LIABOCCUR EACH OCCURRENCE $ 1,000,000 B EXCESS LIAB HCLAIMS-MADE AGGREGATE $ 1,000,000 DED I X I RETENTION BD UMB /12/2015 3/12/2016 $ WORKERS COMPENSATIONWC STATU- GTH- AND EMPLOYERS'LIABILITY Y/NY LIML ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE S es,desalbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S C Crime Coverage 106254087 /27/2015 /27/2016 Limit $100,000 Deductible $5,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) This certificate of insurance represents coverage currently in effect and may or may not be in compliance with any written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Next Step Living ACCORDANCE WITH THE POLICY PROVISIONS. 21 Dry Dock Ave 2nd Floor AUTHORIZED REPRESENTATIVE Boston, MA 02210 f_p M Laorenza/STEPH ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 rgmnwii m Tha Ot'nPn nmmn and Innn arc ranictararl mnrlea of Art)Rr1 Rightfax N2-1 3/13/2015 12:39:57 PM PAGE 3/004 Fax Server qi�o � CERTIFICATE OF LIABILITY INSURANCE DATE 03-13-2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: It the certificate holder I$an ADDITIONAL INSURED,the POilcy(ies)MUStbe endorsed. It 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(a). PRODUCER CONTACT MTM INS ASSOCIATES LLC PHONE 1320 OSGOOD ST FAX N ANDOVER,MA 01835 EMAIL INSURER(S)AFFOROINOCOVERAGE NAICa INSURER A:TRAVELERS PROPERTY CAS CO OF AM INSURED INVALEON TECHNOLOGIES CORP INSURER B: 451 ANDOVER ST STE 330 INSURER C NO ANDOVER,MA 01845 INSURER D INSURER E INSURER F; THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INOR TYPE OF INSURANCE ADD POLICY EFF POLICY EXP GENERAL L1118111TY INSR WVD POLICY NUMBER COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE • $ CLAIMS-MADE❑ OCCUR E ORENTED i MED EXP(Anfr qlp arson PE RSONALd ADVINIURY GE ML AGGREGATE LIOMITAPPLI 6PER; pENERALAGGREGATE 8 POLICY JECT LOC PRODUCTS•COMPIOP AGO S M091LE UABLrrY $ ANY AUTO I ED SINGLE LIMIT S AALL UTOS OWNED SCHEDULED BODILYINIURY(Pe(person) $ AUTOS HIREOAUTOS NON�OWNED BODILY INJURYIPer amidenp $ AUTOS P E $ UMBRELLALLAB OCCUR $ EXCESS UAB CLAIM&MADE EACH OCCURRENCE $ DED RETENTION$ AGGREGATE $ WORKERS COMPENSATION $ AND EMPLOYERWUABILrTY YINX Y/CSTATU• OTH- ANYPROPRIETOR(PARTNEWEXECUrIV�hj TORY LIM ITB ER OFPX:ERYIn NH) EXCLUDED? L•J N/A E.L.EACH ACCIDENT $100,000 (MenCslory In NH) UB 03.08.2015 03.08.201 B II Yes,dozat"unoer 2E788008 E.L.DISEASE-EA EMPLOYEE $100,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMiT ('100,000 DESCRIPTION OF OPERATIONS!LOCATIONSI VEHICLES(Altuh ACORD 101,Add)(bnal Remarks Sdwdule,H mon apace In requlnd) NEXT STEP LIVING,INC. :NOTICE ANY OF THE ABOVE DESCRIBED POLICIES BE 21 ORYDOCK AVE,2ND FLOOR LED BEFORE THE EXPIRATION DATE THEREOF, 7s AUTHORIZED 02210 WILL BE DELIVERED IN ACCORDANCE WITH THE ROVISIONS. ED REPFt=RE NTATIVE ACORD 25(2010105) The ACORD name and logo are registered9mukstof p 1ppljCORPORATION.All rights reserved. /��Jij mnrri+i , I ..............