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Date Issued:
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑ Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Idg ❑ Others: j
❑ Demolition C Oti,
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OWNER: Name: � - .�� '� :� .._ Phone: 2-71'- 65
Address:
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ARCHITECT/EIGII �� '� Phone;
Address: w' j1':L L(D'20 Reg. No.
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FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ FEE: $
Check No.: Receipt No.: ~f '' ®
NOTE: Persons contracting with unregistered contractors do not have a cess to the guaranty fund
REVOLUSUIV
THIS HOME IMPROVEMENT SOLAR ENERGY CONTRACT (this "Contract") IS BETWEEN: Leslie Lopez ("Client") located at 19 Little Rd N. Andover, MA
01845 ("Client's Property")
-AND-
Northeast Solar Services, Inca ("Contractor") of 1 North Ave Suite A Burlington, MA 01803, with Home Improvement Contractor Reg. No. 178137, which
expires on March 17, 2016, and Federal Employer ID 46 0569853. Contractor's sales person for this contract is Kellie McManus.
The parties to this Agreement agree as follows:
A. Installation of PV System. The above Client(s) has engaged Contractor to perform the following residential contracting work (the "Work") in connection
with the installation of the following photovoltaic solar energy system (the "PV System"):
15 SunPower - SunPower 327 watt modules (or equivalent) with 1 Solar Edge - Solar Edge SE 5000A inverters (or equivalent) and all mounting,
disconnects, and all other PV System components necessary for a National Electric Code compliant PV System, totaling 4.905kW, located at Client's
Property.
B. Other Inclusions The Work shall further Include:
• Installation of the PV System in accordance with all State of Massachusetts interconnection standards.
• All reasonable engineering and permitting costs.
• The following building permits are required and will be secured by Contractor as Client's agent: Building and Electrical Permit.
• Following the Installation, Client will receive a PV System orientation and a PV System Client's manual.
Notice: It shall be the obligation of the Contractor to obtain all permits related to the Work. Clients who secure their own permits will be excluded from
the guaranty fund provisions of Chapter 142A of the Massachusetts General Laws.
II, COMPENSATION AND SCHEDI&E
A. Contract Price For Contractor's performance of the Work under this Contract, Client will pay Contractor a total of:
$ 25,219.85 (TWENTY FIVE THOUSAND TWO HUNDRED NINETEEN AND 851100) DOLLARS USD (the "Contract Price").
B. Payment Schedule The Contract Price will be payable in accordance with the following payment schedule:
Date Paid:
$ 12.609.92 Initial Payment - 50% (Due upon Contract signing, which is an amount less than the cost of the materials and equipment
which must be specially ordered in advance of commencement of PV System installation)
$ 11.348.93 Progress Payment - 45% (Due upon Substantial Completion)
$1.261.00 Final Payment - 5% (Due upon Final Completion)
C. Schedule The "Start Date" of this Contract is the date Contractor receives the full amount of Client's initial payment of 50% of the Contract Price.
Subject to adjustment for any Force Majeure reason stated in Section IV.J., the Work is estimated to begin within 12-16 weeks from the Start Date of this
Contract. The parties agree that this date shall be automatically extended to the date of delivery of all materials and equipment which mut be specially
ordered.
Substantial Completion is estimated to occur within 16-20 weeks from the Start Date of this Contract, but the parties agree that this date shall be
automatically shortened or extended to the date on which all racking and electrical work are complete and the PV System Is
capable of generating power and ready and available for use subject to final government and utility approval.
Final Completion is defined as the date on which all punch list items are complete, all permits are closed, all other government and utility
approvals are obtained and the Work is complete to the satisfaction of Contractor and Client.
Client acknowledges and agrees that the Work involves permits, Inspections and approvals from various government agencies and utilities, and
therefore the timing of the Work may vary and is not within Contractor's control. Client further agrees that Contractor shall not be liable for any losses,
costs or damages related to any delays for reasons beyond Contractor's control, Including all causes noted in the Force Majeure section of this
Contract below.
Northeast Solar
1 North Ave Sulte A
Burlington, MA 01803
781.240.6555
A. Contractor's Registration: All home improvement contractors and subcontractors engaged in home improvement contracting, unless specifically
exempt from registration by provisions of Chapter 142A of the Massachusetts General Laws, must be registered with the Commonwealth of
Massachusetts. Inquiries about registration and status should be made to the Director of the following state agency:
Office of Consumer Affairs and Business Regulation
Home Improvement Contractor Registration
Ten Park Plaza, Room 5170
Boston, MA 02116
(617) 973-13700
B. Client's Cancellation Rights: Client may cancel this Contract, without penalty or obligation, within three business days following the date on which
Client signs this Contract, A Notice of Cancellation is attached hereto for Client's convenience.
C. Warranties: For a period of ten (10) years from Substantial Completion, Contractor warrants that the PV System has been designed and installed in a
good, workmanlike and substantial manner in accordance with all applicable building codes.
In the event Contractor is required to penetrate the roof of the Client's property in the course o allat oncauses daM a to the roof within a three
(3) inch radius of a penetration, Contractor will repair such roof damage for a period of ty (20) years from Substantial fnpietion or the remaining
term of the root's existing installation warranty, whichever is shorter, to prevent any water, ifi or-other-moistmJeak s -s epage or entry directly caused
by such penetration. These warranties are for normal use and conditions only. All warranty coverage to equipment and workmanship installed by
Contractor will be VOID if any alterations or repairs are performed by any person or persons not expressly authorized, in writing, by Contractor. THIS
WARRANTY DOES NOT COVER: (a) Damage caused by external forces such as, but not limited to, vandalism, theft, terrorism, fire or act of God; (b)
Damage caused by weather effects exceeding manufacturer tolerances; (c) Normal wear and tear or aging of a PV System; (d) Any implied warranties:
(e) Electric bills, water damages or any other consequential damages; or (f) Damage to the PV System or its efficiency due to adjustment, moving, or
tampering with the PV System or any of its components by individuals not approved by Contractor.
D. Change Orders: Any alteration or deviation from above specifications involving extra costs must be subject to a written change order signed by both
parties, which shall be Incorporated Into this Contract, and Client shall be liable for any additional costs resulting from each change order. By initialing the
space below, Client hereby specifically agrees to execute a change order, and pay the additional costs, if It becomes necessary for Contractor to repair or
replace un -approved or non -code compliant electrical work in order to complete the PV System Installation and satisfy code requirements.
Client's Initials:
Client's Initials:
ARBITRATION: CONTRACTOR AND CLIENT HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT CONTRACTOR HAS A DISPUTE
CONCERNING THIS CONTRACT, THE CONTRACTOR MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN
APPROVED BY THE DIRECTOR OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND CLIENT SHALL BE
REQUIRE TO SUBMIT T0 SUCH ARBITRATION AS PROVIDED INV.G.L. C. 142A.
Client: .� Z-1 Date:Z�
Client: Date:
4
Contractor: - — Date: -a a, % '
NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by Contractor. Client may
Initiate alternate dispute resolution even where this section is not separately signed by the parties.
E. Incentive Guarantee: By Client's initials below, Client acknowledges and agrees that Contractor has not and does not guarantee Client's qualification
for, receipt of or amount of any tax credit, rebate, solar renewable energy credit (SREC) or other incentive amount in connection with the PV System, and
any estimates of Incentives (wither In a PV System proposal or otherwise) are not guaranteed to be accurate or available. Client is responsible for
determining Client's and/or the PV System's eligibility for any Incentives and should consult with tax, legal and other advisors regarding availability and
possible tax consequences of Claiming the same.
Client's Initials: Vt —
Client's Initials:
Northeast Solar
1 North Ave Suite A
Burlington, MA 01503
761.240.6555
108370 W1.6.01g 0611212016
REVOLU, SUN
IV. OTHER TERMS AND CONDITIONS
A. Access To enable Contractor to perform Its Work hereunder, Client shall grant during daylight hours adequate space on Client's property, as mutually
designated by Contractor and Client, for the complete and proper installation, operation, maintenance and repair of the PV System as well as rights of
Ingress and egress to, through and from such property and the space designated for the PV System.
B. Scarcity of Materials: Rights of Termination: The PV System components to be obtained under this Contract are scarce commodities. In order to meet
the performance requirements of the PV System described in this Contract, Contractor may substitute the specified brand of solar module or inverter for a
similar brand of module or inverter that allows for more timely completion of the installation. Such substitution, if necessary, shall be of UL approved
devices, with aggregate performance criteria the same as equipment specified. The governing body for determining performance criteria shall be the CEC
(California Energy Commission) that rates all UL approved modules. The key module statistic used for performance criteria will be the DC STC rating of
the sum of the modules. The key Inverter statistic used for performance criteria will be the AC output of the device.
If, due to code requirements, equipment substitution, final engineering, space availability, etc., the size of a PV System decreases, Contractor shall re-
calculate the Contract Price using Its standard pricing method and the Contract Price shall be automatically reduced. Client shall be credited by the
reduced amount. If due to substitution the DC STC size of the PV System increases slightly, then Client shall not have to pay Contractor similarly.
Contractor shall make every reasonable effort to ensure that PV System size does not decrease from the specifications. If the DC STC size of the PV
System decreases more than 15% from the Contract's specification amount for any of the reasons stated in this paragraph, Client shall have the right to
terminate this Contract within ten (10) days of Contractor's written notification to Client of such decrease, and Contractor shall then refund In full all funds
paid to date under this Contract, but shall have no other liability to Client.
Contractor reserves the right to unilaterally terminate this Contract within 45 days of its approval without any liability to Client if any of the PV System
components required for the completion of Contractor's Work in a timely manner are not available. In the event of such termination, Contractor shall
refund all monies paid by Client to Contractor as of the date of termination.
C. Limitation of LlabilU In no event shall Contractor be liable in an amount exceeding the compensation paid by Client to Contractor under this Contract.
Contractor shall not be liable for any incidental, consequential or special damages or for economic loss or expense of for loss or profits or Income of
Client, or Client's consultants or agents or employees, or any of them, Including but not limited to any electricity costs incurred should Installation of the PV
System be delayed beyond the commencement or completion schedule set forth above.
D. Zonina: Client shall pay for all variances, special permits, or other costs related to zoning, including without limitation any fees or costs related to
attorneys or engineers.
E. Client's Property: Client agrees to remove or to protect any of Client's personal property, inside or out, which may interfere with or obstruct the Work,
Including but not limited to landscaping, and Contractor shall not be held responsible for damage to such property. Client understands and acknowledges
that proper operation of the PV System purchased hereunder is dependent on Client's existing roof and equipment and Contractor shall have no obligation
or liability for the condition thereof, or any other part of Client's improvements or equipment not purchased hereunder. Client expressly represents that the
roof of the property upon which the PV System will be installed is in good condition, with no known water Infiltration problems or other structural defects.
F. Insurance: Client must carry all fire, casualty, hurricane, earthquake, theft, and other insurance related to Client's real and personal property.
G. Cancellation of Contract: If Client cancels or breaches this Contract after the opportunity to execute three (3) day rescission has passed but before
commencement of construction, Client shall pay Contractor the amount of expenses Incurred to that date plus 20% of the Contract Price. If Client falls to
pay said amounts within thirty (30) days of Contractor's demand for payment and Contractor files suit, Contractor shall be entitled to recover all of its
damages Including Its loss of net profits and attorneys' fees and costs if Contractor is the prevailing party.
H. Costs of Collection: If Client fails to pay any amounts owed to Contractor when due, Client shall be liable for all costs of collection, including
reasonable attorneys' fess, plus 18% interest per annum on the unpaid balance. Contractor also shall have option of removing all or part of the PV
System from Client's premises In addition to receiving payment equal to the value of the unpaid balance to cover all or a portion of Contractor's
consequential damages.
I. Liens: Contractor, any subcontractor(s) and any other persons or entities supplying labor and materials to Client under this Contract, have the right
under applicable law to Impose a lien on Client's real property for the value of the labor or materials provided. Upon Client's payment of all amounts due
under this Contract, Contractor will provide, upon Client's request, a release and waiver of any liens.
J. Force Majeure Contractor shall not be liable for any delay in material and/or equipment delivery or for failure to deliver or failure to perform the Work
which results from any cause beyond the Contractor's control. Such causes include but shall not be limited to: an act of God or of the public enemy; an
act (or failure to act) of any government or utility; a fire, flood or epidemic; quarantine, restriction, strike, freight embargo, terrorism, theft or unusually
severe weather; Contractor's inability to obtain necessary materials, labor or transportation; custom permitting caused by Cilent's site conditions;
homeowner association review or approval; building or other code requirements relating to Client's existing electrical system or building characteristics;
and any other Impediments to the installation of the PV System arising from Client's acts or omissions and/or the condition of Client's property.
Northeast Solar
1 North Ave Suite A
Burlington, MA 01803
781,240.6555
106378 W1.9.010 0612r,015
K. legal Compliance and Severability: Contractor and Client acknowledge that the form, substance, content and notices contained in this Contract are
Intended to comply with Chapter 142A of the Massachusetts General Laws, and regulations promulgated thereunder. in the event of any Instance of non-
compliance, only such portion shall be invalid and the remainder of this Contract shall be in full force and effect, in addition, any such portion not In
compliance shall be read and Interpreted so as to have Its Intended meaning to the maximum extent allowed under such law and applicable regulations.
L. Entire Contract: No Waiver Unless In Writing: This Contract constitutes the entire contract between the parties; there Is no representation, warranty,
collateral contract or condition affecting this Contract except as expressed in it. No provisions of this Contract shall be changed or modified, nor shall this
Contract be discharged or waived, in whole or part, except in writing signed by both parties. This Contract shall not be effective until fully executed by
Client and an Authorized Representative of Contractor.
M. Client's Representation of Authority: If this Contract Is signed by less than all of the persons or entities who own the subject property, then Client who
signs this Contract (or any of the provisions hereof) represents to Contractor that he, she or it has full legal authority to bind the other persons and/or
entities.
N. Governing Law: The laws of the Commonwealth of Massachusetts shall govern any proceeding or dispute related to this Contract.
O: Production Gap Guarantee: This production guarantee covers 90% of estimated production in year 1 and decreases at .5% each year for a total term of ten
(10) years. This guarantee Is determined on an accrual basis and payments are made when the aggregate system production falls below total production
estimated on the schedule above. Payments will be made at the end of each anniversary of the system's in service date of interconnection. Production Gap
Garranty is void if site conditions and solar access change after the date of interconnection.
Client's Initials: LL,
Client's Initials:
P. 3rd party Financing: Should the client obtain financing from a 3rd party which Is approved by the Contractor, the payment terms of the lender will apply.
Client: Contractor:
Name:
Date: �' Title:
Date:
Northeast Solar
1 North Ave Suite A
Burlington, MA 01803
781.240.6555
106378 w1.5.019 0611WO15
G
Project Number: U1883-0035-151
December 15, 2015
RevoluSun
1 North Avenue
Burlington, MA 01803
ATTENTION: Ryan Stair
REFERENCE: Leslie Lopez Residence: 19 Little Road, North Andover, MA 01845
Solar Panel Installation
Dear Mr. Stair:
Per your request, we have reviewed the layout and photos relating to the installation of solar panels at the above -
referenced site. The following materials and components are proposed in the installation of the solar panels.
Roof Structure: 2x6 rafters at 24" O.C.
Roof Material: Composition Shingles
Based upon our review, it is our conclusion that the installation of solar panels on this existing roof will not adversely
affect the structure of this house. The design of solar panel supporting members and connections is by the
manufacturer and/or installer. The adopted building code in this jurisdiction is the 2009 International Building Code
and ASCE 7-05. Appropriate design parameters which must be used in the design of the supporting members and
connections are listed below:
Ground snow load: 55 psf per Massachusetts amendments to the IBC (verify with local building department)
Design wind speed for risk category II strictures: 110 mph (3 -sec gust)
Wind exposure: Category B
Our conclusion regarding the adequacy of the existing roof is based on the fact that the additional weight related to the
solar panels is less than 3.05 pounds per square foot. In the area of the solar panels, no 20 psf live loads will be
present. With an assumed roof dead load of 15 psf, roof snow load of 38.5 psf per above, solar panel dead load of 3.05
psf, and affected rafter span of 87% (maximum), the additional gravity load will be 4.9%. Because the increase is less
than 5%, this alteration meets the requirements of the exception in Section 707.4 of the 2009 International Existing
Building Code. Thus the existing structure is permitted to remain unaltered. Similarly, at arrays where the solar panel
dead loads are 2.98 psf and 2.93 psf, a maximum affected rafter span of 89% and 91 %, respectively, are allowed while
still maintaining less than a 5% increase in additional gravity loads. Regarding wind loads, we conclude that any
additional forces will be negligible due to the low profile of the panel system. It is our conclusion that any additional
seismic loadings related to the addition of these solar panels is negligible.
During design and installation, particular attention must be paid to the maximum allowable spacing of attachments and
the location of solar panels relative to roof edges. The use of solar panel support span tables provided by the
manufacturer is allowed only where the building type, site conditions, and solar panel configuration match the
description of the span tables. Attachments to existing roof joist or rafters must be staggered so as not to over load any
existing structural member. Waterproofing around the roof penetration is the responsibility of others. All work
performed must be in accordance with accepted industry -wide methods and applicable safety standards. Vector
Structural Engineering assumes no responsibility for improper installation of the solar panels.
Please note a representative of Vector Structural Engineering has not physically observed the roof framing. Our
conclusions are based upon the assumption that all structural roof components and other supporting elements are in
good condition, free of damage and deterioration, and are sized and spaced such that they can resist standard roof loads.
Very truly yours,
VECTOR STRUCTURAL ENGINEERING, LLC
Roger T. Alworth, S.E.
Principal
RTA/amw
-15,2015
9138 S. State St., Suite 101 / Sandy, UT 84070 / 7'(801) 990-1775 / F (801) 990-1776 / www.vectorse.com
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_ Department of In(krstrial Accidents
Office of Invesdgations
' 1 Congress Street, Suite 100
Boston, MA 02114-2017
mm mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Northeast Solar Services Inc
Address:1 North Ave Suite A
City/State/Zip:Burlington / MA / 01803 Phone #: 781 - 270 - 6555
Are you an employer? Check the appropriate box:
Type of project (required):
1.✓0 I am a employer with 12
4. [J I am a general contractor and I
6. ❑New construction
employees (full and/or part-time).*
2. ❑ I am a sole proprietor or partner-
have hired the sub -contractors
listed on the attached sheet.
7. ❑ Remodeling
ship and have no employees
These sub -contractors have
8. F] Demolition
workingfor me in an capacity.
Y p $'•
employees and have workers'
comp. insurance.#
9. E] Building addition
[No workers' comp. insurance
required.]
5. n We are a corporation and its
10. ❑ Electrical repairs or additions
3. ❑ I am ahomeowner doing all work
officers have exercised their
11.❑ Plumbing repairs or additions
myself. [No workers' comp.
right of exemption per MGL
12. ❑ Roof repairs
insurance required.] t
c. 152, § 1(4), and we have no
13.R Other Solar PV
employees. [No workers'
comp. insurance reQuired.l
*Any applicant that checks box # 1 must also till 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.
tContractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have
employees. Uthe sub -contractors have employees, they must provide their workers' comp. policy number.
I ant (tit eheployer that is providing workers' compensation insurance for my employees. Below is the policy and job site
ii formation
Insurance Company Name: Federated Mutual Insurance Company
Policy # or Self -ins. Lic. #:9884086 Expiration Date: 1/08/2016
Job Site Address: t t CA City/State/Zip:IV• lldoyerl
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 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.
I do Isere certify under flee gins and enaliies o e it that the information provided above is trite and correct
Phone #: 781-270-4899
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 M
'4 L'® CERTIFICATE OF LIABILITY INSURANCE
DATE (MMlDD/YYYIf)
01/OMS
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 poilcy(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 endorsements .
PRODUCER
FEDERATED MUTUAL INSURANCE COMPANY
HOME OFFICE: P.O. BOX 328
CONTACT CLIENT CONTACT CENTER
PNC No Ext : 888 3 -4949 FAX No): 507446-4M
AIL
ADDRE s: C ENTCO ACTCEN ER EDINS CO
OWATONNA, MN 55080
INSURERIS) AFFORDING COVERAGE NAIC U
INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935
EACH OCCURRENCE $1,000,000
INSURED 297-673-6
INSURER B:
NORTHEAST ELECTRICAL INC, NORTHEAST SOLAR SERVICES INC
INSURER C:
1 NORTH AVE
BURLINGTON, MA 01803
INSURER D.
INSURER E:
INSURER F.
A
(1evFDnc;Fc CERTIFICATE NUMBER: 64 REV15ION NUMBER: z
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.
1CY
�T R
TYPE OF INSURANCE
SR
IN BD
POLICY NUMBER
P�LODY EFF
PO)ODI EXP
UMIT8
GENERAL LIABILITY
EACH OCCURRENCE $1,000,000
_
DAMX
PREMI SE$ET .ELATED $100,000
COMMERCIALOENERALUABIUTY
MED EXP (Any one Person) EXCLUDED
A
CLAIMS -MADE N OCCUR
Y
N
9884094
12/31/2014
12/31/2015
PERSONAL& ADV INJURY $1,000,000
OENERALAOOREOATE $2,000,000
OEN'L AGOREOATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGO $2,OOD,000
X POLICY P pT n LOC
AUTOMOBILE LIABILITY
POM ED SINOLE LIMIT $1,0,000
BODILY INJURY (Per person)
X ANY AUTO
A
SNED SCHEDULED
AUTOAUTOS
Y
N
9884085
12/31/2014
12/31/2015
BODILY INJURY (Per ecciden0
r ROPE TV DAMAGE
e
NON -OWNED
HIRED AUTOS AUTOS
X
UMBRELLA LIAR
X
OCCUR
EACH OCCURRENCE $51000,000
AOGREOATE $5,000,000
A
EXCESS LIAR
CLAIMS•MADE
N
N
9664087
12/31/2014
12/31/2015
DED RETENTION
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOIUPARTNERIEXECUTIVE FR
O (MandatoryIn MR EXCLUDED?
(MatMatory In NH)
IA A
N
9884088
12/31/2014
12!31/2015
WCSTATU• OTH-
X TORY UMITS ER
F.L. EACH ACCIDENT $1,000,000
E.L. DISEASE - EA EMPLOYEE $110001000
E.I.DISEASE - POLICY LIMIT $1,000,OOO
If yes• describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N more space Is required)
THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT
ENDORSEMENT FOR GENERAL LIABILITY.
THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT
ENDORSEMENT FOR BUSINESS AUTO LIABILITY.
f`FRTLCICATF Lina ncp CANCELLATION
��7lCtfV 2
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATNE
® 1988.2010 ACORD CORPORATION. Ali rights reservelf.
ACORD 26 (2010!05) The ACORD name and logo are registered marks of ACORD
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