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17A-136 237 CHESTNUT ST BP-2022-0099 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17A- 136 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:renovation BUILDING PERMIT Permit# BP-2022-0099 Project# JS-2022-0001 35 Est.Cost: $234500.00 Fee: $1527.50 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: THOMAS DADMUN 107919 Lot Size(sq. ft.): 23478.84 Owner: ROTHSTEIN JULIE Zoning: URA(100)/ Applicant: THOMAS DADMUN AT: 237 CHESTNUT ST Applicant Address: Phone: insurance: 60 SCHOOL ST (413) 387-7381 HATFIELDMA01038 ISSUED ON:7/27/20210:00:00 TO PERFORM THE FOLLOWING WORK:INTERIOR RENOVATION POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: i 0 • it a >2 - 3)0,17/ FeeType: Date Paid: Amount: Building 7/27/2021 0:00:00 $1527.50 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner t1-1-CL r(07n.__S ')1 • 04, The Commonwealth of Massachus-. sbo o,4.e c�6+c7 4:) Board of Building Regulations and Standa 43 cj FO' `, Massachusetts State Building Code, 780 CM' ?'"04,'• C r ALITY �sA SE Building Permit Application To Construct,Repair,Renovate Or D 'ai1y: Revi•-d Mar 2011 One-or Two-Family Dwelling �9(5'1's This Section For Official Use Only Building Permit Number:,e,p►. — Try Date Applied: Building Official(Print Name) f Signature D to SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers Al c t w c Y, (Ly(.► 4•t 11 tr 010(9-- i 1 A 1 Co 1.1 a Is this an accepted street?yes x no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: U,F A. 13 Etc CietA>,Ly Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public Private 0 Zone: _ Outside Flood Zone? Municipal g On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: J.)Ltk. 11.-51i-p-I V�oravoci, t M Pc ok o io 2-- Name(Print) City,State,ZIP II I �Z3i GI Sh�ut C 4Ib-S11-(�ol'1 �,Aktooto in5tca\& i-o��l ,i4 No.and Street Telephone Fail Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building Owner-Occupied 0 Repairs(s) 0 Alteration(s) It Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': 1 Nth-to?- RENOVAil o,a 5 Ir W t7t a(.- ' o�A-nt(- W A-t ,5 To A-Do A 17 f.01Loo►A I 'P-e Ae o►iA.- Th-*.., 0.4 r t,, R�i> 2')9 11--koofL gA-at , 1 L o*c&P - k ' hit". LA-I-L titz.u. felrtuuo ¶o..1, 1-wo tot,aoo„,5, SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 2,.t911 000 a' 1. Building Permit Fee: $ Indicate how fee is determined: u 0 Standard City/Town Application Fee 2.Electrical $ 1 G,S0 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 12, 006 ."2 2. Other Fees: $ 4. Mechanical (HVAC) $ 5,0 00 List: 5.Mechanical (Fire Suppression) $ I) $$, Total All Fee/s:: �) Check No.I Ub I Check Amount: I )6 , =�" 6.Total Project Cost: $ i 1741500 . 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) . Q t Q /Z,1 17A 1 W1 j y*c j�v� License Number Expirationi Date Name of CSL Holder List CSL Type(see below) (oo ot, ST. No.and Street Type Description gyp, U Unrestricted(Buildings up to 35,000 Cu.ft.) ��"n A '0 v R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding I t fI SF Solid Fuel Burning Appliances tt �"3�1 J�l T�w� C"' Wt�1�GLG.(�JWL I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) t�a i 51 b l 21I 1,p22 TUL11A-V- ( tA9,9' LLC HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name too 5tilbroL br. �ow� °�dtdlAAJv,a ,cdW. No.and Street "� n Email address bb City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes No . 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES V FORiI1 BUILDING` � PERMIT I,as Owner of the subject property,hereby authorize Ti4 ,'- .w'. po2�"`"'Y" to act on my behalf,in all matters relative to work authorized by this building permit application. ,1 �l.ltt✓ v1 .3t 14� 2 Print Owner's Name(Electronic Signature) ate SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. l - 'D AO A/0 •• U 1A 1 Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" Commonwealth of Massachusetts 11 Division of Professional Licensure Board of Building Reguiattons and Standards orxstr- iOl'SU rvisor CS-107919 spires:09/241202/ THOMAS DAC MUN 60 SCHOOL ST HATFIELD MA 01G3 . Cornmissiotler �. Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC Registration: 179682 THE TUCKER GROUP LLC. Expiration: 08/27/2022 60 SCHOOL ST HATFIELD, MA 01038 Update Address and Return Card. Office of Consumer Affairs & Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE: LLC before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 179682 08/27/2022 1000 Washington Street - Suite 710 THE TUCKER GROUP LLC. Boston, MA 02118 � t THOMAS DADMUN 60 SCHOOL ST HATFIELD, MA 01038 Undersecretary Not valid without signature R ® A rfl CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 05/21/2021 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(ies)must have ADDITIONAL INSURED provisions or 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 • CONTACT Susan Fleury CIC CISR CPIA NAME: King&Cushman Inc. (AHCNN Ext): (413)584-5610 FAXX,No): (413)584-9322 P.O.Box 447 E-MAIL sfleury@kingcushman.corn ADDRESS: 176 King Street INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01061 INSURER A: Main Street America Assurance Co. 29939 • INSURED INSURER B: DADMUN DESIGN&CONSTRUCTION INSURER C: 60 SCHOOL ST INSURER D: INSURER E: HATFIELD MA 01038-9747 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2152104235 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. INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMA_ CLAIMS-MADE X OCCUR PREMISES(EaENTED occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 A MPT4694Q 11/13/2020 11/13/2021 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT PRO LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: FITRV $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY _ AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAR _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 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 REPRESENTATIVE ,�f I >etA .LJ J ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD City of Northampton Ns Massachusetts eirfr' � DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: The debris will be transported by: Name of Hauler: Vuoor,.9t3 (c-IZVt�i.,� ) ` 13 -U0 -543o Signature of Applicant: 1. � Date: t. Z,,ff 202A :L.Nc The Commonwealth of Massachusetts iiii.olo ow: taiMilmo r Department of Industrial Accidents I Congress Street, Suite 100 .......7;4;....._ ...,2......-- Boston, 31-1 02114-2017 .. www.mass.goridia Vi in kers'I.ompensation Insurance Affidavit:BuiklersitontractorsdElectriciansoPlumbers. TO HE FILED WITH THE PERMITTING AUTI1()10 IA. Applicant Information Please Print Legibly' Name l hlustness,'OrganizatiowIndivitinall: lik-k- l'94?-- Caz-.0 _1-1-t Address: (PO L1,)1. eDt. . . City/State/Zap. ‘A-011-11c4,i7 OA t'10 bf, Phone #: il 1-) 7 - 7- 7 e, Are per an employee Check Ihe apprapriate hos: Type of project(required): ID 3 ant a urnploya with cnipkyous lfull miter part-time).* 1 7. o New construction 20 I am a iok proprietor in partnership and hate DU ednployeva working fur nic in 8. tI Remodeling any L.-spicily.[No vomiters'eortm.insuratior norinned_j 9.3E3 1 ant a horticowniir doing all work myself.[No*odors'comp.imemes ilquiset]9 0 Demolition i 0 0 Building addition .t.E1 I am a lioirwowIlen and will tic hiring i.-ontractors kt.conduct all week uni say pmpie1y. I will ! ensure that all contractors cillier has c worker% corripc-niaition insurance Of IMS Stes 110 Electrical repairs or additions proprietors viith nu empdoyecti, I 2.0 Plumbing repairs or additions a remind contractut and I bast:hired the aub-uontractirri Fisted on the attached Acct. I 30 Roof repairs These sub-contractors Foie employers and hate workers'L'omp.insurance 1) I-4.0 Other h.0 I.arc a corporathm and its officen hate exercised their right of exemption per-NCI_c. / 132.-,-:lit).and we have at,Cinployors.[No workers comp.iniurance required.) ▪An appinant that chocks Isoi.al Inuit also fill out the icetion below allowing their workers'compensation poIc Lidinntiort ` noniron nem who militant dut affiikort indicating ila.-y are doing all work arid then hue outside contractocs must submit a raCA anidas it Indic-wiling%Lodi t.LiiitraL tom that clicLls Olt+601 MIA attached an additional short shoo,iniz,the name of the milli-Lliath actors and'laic siinfilwr 07 alit 111,1M:4.711211K,11.1'4,2 • iri,,it:8 It the"iLi .11r,,,,,.'.;,,T,hate,:.!;47'ik,!,.:. .the..s.most pr. idc their workers"comp poitcy ninnt),:r. I am an employer that is providing worAers'compensation insurance for my employees. Below is the policy and job Nile information. trbtihince Company Name: TWL or Self-ins.Lie..1: 1(7 Q -el 0 h2-7b3-2.-2( Expiration Date: 2"j(t-2 a Job Site Address: 2'1).1 Clli-tjtoor '1",r cityistateizip: ft,*.koct, tilA- 0102— Attach a copy of the workers'compensation policy declaration page(showing the policy number and eapiratios date). Failure to secure coverage as required under MCA.c. i 52. §25A is a criminal violation punishable by a tine up to 51.500_00 andior one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to 5250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations oldie DIA liar insurance coverage verification. I do hereby certify atter the pains/in d penalties of perjury that the information provided above is trite and correvt. I Signature: i it/vvw-K:..... C. 1i4. -- Date: .. --‘514 lii 7,2 I Phone tg: 1 1 •, t'l- 7?)et Official use only_ Do not write in this area,to be completed by city or town official city or"Town: PerniitoLieense 4/ Issuing iAuthority (circle one): I. Board of Health 2,Building Department 3.tityriown Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone 4: - — — DADMUN Design + Construction Project Address: SubContractor List 237 Chestnut St 7/12/2021 Florence, MA 01062 Subcontractor: Has Employees: Yes No Geryk Plumbing & Heating X James Elkins Electrician X Brian Polan x Powers Air, Inc. X Right Way Drywall X Northern Granite X Executive Painting X Dion and Sons Flooring X Cortina Tile X • A ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 05/24/2021 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(ies)must have ADDITIONAL INSURED provisions or 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 CONTACT Cyndie Henderson CISR,CPIA NAME: Webber&Grinnell PHC,NNo,EMI: (413)586-0111 FAx No): (413)586-6481 8 North King Street E-MAIL s: chenderson@webberandgrinnell.com ADDRE INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURER A: Citizens Ins America/Hanover 31534 INSURED INSURER B: Allmerica Financial Benefit/Han 41840 John T.Geryk Plumbing&Heating,LLC INSURER C: Massachusetts Bay Ins/Hanover 22306 89 Oak Street INSURER D: INSURER E: Florence MA 01 062 INSURER F: COVERAGES CERTIFICATE NUMBER: Master Exp 11/2021 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. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTRINSD WVD (MM/DDIYYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,DAMAGE TO 000 CLAIMS-MADE X OCCUR PREMISES(EaENTED occurrrence) $ 100,000 MED EXP(Any one person) $ 10,000 A ZBNH092909 11/15/2020 11/15/2021 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY JECT PRO LOC PRODUCTS-COMP/OPAGG $ 4,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED X SCHEDULED AWNH9175601 11/15/2020 11/15/2021 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) Underinsured motorist BI $ 100,000 UMBRELLA LIAB . _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X MUTE X ERH AND EMPLOYERS'LIABILITY Y/N 500 000 C ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A WDNH09187001 03/12/2021 03/12/2022 E.L.EACH ACCIDENT $ , OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Dadmun Design&Construction ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street AUTHORIZED REPRESENTATIVE Hatfield MA 01038 1/I( y„ I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • A� �!� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 05/24/21 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(ies)must have ADDITIONAL INSURED provisions or 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 CONTACT NAME: Hannah O'Shea Bresnahan Insurance Agency,In PHONE 413-536-0536 FAX 413-534-4291 g y, (A/C,No,Ext): ( ) 100 Whiting Farms Road ADDRESS: hoshea@bresnahaninsurance.com Holyoke,MA 01040 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Mapfre/Commerce Insurance Co. INSURED INSURER B: James Elkins INSURER C: 2 Williams Street INSURER D: Holyoke,MA 01040 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. I EXP NSR ADOTYPE OF INSURANCE INSD wvoUBR POLICY NUMBER MM/DD/YYYY MM DDPOLICY EFF YYYYY LIMITS LTR INSD WVD ( ) ( ) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE RENT ED S 1,000,000 CLAIMS-MADE X OCCUR PREMISESO(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A 8008030003716 05/05/21 05/05/22 PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PE� LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) $ UMBRELLA LIAB _OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE $ 'DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Proof of Insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Dadmun Design&Construction 60 School St. Hatfield,MA 01038 AUTHORIZED REP ATIVE cr • ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD � � DATE(MM/DD/YYYY) A RL' CERTIFICATE OF LIABILITY INSURANCE 11/06120 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(ies)must have ADDITIONAL INSURED provisions or 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 CONIACT NAME: Karina Linares Dale A Frank Insurance Agency,Inc. PHONE IJo,Extl: 413-665-8324 FAX No): 413-665-1280 PO Box 455 E-MAIL Sunderland,MA 01375 ADDRESS: info@DaleFranklnsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Main Street America INSURED INSURER B: Brian Polan INSURER C: 26A Elm Cir INSURER D: South Deerfield,MA 01373 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE RENTED $ 1,000,000 CLAIMS-MADE OCCUR PREMISESO(Ea occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 A MPP0949K 11/05/20 11/05/21 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER CTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN DADMUM Design+Contraction ACCORDANCE WITH THE POLICY PROVISIONS. Tom Dadmun 60 School St AUTHORIZED REPRESENTATIVE Hatfield,ma 01038 Karina Linares ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD a A CCP R CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/VYYY) 11/5/2020 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(ies)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 CONTACT Judy Pashko NAME: �' FAX Pettengill Insurance Agency PHONE /o Nn o,Ext): (413)532-8600 (A/C,NO): (913)538-5761 • 460 Newton Street E-MAIL jpashko@completepayrollsolutions.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# South Hadley MA 01075 INSURER A:MAPFRE INSURED INSURER B: Drew E. Powers dba Powers Air INSURER C: 96 Cold Hill Road INSURERD: INSURER E: Granby MA 01033 INSURERF: COVERAGES CERTIFICATE NUMBER:CL2092303249 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP W LIMITS LTR INSR POLICY NUMBER (MM/DD/YYYY) ,(MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE A CLAIMS-MADE x OCCUR PREMISESO(Ea o currrrence) $ 100,000 8008030006939 8/5/2020 8/5/2021 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E L DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE For Proof of Coverage THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Linda Zurlino/LZ 02-4494 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) • AC DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/31/21 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(ies)must have ADDITIONAL INSURED provisions or 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 CONTACT NAME: Cecilia Olsen Dale A Frank Insurance Agency,Inc. (A/C, o,Ext): 413-665-8324 FAX No): 413-665-1280 PO Box 455 E-MAIL Sunderland,MA 01375 ADDRESS: info@DaleFrankInsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: RPS INSURED INSURER B: Rightway Drywall Inc. INSURER C: Brian Johnson INSURER D: 206 Coles Meadow Road Northampton,MA 01060-1111 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR ADDLSUBRI POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 DAMAGE TO REN1 ED 100,000 CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 5,000 A WS411028 01/20/21 01/20/22 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE S 2,000,000 POLICY JE0 LOC PRODUCTS-COMP/OP AGG 5 2,000,000 OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) $ - OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY _AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ - EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN DADMUN Design+Construction ACCORDANCE WITH THE POLICY PROVISIONS. Tom Dadmun 60 School St AUTHORIZED REPRESENTATIVE Hatfield,MA 01038 Cecilia Olsen ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD A� ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYV) O OS/24/2021 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(ies)must have ADDITIONAL INSURED provisions or 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 CONTACT Lynn Barry NAME: Goss&McLain Insurance Agency HC N (413)534-7355 FAX a (413)536-9286 (A/C,PHONE EM): /c,No): 1767 Northampton Street E-MAIL : Ibarry@gossmclain.com ADDRESS INSURER(S)AFFORDING COVERAGE NAIC# Holyoke MA 01041-1128 INSURERA: National Grange Mutual 29939 INSURED INSURER B: A.I.M. Mutual Ins Prestige Granite Inc,DBA:Northern Granite LLC INSURER C: 380 Union Street INSURER D: INSURER E: West Springfield MA 01089 INSURER F: COVERAGES CERTIFICATE NUMBER: CL213806310 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DO/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE 0 REND CLAIMS-MADE X OCCUR PREMISES(Ea occuE ence) $ 500,000 MED EXP(Any one person) $ 10,000 A MPI5382Z 04/01/2021 04/01/2022 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JECT PRO LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ 1,000,000 A OWNED X SCHEDULED M1T2939W 04/01/2021 04/01/2022 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) Underinsured motorist $ X UMBRELLA LIAR 1 OCCUR V -OV-RR NCE $ , , A EXCESS LIAB CLAIMS-MADE CUT2939W 04/01/2021 04/01/2022 AGGREGATE $ DED X RETENTION $ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY X STATUTE OTH- ER Y/N 500,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE Y N/A AWC-400-7033443-2020 10/26/2020 10/26/2021 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Granite Installation. Officer Slava Katko,is excluded from the workers comp coverage. Certificate holders are additonal insured on the above captioned policy,as per lease agreement;subject to policy forms,conditions,and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN DADMUN Design+Construction ACCORDANCE WITH THE POLICY PROVISIONS. 60 School St. AUTHORIZED REPRESENTATIVE ( , "/ Hatfield MA 01038 ,a, Q7a e•'(// ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • ACCORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 4/12/2021 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(ies)must have ADDITIONAL INSURED provisions or 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 CONTACT CLTEAM aKoveera e rou com NAME: G g g p Koverage Insurance Group ((AE_ICNNo,Ext): 860-745-4222 FAX No): 860-741-6901 657 Enfield Street ADDRESS: CERTIFICATE@koveragegroup.com INSURER(S)AFFORDING COVERAGE NAIC# Enfield CT 06082 INSURER A: UTICA FIRST INS CO 15326 INSURED INSURER B: EXECUTIVE PAINTING& INSURER C: 10 SOUTH ROAD INSURER D: INSURER E: _ ENFIELD CT 06082 INSURER F: COVERAGES CERTIFICATE NUMBER: 001 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. INSR AUULSUIIK PULICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDDIYYYY) LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE x OCCUR PREMISESO(Ea occurrence) $ 50,000 MED EXP(Any one person) $ 5,000 A ART513998201 02/13/2021 02/13/2022 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 x POLICY JE LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMI F $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED —SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS —HIRED —NON-OWNED PROPER I Y DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PLR AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Tom Dadmund ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street AUTHORIZED REPRESENTATIVE Maria Rude.; i I Hatfield MA 01038 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • to ACo D CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 11/05/2020 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(ies)must have ADDITIONAL INSURED provisions or 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 CONTACT Barbara Grynkiewicz NAME: Webber&Grinnell PH No,Ext): (413)586-0111 (A/C,No): (413)586-6481 (A/8 North King Street E-MAILSS: bgrynkiewicz@webberandgrinnell.com INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURER A: Patrons Mutual Ins.Co.of CT 14923S INSURED INSURER B: State Auto Property&Casualty Ins.Co. 25127 A.Dion&Son Floor Contractors,LLC INSURER C: Attn:Donald&Daren Dion INSURER D: P.O.Box 656 INSURER E: Hadley MA 01035 INSURER F: COVERAGES CERTIFICATE NUMBER: Exp 7/1/21 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. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTRINSD WVD -(MMIDD/YYYY) (MMIDD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE l 0 REN 1ED 300,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 5,000 A BOP2806463 06 07/01/2020 07/01/2021 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY X JECT LOC PRODUCTS-COMP/OPAGG $ 4,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ A OWNED X SCHEDULED BAP2406132 06 07/01/2020 07/01/2021 BODILY INJURY(Per accident) $ _ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) - X 19 PIP-Basic $ 8,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAB CLAIMS-MADE CXS2125771 06 07/01/2020 07/01/2021 AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION X STATUTE EOTH AND EMPLOYERS'LIABILITY Y/N 1 B ANY PROPRIETOR/PARTNER/EXECUTIVE N NIA WCP2227689 07/01/2020 07/01/2021 E.L.EACH ACCIDENT $ , , OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1'000'000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Dadmun Design&Construction ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street AUTHORIZED REPRESENTATIVE Hatfield MA 01038 /0,,, y,,"i 1 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • ���, CORTTIL-01 MHENDERSON ,4COR0 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/12/2021 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(ies)must have ADDITIONAL INSURED provisions or 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 CONTACT Mary Henderson NAME: People's United Insurance Agency,Inc. One Monarch Place,12th Fir (A/C,PHONE Eltt):(413)327-7516 (Nc,No):(413)327-7516 MAI Springfield,MA 01144 ADDRRESS:Mary•Henderson@AssuredPartners.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Merchants Mutual Insurance Co 23329 INSURED INSURER B: Cortina Tile of West Springfield INSURER C: 1645 Riverdale Street INSURER D: West Springfield,MA 01089 INSURER E: _ INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD IMMIDDIYYYYI (MM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR BOPI071849 3/30/2021 3/30/2022 DAMAGE TO RENTED 500,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ Included GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $_ OWNED SCHEDULED AUTEO�S ONLY _ AUTOSW�.� BODILY INJURY(Per accident) $ AUTOS ONLY AIRS ONLY (Per PROPERcidTY ent)DAMAGE ac $ $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE CUP9146566 3/30/2021 3/30/2022 AGGREGATE $ 1,000,000 DED X RETENTION$ 10,000 $ A WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY IN WCAI033448 3/30/2021 3/30/2022 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE Y E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N N/A 500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Proof of Insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE DADMUN Design+Construction THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Tom Dadmun 60 School Street Hatfield,MA 01038 AUTHORIZED REPRESENTATIVE Peaged, a%ted `adaita rce "49eacet, lac, ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD