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Shawmut COI With Waiver updated 9-108/31/2021 Bell & Hudson Insurance Agency 19 N. Main Street Belchertown MA 01007 Felice Pellegri (413) 323-9611 (413) 323-8132 fpellegri@bellandhudson.com Fire Service Group, LLC 1010 Thorndike Street Palmer MA 01069 Everest Indemnity Insurance Company 10581 Safety Indemnity 33618 AMGuard Insurance Company 42390 20-21/21-22 A Liability Deductible $1,000 BI & PD Per Claim Basis Y 51GL012741-201 11/05/2020 11/05/2021 1,000,000 50,000 5,000 1,000,000 2,000,000 2,000,000 Professional Liability included B 6222375 03/21/2021 03/21/2022 1,000,000 AUENP A 10,000 51CC004592-201 11/05/2020 11/05/2021 5,000,000 5,000,000 C Y FIWC290917 09/01/2021 09/01/2022 1,000,000 1,000,000 1,000,000 Fire Suppression Installations, Service or Repairs and Alarm Installations, Service or Repairs. Alarm Monitoring- 3rd Party. Key card access and security camera work. Member, Daniel Belanger, is excluded from the workers' compensation coverage. RE: Smith College Alumnae House PO#171336 Shawmut Woodworking & Supply, Inc. dba Shawmut Design and Construction560 Harrison Ave Boston MA 02118 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?(Mandatory in NH) DESCRIPTION OF OPERATIONS belowIf yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCEDAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY Fire Service Group, LLC 00008845 Bell & Hudson Insurance Agency 25 Certificate of Liability Insurance Shawmut Design and Construction and The Trustees of the Smith College, its agents, its employees, and its assigns required by specific contract is includedas an Additional Insured on a Primary and Non-Contributory basis on all coverages other than Workers Compensation. Additional Insured coverage on General Liability and Excess Liability includes Completed Operations. Waiver of Subrogation applies in favor of certificate holder on all policies. ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: PIP-Basic PIP 8,000 Medical payments MEDPM 5,000 Underinsured motorist BI split limit UNDSP 100,000 300,000 Uninsured motorist BI split limit UMISP 100,000 300,000 Premium discount PDIS -$5,682.00 Deductible Mod Factor DEDFC -$2,966.00 Experience Mod Factor 1 EXP01 -$7,793.00 Assessment Fund ASMNT $2,403.00 Expense constant EXCNT $338.00 ADDITIONAL COVERAGES Ref #Description Edition DateForm No.Coverage Code Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Copyright 2001, AMS Services, Inc.OFADTLCV Massachusetts Commercial Auto SCA 005 04 17 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 1 of 7 Safety Insurance Company Safety Indemnity Insurance Company Safety Property and Casualty Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SAFETY COMMERCIAL AUTO ENHANCER PLUS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MASSACHUSETTS MANDATORY ENDORSEMENT With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. 1. COVERAGE EXTENSION FOR TRAILERS SECTION I - COVERED AUTOS C.1. is replaced as follows: “Trailers” with a load capacity of 3,000 pounds or less designed primarily for travel on public roads. 2. BROAD FORM NAMED INSURED SECTION II – LIABILITY COVERAGE A.1. Who Is An Insured is amended to add: d. Any business entity newly acquired or formed by you during the policy period provided you own more than 50% of the voting stock or otherwise have a controlling interest in the business entity and the business entity is not separately insured for Business Auto Coverage. Coverage is extended up to a maximum of 180 days following acquisition or formation of the business entity or until expiration or termination of this policy. 3. EMPLOYEES AS INSUREDS SECTION II – LIABILITY COVERAGE A.1. Who Is An Insured is amended to add: e. Any employee of yours while using a covered “auto” you do not own, hire, or borrow in your business or your personal affairs. 4. EMPLOYEE HIRED AUTOS SECTION II – LIABILITY COVERAGE A.1. Who Is An Insured is amended to add: f. An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. SECTION IV - BUSINESS AUTO CONDITIONS B.5.b. is replaced as follows: For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". Massachusetts Commercial Auto SCA 005 04 17 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 2 of 7 5. PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE – BLANKET ADDITIONAL INSURED SECTION II – LIABILITY COVERAGE A.1. Who Is An Insured is amended to add: g. Anyone who is required by a written contract to be an additional insured as respects the use of covered “autos”. The contract must be in effect during the policy term, and be executed prior to loss. Exceptions: (1) No additional contractual liability is assumed under this extension of coverage. (2) This liability coverage does not apply to “bodily injury” or “property damage” which result from the operation of machinery that is located on, attached to, or part of any vehicle. SECTION IV – BUSINESS AUTO CONDITIONS B.5. Other Insurance is amended to add: e. Regardless of the provisions of item a. and item d. of this part 5. Other Insurance, if required by the written contract or agreement, coverage afforded to an additional insured will be primary and non- contributory. This coverage does not apply unless said written contract or agreement has been executed, or said permit has been issued, prior to the “bodily injury” or “property damage”. Coverage is not primary to other policies providing coverage to the additional insured. We will share with those policies by the method described in this policy. 6. LIABILITY COVERAGE EXTENSIONS - SUPPLEMENTARY PAYMENTS SECTION II – LIABILITY COVERAGE A.2.a. Supplementary Payments Items (2) and (4) are replaced as follows: (2) Up to $3,500 for the cost of bail bonds (including bonds for related traffic law violations) required because of an “accident” we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the “insured” at our request, including actual loss of earnings up to $750 per day because of time off from work. 7. AMENDED FELLOW EMPLOYEE EXCLUSION SECTION II – LIABILITY COVERAGE B.5. Fellow Employee is replaced as follows: “Bodily injury” to any fellow employee of the “insured” arising out of and in the course of the fellow “employee’s” employment or while performing duties related to the conduct of your business. However, we will cover “bodily injury” caused by your employee to his or her fellow employee if: a. you have workers compensation insurance in force covering all your employees and, b. the “bodily injury” results from the use of a covered “auto” you own or hire. Coverage is excess over any other collectible insurance. 8. HIRED AUTO PHYSICAL DAMAGE COVERAGE SECTION III - PHYSICAL DAMAGE COVERAGE A. Coverage is amended to add: If hired “autos” are covered “autos” for Liability Coverage and if Comprehensive, Specified Causes of Loss, or Collision are provided under Coverage form for any “auto” you own, then the Physical Damage Coverages provided are extended to “autos” you hire without a driver, subject to the following limits: The most we will pay for “loss” to any hired “auto” in any one accident is the smallest of: Massachusetts Commercial Auto SCA 005 04 17 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 3 of 7 1. $100,000; 2. The actual cash value of the damaged or stolen property as of the time of “loss;” or 3. The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. Our obligation to pay for loss to any hired “auto” will be reduced by an amount that is equal to the largest deductible applicable to any owned “auto” for that coverage. No deductible applies to “loss” caused by fire or lightning. Hired Auto Physical damage is excess over any other collectible insurance. Subject to the limit, deductible and excess provision, we will provide coverage equal to the broadest coverage applicable to any covered “auto” you own. SECTION III - PHYSICAL DAMAGE COVERAGE A.4.b. Loss of Use Expenses Paragraph 2 is replaced as follows: However, the most we will pay for any expenses for loss of use is $75 per day, to a maximum of $1,250. 9. TRANSPORTATION EXPENSES SECTION III - PHYSICAL DAMAGE COVERAGE A.4.a. Transportation Expenses is replaced as follows: We will pay up to $75 per day to a maximum of $1,500 for temporary transportation expense incurred by you because of the total theft of a covered “auto” of the private passenger type. We will pay only for those covered “autos” for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy’s expiration, when the covered auto is returned to use or we pay for its “loss.” If the transportation expense incurred arises from your rental of an “auto” of the private passenger type, the most we will pay is the amount it costs to rent an “auto” of the private passenger type which is of the same like kind and quality as the stolen covered “auto.” 10. PERSONAL EFFECTS COVERAGE Under SECTION III - PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions, the following is added: c. Personal Effects Coverage We will pay up to $500 for loss to wearing apparel and other personal effects which are owned by an “insured” and in or on your covered auto. This coverage applies only in the event of a total theft of your covered “auto.” No deductibles apply to this coverage. 11. AUTO LOAN/LEASE GAP COVERAGE Under SECTION III - PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions, the following is added: d. Auto Loan/Lease Gap Coverage In the event of a total “loss” to a covered “auto” we will pay any unpaid amount due on the lease or loan for a covered “auto,” less: (1) The amount paid under the Physical Damage Coverage Section of the policy; and (2) The applicable Physical Damage deductible; and Massachusetts Commercial Auto SCA 005 04 17 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 4 of 7 (3) Any: (a) Overdue lease/loan payments, penalties, taxes, interest or charges resulting from overdue payments, or lease termination fees at the time of the “loss”; (b) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (c) Security deposits not returned by the lessor; (d) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and (e) Carry-over balances from previous loans or leases. 12. EXPENSE OF RETURNING A STOLEN AUTO Under SECTION III - PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions, the following is added: e. Expense Of Returning A Stolen Auto We will pay for the expense of returning a stolen covered “auto” to you. 13. TOWING Under Section III – PHYSICAL DAMAGE COVERAGE, A.2. Towing is replaced as follows: We will pay towing and labor costs up to $100 each time an “auto” of the private passenger type or light truck type is disabled. Light trucks are trucks that have a gross vehicle weight (GVW) of 10,000 pounds or less. However, the labor must be performed at the place of disablement. 14. CUSTOMIZED FURNISHINGS COVERAGE Under SECTION III - PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions, the following is added: f. Customized Furnishings Coverage We will pay with respect to a covered “auto” for “loss” to custom furnishings including but not limited to: (1) Special Carpeting and insulation, (2) Height extending roofs, (3) Custom murals, paintings or other decals or graphics. Our limit of liability for loss to custom furnishings shall be the least of: (1) The actual cash value of the damaged or stolen property, (2) The amount necessary to repair or replace the property, (3) $1000. This coverage does not apply to electronic or communication equipment. No deductible applies to this coverage. 15. AIRBAG COVERAGE Under SECTION III - PHYSICAL DAMAGE COVERAGE, B.3.a., the following is added: The exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag. No deductible applies to this coverage. Massachusetts Commercial Auto SCA 005 04 17 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 5 of 7 16. ELECTRONIC AND COMMUNICATION EQUIPMENT COVERAGE Under SECTION III - PHYSICAL DAMAGE COVERAGE, B.4., Exclusions 4.c. and 4.d. do not apply to: a. Equipment designed to receive, transmit, or reproduce audio, visual, or data signals and accessories used with such equipment, provided such equipment is permanently installed in the covered “auto” at the time of the “loss,” or such equipment is removable from a housing unit which is permanently installed in the covered “auto” at the time of the “loss,” and such equipment is designed to be solely operated by use of the power from the “auto’s” electrical system, in or upon the covered “auto,” or b. Any other electronic equipment that is: (1) Necessary for the normal operation of the covered “auto” or the monitoring of the covered “auto’s” operating system; or (2) An integral part of the same unit housing any audio, visual or data signal equipment for receiving, transmitting, or reproducing as described in a. above and permanently installed in the opening of the dash or console of the covered “auto” normally used by the manufacturer for installation of a radio. The most we will pay for all “loss” to audio, visual, or data electronic equipment and accessories used with this equipment as a result of any one “accident” is the least of: a. The actual cash value of the damaged or stolen property at the time of “loss;” or b. The cost of repairing or replacing the damaged or stolen property with property of like kind and quality. No deductible applies to this coverage. 17. NOTICE OF AND KNOWLEDGE OF OCCURRENCE SECTION IV - BUSINESS AUTO CONDITIONS A.2.a. Duties In The Event of Accident, Claim, Suit or Loss is amended to add: The requirement that you must notify us of an “accident” applies only when the “accident” is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. 18. BLANKET WAIVER OF SUBROGATION SECTION IV - BUSINESS AUTO CONDITIONS A.5. Transfer Of Rights Of Recovery Against Others To Us is amended to add: We waive any right of recovery that we may have against any person or organization because of payments we make for “bodily injury” or “property damage” arising out of the use of a covered “auto” when you have waived those rights under a written contract executed prior to any “accident.” This waiver applies only to the person or organization designated in the contract. 19. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV - BUSINESS AUTO CONDITIONS B.2. Concealment, Misrepresentation Or Fraud is amended to add: If you inadvertently fail to disclose any hazards or make an unintentional error in any information provided by you, we will not deny coverage under this form because of such failure or error. This provision does not preclude us from collecting any additional premium or exercising our right of cancellation or non-renewal. Massachusetts Commercial Auto SCA 005 04 17 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 6 of 7 20. MENTAL ANGUISH SECTION V - DEFINITIONS C. is replaced as follows: “Bodily injury” means bodily injury, sickness or disease sustained by a person including mental anguish or death resulting from any of these. 21. EXTENDED CANCELLATION CONDITION Condition A., Cancellation in the MASSACHUSETTS MANDATORY ENDORSEMENT applies except as follows: If we cancel for any reason other than nonpayment of premium, any notice of cancellation will be sent to you at your last address shown on the Declarations at least 60 days prior to the effective date. 22. GLASS REPAIR - WAIVER OF DEDUCTIBLE Under the MASSACHUSETTS MANDATORY ENDORSEMENT, PHYSICAL DAMAGE COVERAGE D. Deductible is amended as follows: No deductible applies to glass damage whether the glass is repaired or replaced. 23. DRIVE OTHER CAR COVERAGE FOR SOLE PROPRIETORS, EXECUTIVE OFFICERS OR PARTNERS A. This section changes only those coverages where a premium is shown in the Declarations. B. Additional Definitions for drive other car coverage for sole proprietors, executive officers or partners: 1. “Executive officer” means a person holding any of the officer positions created by your company charter, constitution, bylaws, or any other similar governing document. 2. “Partners” means a person having a registered ownership position in your company. 3. "Family member" means a person related by blood, marriage or adoption who is a resident of the household of the sole proprietor, executive officers, or partners, including a ward or foster child. 4. An “individual” is a Sole Proprietor, Executive officer or Partner as described in 23.B.1. and 23.B.2. 5. “Occupying” means in, upon, getting in, on, out or off. C. Changes In Liability Coverage The following is added to Who Is An Insured: 1. An “individual” and his or her spouse, while a resident of the same household, are "insureds" while using any covered "auto" described in 23.C.2. of this endorsement. 2. Any "auto" you hire, borrow or don't own is a covered "auto" for Liability Coverage while being used by an “individual” or by his or her spouse while resident of the same household, except: a. Any “auto” owned by that “individual” or by any member of his or her household. b. Any "auto" used by that “individual” or his or her spouse while working in a business of selling, servicing, repairing or parking "autos". D. Changes In Auto Medical Payments The following is added to Who Is An Insured: Massachusetts Commercial Auto SCA 005 04 17 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 7 of 7 An “individual” and his or her "family members" are "insureds" while "occupying" or while a pedestrian when being struck by any "auto" you hire, borrow or don’t own except, any "auto" owned by that individual or by any "family member". E. Changes In Physical Damage Insurance Any private passenger type "auto" you hire, borrow or don't own is a covered "auto" while in the care, custody or control of an “individual” except: 1. Any "auto" owned by that “individual” or by any member of his or her household. 2. Any "auto" used by that “individual” or his or her spouse while working in a business of selling, servicing, repairing or parking "autos". F. Changes In Uninsured Motorists Insurance The following is added to Who Is An Insured: An “individual” and his or her "family members" are "insureds" while "occupying" or while a pedestrian when being struck by any "auto" that said “individual” and “family members” hire, borrow or don’t own, unless such “individual” or “family member,” has a Massachusetts auto policy of his or her own providing similar coverage or is covered by a Massachusetts auto policy of another “family member” providing similar coverage. 24. LIMIT OF INSURANCE The insurance provided by this endorsement is excess over any other collectible insurance available to you.