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31A-285 (7) 3 JAMES AVE BP-2019-0775 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 3 1 A-285 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Bath reno BUILDING PERMIT Permit# BP-2019-0775 Project# JS-2019-001277 Est.Cost: $44000.00 Fee: $286.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: THOMAS DADMUN 107919 Lot Size(sa.ft.): 8929.80 Owner: HICKS KATHERINE Zoning: URB(100)/ Applicant. THOMAS DADMUN AT. 3 JAMES AVE Applicant Address: Phone: Insurance: 60 SCHOOL ST (413) 387-7381 HATFIELDMA01038 ISSUED ON:1/7/2019 0:00:00 TO PERFORM THE FOLLOWING WORK.-BATHROOM REMODEL INCLUDING ONE WINDOW REPLACEMENT 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: FeeType: Date Paid: Amount: Building 1/7/2019 0:00:00 $286.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2019-0775 APPLICANT/CONTACT PERSON THOMAS DADMUN ADDRESS/PHONE 60 SCHOOL ST HATFIELD (413)387-7381 PROPERTY LOCATION 3 JAMES AVE MAP 31A PARCEL 285 001 ZONE URB000Z THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building,Permit Filled out Fee Paid Typeof Construction: BATHROOM REMODEL INCLUDING ONE WINDOW REPLACEMENT New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 107919 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay SidAure of Building Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. City of Northampton Building Department 212 Main Stre t SAN sRoom 100 Northampton, MAP 1 0� "OF BUILDING IN phone 413-587-1240 Fax -58M2TA2PT0N / APPLICATION TO CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be compleette�.byoffice Map 4 Lot Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: �, L40k, 0. i io4� Aj� I OoEi*� NP 'j OA 01000 Name(Print) Current ailing Address: 52,0 A) Telephone Signature 2.2 Authorized Agent: Name(Print) Current Mailing Address: L� (. 413- Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building l00 cro (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing O 1 a� Building Permit Fee Q�A 4. Mechanical(HVAC) 5. Fire Protection v+ 6. Total=0 +2+3+4+5) 0 0(� uO Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: H-// Building Commissionedlnspector of Buildings Date +D*VA @ bAVO R r�c , c� VA EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size ................. . ....... ,,, .. Frontage _..._.. ......... .„_..., .......................... ..._..... .,.... ....... .._,,, Setbacks Front �...�...... Side L .......... R. L:. . R::"- Rear :Rear ......... Building Height Bldg. Square Footage oho Open Space Footage ° z_�.. �...... _ o r..,. . z. , (Lot area minus bldg&paved ............. parking) #of Parking Spaces ..............,.............. „....._. . . _........... ............... Fill: volume&Location) �.,.,.... ... �...... ........_ ......... A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW (D YES Q IF YES, date issued:; IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES Q IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained ® , Date Issued: C. Do any signs exist on the property? YES NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES ® NO111) IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO a IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing Or Doors LSI Accessory Bldg. E] Demolition ❑ New Signs [O] Decks Siding[fes] Other[p] Brief Description of Proposed Work: �Al'koA P- Aob" 0A W100DW Alteration of existing bedroom Yes�_No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa.if New house and or anion to exisiOl?a housing. comMefe ft f Wilma: a. Use of building:One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, 1`' �+� ✓ as Owner of the subject property hereby authorize 'P/ 0AyVD to act o my behalf, in all maters relative to work authorized by this building permit application. Signatur of Owner Date I, �(,�h►\J t � y�'�r"�� ,as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print Name !j \ aw""- Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor:'j'•, Not Applicable I❑ Q Name of License Holder: 1 1 i� �`J DAJ>M,)0 C'S _`D�q I 1 License Number 60 5fi.�t)L St— I4AmUD, MA 6103° 112 q I �Vl Addres � Expiration Date Signature Telephone 9.Registered Home lmoro temertt CcntracWr: Not Applicable ❑ Company Name Registration Number iso SAIAD6-0 1X1 120z-0 Address / —� Expiration Date -� , i Telephone q15-361 -7M ( SECTION 10-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...... ❑ City of Northampton f� Massachusetts j c DEPARTMENT OF BUILDING INSPECTIONS ` 212 Main Street • Municipal Building may9 Northampton, MA 01060 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes, a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L. Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeowner has contracted with a corporation or LLC,that entity must be registered Type of Work: �71Cf1}� yp Ko pi,c, Est. Cost: "000. Address of Work: 1jy i. Date of Permit Application: J 20 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law(explain): _Job under$1,000.00 Owner obtaining own permit(explain): Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner: W. 4, 2'[4 'Votku P D�,6tW Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature City of Northampton f� Massachusetts ���� ���� { DEPARTMENT OF BUILDING INSPECTIONS } 212 Main Street •Municipal Building Northampton, MA 01060 Debris Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: 3 3 A--�Att X& . (Please print house number and street name) Is to be disposed of at: (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: A'jbt0'S a W"ni.y H� (Company Name and Addres ) t Signature of Permit Applicant or Owner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. ds is o{ is ; 1Sov So con5 fi,S.1o'Ts99 � �yy Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Mahusetts 02118 Horne lmproverr�ttlractor Registration Type: LLC THE TUCKER GROUP LLC. Reratlon: 179882 60 SCHOOL ST Expiration. 08/27/2020 HATFIELD,MA 01038 Update Address and Return Card. `CA 1 C, 20M-05117 OfNce of Consumer Affelrs&Busina m Requloftn HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use orgy TYPE:LLC before the expirstion date. It found return to: RjU4021iff. mon Office of Consuaw Affairs and Business RegitAstion 170W,,,_ 48127MM 1000 WashbVion$treot-Suite 710 THE TUCKER Gf:C}i, 4 Boston,MA 02118 THOMAS t7ADMUhd e SC HATFIELD,MA 01038 Undersecretary Not vidid without signeAure C 0 DATE(MMIDDNYYY) s. CERTIFICATE OF LIABILITY INSURANCE 11/26/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must 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: Susan Fleury,CIC,CISR, King&Cushman Inc. PHONE (413)584-5610Ata Na; (413)584-9322 AIC No Ext P.O.Box 447 ADDRESS: stieury@kingcushman.com 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: CL18112602970 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, IIINSR ALAUL 5UHR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVO POLICY NUMBER (MMIDDIYYYYJ IMMIDONYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE To Rt_NT E CLAIMS-MADE FRI OCCUR PREMISES Ea occurrence S 500,000 MED EXP(Any one arson) $ 10,000 A MPT4694Q 11/13/2018 11/13/2019 PERSONAL&ADV INJURY s 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY EIJECT El LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: Identity Recovery $ 25,000 AUTOMOBILE LIABILITY Ea BFNED SINGLE LI $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED HNON-OWNED Y DAMAGE S AUTOS ONLY AUTOS ONLY 4R ."edent $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTION S $ WORKERS COMPENSATION R OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ Ityes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached H 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents .Q 1 Congress Street,Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information h Please Print Leeibly Name (Business/Organization/Individual): �1Y17 M1 VI b►� �o�`J i��L�� Address: 6b �CA6 (, ST, City/State/Zip: MA 61A3y Phone#: Are you an employer?Check the appropriate box: 'Type of project(required): 1.E]I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.[D I am a sole proprietor or partnership and have no employees working for me in 8. N Remodeling any capacity.[No workers'comp.insurance required.] 9. Demolition 3.F-1 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10E] Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.[:]Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.�I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. Roof repairs These sub-contractors have employees and have workers'comp.insurance.- 6.M We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill 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. $Contractors 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. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.22I #: ,, Expiration Date`:l Job Site Address: ✓ ** b �. City/State/Zip: I`t of( MID, VI1 A o tc�v b Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains ad penalties ofperjury that the information provided above is true and correct. Signature f wc�/ww' Date: �A►—' 4.1 zo�� Phone# 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#: DADMUN Design + Construction Project Address: SubContractor List 3 James Ave January 4,2019 Northampton, MA 01060 Subcontractor: Has Employees: Yes No Wallace Plumbing and Heating X James Elkins Electrician X Brian Polan X SDL Home Improvement X Right Way Drywall X Cortina Tile X Executive Painting X ACo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/29/2018 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 Elizabeth W.Downie NAME: Encharter-MA PAHiCNNo ExtI: (800)675-6695 �� No): (800)754-1602 Encharter Insurance LLC E-MAIL edownie@encharter.com ADDRESS: 25 University Drive INSURER(S)AFFORDING COVERAGE NAIC# Amherst MA 01002 INSURERA: Travelers Cas&Surety of IL 19046 INSURED INSURER B: Jason Wallace INSURER C: 312 Main Rd INSURER D: INSURER E: Gill MA 01354 INSURER F: COVERAGES CERTIFICATE NUMBER: 2018-2019 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. IY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MOL pY EFF MM/DCDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE Fx_]OCCUR PREMISES Ea occurrence $ 300,000 MED EXP(Any one person) $ 5,000 A 680-3E561935-18-42 02/27/2018 02/27/2019 -PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JECT PRO LOC PRODUCTS-COM P/OPAGG $ 2,000,000 OTHER: Otherinsurance $ AUTOMOBILE LIABILITY Ea Cf�MBINEB 9IN6LEt•IMIT $ accident ANYAUTO BODILY INJURY(Per person) $ 100,000 A OWNED SCHEDULED BA-7G304126-18-SEL 01/22/2018 01/22/2019 BODILY INJURY(Per accident) $ 300,000 AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ 250,000 AUTOS ONLY AUTOS ONLY Per accident Uninsured motorist BI $ 100,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ r $ WORKERS COMPENSATION PER —FTOTH- 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 I I I 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 and Construction ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street AUTHORIZED REPRESENTATIVE Hatfield MA 01038 ©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) AC"Ro® CERTIFICATE OF LIABILITY INSURANCE 07/17/18 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder is an ADDITIONAL INSURED,the policy(les)must 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 NAME: Bresnahan Insurance Agency,In PHONE 413 536-0536 AX A/C No Ext No): 413-534-4291 100 Whiting Farms Road Holyoke,MA 01040 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Mapfre/Commerce Insurance Co. INSURED INSURER B: James Elkins INSURERC: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ 5,000 A 8008030003716 05/05/18 05/05/19 PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X JECT LOC PRODUCTS-COMP/OP AGG $ 2,ODD,000 POLICY 7 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 IPER AND EMPLOYERS'LIABILITY Y/N STATUTE ER H 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) Electrician 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. Hatfield,MA 01038 AUTHORIZED PRESENTATIVE ©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 FDATE(MM/DD/YYYY) O 12/18/2017 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 MSAService Center NAME: SAN GROUP INC-MA-CL SC A No Ext): 866 299 7991 FAX XC No: (866)332-4776 MSA Service Center E-MAIL servicecenter@msagroup.com ADDRESS: PO Box 2006 INSURER(S)AFFORDING COVERAGE NAIC# Keene NH 03431 INSURERA: Main Street America Assurance 29939 INSURED INSURER B: BRIAN POLAN INSURER C: 175 RUSSELL ST INSURER D: INSURER E: SUNDERLAND MA 01375-9308 INSURER F. COVERAGES CERTIFICATE NUMBER: 17/18 Master MP 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. IEXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM DD/1EMFF MM/DCDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR PREMISES Ea occurrence $ 500,000 MED EXP(Any one person) $ 10,000 A MPT4731K 11/05/2017 11/05/2018 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO ❑LOC PRODUCTS-COMP/OPAGG $ 2,000,000 JECT OTHER: 1:1 $ 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 I I RETENTION$ $ WORKERS COMPENSATION I PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVEr_1 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 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 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Q ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACtOReOAIE(MMiDD4YYYY) CERTIFICATE OF LIABILITY INSURANCE 0110312019 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 INSURERS),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the tarms and conditions of the policy,certain policies may require an endorsement. A statement on this cortlificato does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER NAM?!ONT,;CT Cyndre Henderson GISR,CPIA Webber&Grinnell P,46NE (413)586-0111 (413)586-6481 jAsC.No.ExtI! 8 North King Street E-MAfL _ r ADORES., herdiW$Ongwebt)eranogrinr,-Il.com -------------------- INSURERJS)AFFORDING COVERAGE I NAIC III Northampton MA 01060 INSUp CERA Selective Ins Co of S Carolina 39259 INSURED INSURER 8 Selective Ins Co of Southeast 39926 SOL Home Improvement Contractors,Inc. INSURER C ............... 24 Chestnut Street _._._. __.___. ,dd_, INsuRER a INSURER E: Hatfield MA 01038 INSURER F COVERAGES CERTIFICATE NUMBER. Master Exp 2020 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. AM71 LTR TYPE OF INSURANCE INSD POLICY NUMBER (MMODNYYY) IMMT2;YYYYL LIMITS X COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,000 DAMAM!V3 RER M- Y——-----—-------------------------------------------- ClAIMS-MAI)E CC�;UR $ 500,000 PREMISES(Es occwww* MED EXP iLnI.ons 16,000 A000 S22915M 0110112019 0110"2020 'EISONILIADIIIIIII S 1;000, GENLAGGRE-GATELIMI!APP!JES PER GENERALAGGRECATE II 3,000,000 jPFR 3,000,000 PRODUC TS,COMPIOP AGG $ 0`1 E R. $ AUTOMOBILE LIABILITY .-.,,,.,.,,, COMBINEDa8I3LE LIMIT $ (Ea ixdem) W, ANYAU10 Li DILY INJURY(Pw porsw) $ A DU LE rl4 i A9105420 01101,'2019 0110112020 aonriv iNjuRy(Pm wx1dwill, $ A,UTOSONLI AUTOS HIRED NONOWNED PROPERTY DAMAGE AUTOS,)NLY rx AUTOSON' iPv acci*iariv Undennsured motorist BI s 100, WO EACHOCCURRENCE $ 1,000.550 20 A EXCESS LIAR OE 52291509 01/01,12019 01101i 20 AGGREGATE 1,000,000 7— WORKERS COMPENSATIONOTH, SIR11TUTE FR AND EMPLOYERS'LIABILITY YIN A14Y;IROPRIETORPIARTNER!EXF.CU';V�.' S 500,000 8 OVTICEWMEMBERZCLUDE W% Y I NIAJ WC9024456 0212312019 02J2312020 _LL EACH ACCIDENT (Mande"in NH) E L DISEASE-EA EMPLOYEE $ 500,000 500,000 E I.DISEASf POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,AdiditionAi Remarks S4hedu3oj may be auach#d if mono spAc4 is mqtAr*d) The Workers Compensation poliqy does not include coverage for Paul Schmidt,Kendrick Dempsey and Douglas Schmidt. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CA14CELLED BEFORE THE EXPIRATION DATE THERE(X NOTICE MLL BE DELIVERED IN DADMUN Design+Construction ACCORDANCE MTN THE POLICY PROVISIONS. 60 School Street AUTHORIZED REPIRESENTATA& Hatfield MA 01038 01988-2015 ACORD CORPORATION. Ali rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD ' ® DATE(MM/DD/YYYY) ACORN CERTIFICATE OF LIABILITY INSURANCE 4/3/17 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 endorsemen s. PRODUCER ACT NAME: Mathew Brown Dale A Frank Insurance Agency, PHONE 413 665-8324 FAX N (413) 665-1280 PO Box 455 ADDRESS: info@DaleFrankInsurance.com Sunderland, MA 01375 INSURE S AFFORDING COVERAGE NAIC# INSURER A:Providence INSURED INSURER B:Progressive Rightway Drywall Inc. INSURER C:Guard Brian Johnson INSURER D: 206 Coles Meadow Road INSURER E: Northampton, MA 01060-1111 1NSU RERF: 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. IN RI ADDL SUBR POLICY EFF POLICY EXP LIMITSTR TYPEOFINSURANCE INSR WVD POLICY NUMBER MM/DD/Y MM/DD/YYW A GENERAL LIABILITY BOP0093210 1/15/17 1/15/18 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DPREMISES AMAGE tE.occRENTurrence) $ 50,000 CLAIMS-MADE 1-1 OCCUR MED EXP(Arty one person) $ 5,000 PERSONAL&ADVINJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY PRO, CT LOC $ B AUTOMOBILE LIABILITY02849700_1 1/26/17 1/26/16 (Eaac id.') GLELIMIT $ ANYAUTO BODILY INJURY(Per person) $ ALLOWPED SCHEDULED BODILY INJURY(Per accident) $ 500,000 AUTOS AUTOS HIRED AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ (Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION R2WC815297 3/8/17 3/8/18 WC STATU- OTH- AND EMPLOYERS'LIABILITY I TORY 1.IM ITS ANY PROPRIETOR/PARTNER/EXECUTIVE Y� N/A E.L.EACH ACG DE NT $ 100,000 OFFICERMIEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below -7 E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Renarks Schedule,if more space is reguired) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Tom Dadmun ACCORDANCE WITH THE POLICY PROVISIONS. 60 School St Hatfield, MA 01038 AUTHORIZED REPRESENTATIVE Matthew Brown ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: Client#: 41601 CORT11 DATE(MM/DD/YYYY) ACORD,., CERTIFICATE OF LIABILITY INSURANCE 4/07/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTCT PRODUCER NAME: Mary A. Henderson People's United Ins.Agency MA PHONE 413 781-6871 AX No: A/C No Ext 1391 Main Street,3rd Floor E-MAIL Mary.ADDRESS: Henderson@peoples.com les.com p PO Box 4950 INSURER(S)AFFORDING COVERAGE NAIC# Springfield,MA 01101 INSURERA:Merchants Mutual Insurance Co 23329 INSURED INSURER B Cortina Tile of West Springfield 1645 Riverdale ST INSURER C INSURER D: W.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 CONTRACTOR 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. LTRR TYPE OF INSURANCE ADDLSUBR NSR WVD POLICY NUMBER POLICY EFF POLICY LIMITS A X COMMERCIAL GENERAL LIABILITY X BOP1071849 3/30/2017 03/30/2018 EACH OCCURRENCE $1,000,000 CLAIMS-MADE 4 OCCUR PREMISES Ea oNceurre,,ce $500,000 X Blkt Al Per Prior MED EXP(Any one person) s5,000 Written Contract PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- El PRODUCTS-COMP/OP AGG $2,000,000 JECTLOC POLICY X PRO- 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 PeOPEaccident)Y DAMAGE $ HIRED AUTO S AUTOS $ A X UMBRELLA LIAB X 1 OCCUR CUP9146566 3/30/2017 03/30/2018 EACH OCCURRENCE $11,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 DED I X RETENTION$10000 $ A WORKERS COMPENSATION WCA1033448 3/30/2017 03/30/201 X PSTATUTE I ER OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? � N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Blanket Additional Insured per Merchants form MU8277(1111); Blanket Additional Insured-Completed Operations per Merchants form MU8530(1111) Proof of Insurance CERTIFICATE HOLDER CANCELLATION DADMUN Design+Construction SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Tom Dadmun ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street Hatfield, MA 01038 AUTHORIZED REPRESENTATIVE Ok4d,�k AW(_ ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S812656/M795873 MADCT INGRAMJ001 MMILLS AcoRn CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/15/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must 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 Melissa L Mills NAM : The Jarrett Agency PHONE AX 657 Enfield Street (A/C,No,Ext):(860)745-4222 jAICC,No):(860)741-6901 Enfield,CT 06082 ADDaRE ,melissa@thejarrettagency.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Main Street America Assurance Company 29939 INSURED INSURER B:NGM Insurance Company 14788 Executive Painting and Wall Covering LLC INSURER C: 10 South Road INSURER D: Enfield,CT 06082 INSURERE: 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 SUBR POLICY NUMBER POLICY EFF POLICY EXPLIR LIMITS A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE � OCCUR MPT7137P 08/22/2017 08/22/2018 DAMAGES( RENTED 500000 PREMISES REMI E Ea occurrence) $ X BOP MED EXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEKL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑ PEPT F] LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS WNE BODILY INJURY Per accident $ AUTOS ONLY ARTOS ONLY PPe�acEatlentDAMAGE $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAR CLAIMS-MADE CUT7137P 06/22/2017 08/22/2018 AGGREGATE $ 1,000,000 DED I X I RETENTION$ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N PIATLITE ERH ANY OFFICER/MEIMBER EXCLUDED?ECUTIVE ❑ N/A E.L.EACH ACCIDENT $ (Mandatoryn NH) E.L.DISEASE-EA EMPLOYE $ 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 Dadmun Design&Construction THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g ACCORDANCE WITH THE POLICY PROVISIONS. 60 School St Hatfield,MA 01038 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD