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32A-239-001 UNIT 1 BP-2024-0991 2 POMEROY TERR UNIT COMMONWEALTH OF MASSACHUSETTS l Map:Block:Lot: CITY OF NORTHAMPTON 32A-239-001 Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2024-0991 PERMISSION IS HEREBY GRANTED TO: Project# DOOR 2024 Contractor: License: Est.Cost: 2483 LOWES HOME CENTERS INC 117055 Const.Class: Exp.Date: 08/02/2025 Use Group: Owner: JIM KING Lot Size (sq.ft.) Zoning: URC Applicant: LOWES HOME CENTERS INC Applicant Address Phone: Insurance: 1000 LOWES BLVD 860-505-9314 WA565D294595014 MOORESVILLE, NC 28117 ISSUED ON: 08/08/2024 TO PERFORM THE FOLLOWING WORK: REPLACEMENT DOOR POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Kuilding Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: t77P Fees Paid: S60.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner , ,,ekr- - e .. / QUO43ifliAjo,,O,,ntb 1.," ey .S44-1°104(- The Commonwealth of Massachusetts r ..L.ti Board of Building Regulations and Standards FOR Massachusetts State Building Code, 780 CMR MUNICIPALITY USE Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only z Building Permit Number: /�/�.A 'Y'9'l Date Applied: �1.1 d U a` 5 7 WI;- c--11 a.d2 cit-t •- cD Building Official(Print Name) Si Da r— SECTION 1:SITE INFORMATION I .1 1 zi °c 1.1 Property(�d64...,407: 1.2 Assessors Map&Parcel Numbers ,�✓ = LL, 1.1a Is this an accepted street?y _ no Map Number Parcel Number i I r Q. c 13 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq tt) Frontage(ft) 13 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 0 Private 0 Zone: — ��Flood Zone? Municipal 0 On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' /_lJ /^� 2.1 Owner' Record; �`> /I( %144-1 e )'1✓ i A Q/66' Name(Pri (� City,State,ZIP / . No.and Street L ii. / TelephoneOk K mai ddre whd . e — SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s)�Q!' Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify: Brief Description of Proposed Work': - K l',-y 7-y 0 i ki p&et_ 4,2014,4,111.7 SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materia s 1.Building $ alj/g� . 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ 0 Standard City/Town Application Fee 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5. Mechanical (Fireit Suppression) $ Total All Fees: t /n n Check No. (DI( Check Amount: W" Cash Amount: 6.Total Project Cost: $ 20.5 4eto 0 Paid in Full 0 Outstanding Balance Due: 1 • SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor (CSL) i�JD`t �, tik 4 7/� License Number Exp. i Date Name of CSL Hol er ) 2_,,,,,/J. (jijj, , 4 � Lst CSL Type(see below) No.and Street// � i U� Type Description d 7er .0 1/,2 U Unrestricted(Buildings up to 35.000 cu.IL.) / R Restricted I&2 Family Dwelling City/Town, ZIP M Masonry RC Roofing Covering WS Window and Siding q /� SF Solid Fuel Burning Appliances �+ C ohn / � I Insulation Telephone Email address r D Demolition _ 5.2 Registered Home Improv menu Contractor(HIC) )4Ecia /o�,`J/..r\ � (02r1-,�-5 ElkRegistrationNu Number Expiration Date H1C Company Pl �p� j� egi t Naps ,,( ( - � '^"' L Jr��� /9 �/�(/ yY)2X1 f/`t}' ' u1./U0 lv /, No.an `jJ/ �ie. ,�j/N )•5Z 9 Email address /�.n.,� City/Town,State,ZIP(,� �/ "!/ Telephone 1.�"" 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 I • ance of the building permit. Signed Affidavit Attached? Yes No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PPERMIT 1,as Owner of the subject property,hereby authorize L/ `'2 lh.ere to act on my alf,in all matters relative to work authorized by this building permit application. 1,-), 4115,-- °enayaC� V.. '�Print . ame(Electronic ore) Bate 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 pplication is true and accurate to the best of my knowledge and understanding. -,zbit.6G Pi -S---- Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: I. 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.govioca 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" LOWE'S. MASSACHUSETTS SERVICES SOLUTIONS INSTALLED SALES CONTRACT LOWE'S AUTHORIZED REPRESENTATIVE SALES ID DATE CUSTOMER NAME Steven Lockwood 3070929 7/16/202 Jim King STORE NO. STREET ADDRESS STREET ADDRESS 1916 1000 Lowes Blvd Attn: ISI-26 2 Pomeroy Ter Apt#1 CITY STATE ZIP CITY SATE ZIP Mooresville,NC 28117 Northampton MA 01060 III-PI ION{ E l l PHC\I 888-516-1010 774-641-4028 EMAIL EMAIL kteven.Iockwood@Iowes.com jking2z@yahoo.com LOWE'S CONTRACTOR LICENSE tt LOWE'S REPRESENTATIVE LICENSE tt CREDIT/DEBIT CHECK LCC CARD GIFT CARD 'See MA Addendum (If Applicable) LI This is only a quote for the merchandise and services printed below. This becomes an agreement upon payment and issuance of a Lowe's receipt,upon pay-Trent,the entire agreement,including the specifically completed pages of this document,the Terms and Conditions included with this document and any other addenda and attachments hereto,shall be referred to herein as this-Contract'PLEASE READ THIS ENTIRE DOCUMENT, INCLUDING THE "NOTICES," "TERMS AND CONDITIONS," AND "ADDENDUM" CONTAINED WITHIN THIS CONTRACT ON THE FOLLOWING PAGES BEFORE SIGNING. INSTALLATION STREET ADDRESS CITY STATE ZIP 2 Pomeroy Ter Apt#1 Northampton MA 01060 Lowe's does not offer services to paint,seal or stain fences. MERCHANDISE AND INSTALLATION SUMMARY(I.E.ITEM NUMBERS,COLORS,DIMENSIONS,CONSIDERATIONS): CONTRACT TOTAL $2,483 46 (INCLUDING TAX) Work is to commence upon reasonable availability of Contractor and/or any special order or custom made Good(s) which is anticipated to be 08/16/2024 [fill in date].Estimated completion date is 09/20/2024 [fill in date]. Rev.05/01/2024 1 LOWE'S SERVICES CONTINUATION OF MERCHANDISE AND INSTALLATION SUMMARY (I.E. ITEM NUMBERS, COLORS, DIMENSIONS, CONSIDERATIONS): (install exterior door and storm door ( ( 1 Rev.05/01/2024 2 Entry Door 1 Quantity 1 L Options ✓ C i Description: IHC Fiberglass Single Unit P 9 9 Select U.S.Energy Star Zone: None Masonite Performance Door Systems(MPDS): No . Handing: Right Inswing m • Sill Style: Mill Finish Door System Width: RO:381/4-in//Frame:371/2-in//Door 36-in Door System Height: RO:821/8-in//Frame:81 S/in//Door.79-in ` Slab Nominal Width: 36-in . _ 1{ Slab Nominal Height: 79-in Slab Width: 36 37 117 Slab Height: 79 Material Type: Oak Textured Fiberglass Elevation Door Style: I-ull Lite Glass Style: Decorative Glass Family. Flement Glass Caming: Antique Black Lxterior Finish: Unfinished Interior Finish: Unfinished Satisfied Energy Star Tones: None U-Factor Door: SHGC Door: 0.27 Brickmould Options: No Jamb Material: Composite Jamb Size: 69/16-in Jamb Finish: Unfinished Lockset Bore Option: 51/2-in Double Bore Hinge Type: Stainless Steel Room Location: Remake: No Delivery Method: In-Store Pick-Up SOS: 1066035 SOS Description: WTS MAS-IHC FG PH Labor SKU: 1098734 LCZ: NP-01 Satisfied Energy Star Zone(s): None Production Time(Does not include transit time): 21 Customer Service Number: 866-736-7322 Catalog Version Date O6/2_5/2024 Additional Project Details permit: permit Quantity 1 item 262515 larson door: Quantity 1 Package Price: $2,483.46 Your Price: $2,483.46 NOTICES LEAD SAFE INFORMATION. Federal and applicable state laws require that You be provided with a lead hazard information pamphlet such as The Lead-Safe Certified Guide to Renovate Right: Important Lead Hazard Information for Families, Child Care Providers and Schools. By signing this Contract, You acknowledge having received a copy of this information pamphlet before work began informing You of the potential risk of the lead hazard exposure from renovation activity performed in Your dwelling unit or facility. A copy of the pamphlet is available at the following website: www.lowes.com/EPARRP. For more information see: https://www.epa.gov/lead/lead-renovation-repair-and-painting-program. NOTICE OF ARBITRATION AGREEMENT: This Contract provides that all claims by Customer or Lowe's will be resolved by BINDING ARBITRATION. Customer and Lowe's GIVE UP THE RIGHT TO GO TO COURT to enforce this Contract (EXCEPT for matters that may be taken to SMALL CLAIMS COURT). Lowe's and Customer's rights will be determined by a NEUTRAL ARBITRATOR and NOT a judge or jury. Lowe's and Customer are entitled to a FAIR HEARING. But the arbitration procedures are SIMPLER AND MORE LIMITED THAN RULES APPLICABLE IN COURT. Arbitrator decisions are as enforceable as any court order and are subject to VERY LIMITED REVIEW BY A COURT. FOR MORE DETAILS: Review the section titled ARBITRATION AGREEMENT, WAIVER OF JURY TRIAL AND WAIVER OF CLASS ACTION ADJUDICATION found in the Terms and Conditions of this Contract. NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M.G.L. c. 142A: LOWE'S AND OWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CONTRACT, THAT LOWE'S MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION AS PROVIDED IN M.G.L. c.142A. THE SIGNATURES OF THE PARTIES BELOW APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED BY LOWES, PURSUANT TO M.G.L. c. 142A. THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THIS SECTION IS NOT SEPARATELY SIGNED BY THE PARTIES. If customer has a complaint which cannot be resolved informally, the home Improvement Contractor Law (M.G.L. c. 142A) may provide Customer with the right to request arbitration through a private arbitration program approved by the Director of the Office of Consumer Affairs and Business Regulation, as an alternative to court action. The same right is not afforded to Lowe's unless this Notice is signed and dated by Lowe's and Customer. All claims by Customer or Lowe's concerning this Contract which cannot be resolved informally. and which are not covered by M.G.L. c142A or subject to the jurisdiction of a small claims court, shall be resolved by binding arbitration as set forth in the Terms and Conditions. By: Date: Signed at 07/16/2024 03:55 PM Lowe's Authorized Representative By: Date: Signed at 07/16/2024 07:36 PM Customer PRICE CALCULATIONS. If this Contract includes Goods and related Installation Services sold by unit of measurement, such as per square foot, the Price may include more Goods than the actual measurements of Your project area. The Price includes the total amount of Goods required by Lowe's to fulfill the Contract (including surplus materials and overages) (together the "Estimated Product") and the Installation Services required based upon this total amount of Goods. For instance, a 120 square foot room may require 140 square feet of carpet to properly match the carpet seams, pattern, or unique room characteristics, and the Price would include Installation Services based upon the 140 square feet of carpet. The total amount of Estimated Product is based upon the total Goods recommended by the Installer, based on the Installer's assessment of unique characteristics of Your project. If any usable Goods are left over, Lowe's may, at its discretion, initiate a Price adjustment. Lowe's will not adjust the Contract Price for the related Installation Services. By signing this Contract, You acknowledge You are aware of Your project area measurements and the amount of Estimated Product, and that the Estimated Product may exceed Your actual project area. If Your project includes the installation of flooring materials, by signing this Contract You further acknowledge having received a completed Flooring Detail Diagram (the "Diagram") prior to execution of this Contract. Upon request, Lowe's can provide You with additional copies of the Diagram, which identifies the square footage of Your project area and the square footage of the Estimated Goods. PHOTO RELEASE. By signing this Contract, You grant to Lowe's, its representatives, and Installer the right to take and use photographs, videos, or other representations of the Premises before and after the Installation Services and all work performed at the Premises related to this Contract (the "Content"). Lowe's irrevocably keeps all rights (including the copyright), title, and interest in the Content for use in all markets and media, worldwide, in perpetuity. Lowe's can use the Content, in any form or medium, internally for any purpose (e.g., customer service, planning, and claims. CONSENT TO COMMUNICATION. By signing below, You consent to Lowe's and its authorized Installers contacting You through automated means or system at the email address and phone number provided regarding the product and/or Installation Services You requested. You understand Your consent is not required as a condition of purchasing Goods or Installation Services. Privacy Statement, SMS Terms Rev.05/012024 3 NOTICE REGARDING PAYMENT SCHEDULE. If the Contract Price is$1,000 or less, payment of the Price by Customer to Lowe's is due in full upon execution of this Contract. If the Contract Price exceeds$1,000, Customer shall use the following payment schedule: (1) Deposit of $ 819.39 [enter 1/3 of the contract Price] to be paid upon signing this Contact. Any deposit collected at the time this Contract is signed will not exceed one-third (1/3) of the Contract Price; 1564.07 (2) Payment of $ _ [enter 2/3 of the contract Price minus $100] to be collected upon or after the commencement of work. Customer authorizes Lowe's to charge Customer's credit card, or deposit Customer's check, for the amount of the payment indicated in this section anytime upon or after the commencement of the work; and (3) Final payment of$100 to be paid upon completion of the Installation Services to both parties' satisfaction. NOTICE OF CUSTOMER'S RIGHT TO CANCEL. If this is a "door-to-door sale" as defined by 16 C.F.R. § 429.0(a), or if this Contract is signed by Customer at a place other than the address of the seller as set forth in M.G.L. c. 93 § 48, You, the Customer, may cancel this Contract at any time prior to midnight of the third business day after the date of this transaction. See the attached notice of cancellation form to this Contract for an explanation of this right. By executing this Contract, Customer acknowledges receipt of two (2) completed copies of the Notice of Right to Cancel form and certifies Lowe's has informed Customer orally of his or her right to cancel. NOTICE TO CUSTOMER. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Lowe's Home Centers, LLC EXECUTION DATE: Signed at 07/16/2024 07:36 PM LOWE'S AUTHORIZE)REPRESENTATIVE SIGNATURE OWNER'S SIGNATURE CO-OWNER SIGNATUR11 Customer acknowledges receipt of a true copy of this contract which was completely filled in prior to Customer's execution hereof. Rev.05/012024 4 The Commonwealth of Massachusetts Department of Industrial Accidents k_e_ ... � (�`tce of Investigations ==.14_ Lafayette City Center •1=—%�/' 2 Avenue de Lafayette, Boston, MA 02111-1750 www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly Name (Business/Organization/Individual): Lowe's Companies, Inc. Address: 1000 Lowes Blvd City/State/Zip: Mooresville, NC 28117 Phone#:860-505-9314 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ® I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors G. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in capacity. employees and have workers' h' # 9. ❑Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. 'No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] 'Any applicant that checks box it l 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: LM INSURANCE CORPORATION Policy#or Self-ins. Lic. #:WA565D294595014(AOS) Expiration Date:4/1/2025 Job Site Address: C2 / '1L1)/) arr. / City/State/Zip: A(1 767�if YC �>�/A� Attach a copyof the workers' com 'on policydeclaration page(showingthe policynumber and expiration date .t:.(Gt/ P� P� Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of pedury that the information provided above is true and orrect. Signature: Nt-16/44/- ,51 Z Date: eV7ix Phone#: 8605059314 • Official use only. Do not write in this area,to be completed by city or town official. I City or Town: Permit/License# Issuing Authority(check one): 1❑Board of Health 2❑Building Department 3LICity/Town Clerk 4.1:Electrical Inspector 5Elumbing Inspector 6.0Other Contact Person: Phone#: THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washingtaq Streit-Suite 710 Boston,Massachusetts-02118 Home Impro :- :_ .-=.. ••_-Registration y a A. Wf r ^' _ 1 ,,Type: Supplement Card LOWES HOME CENTERS,LLC "�' 10/17l2025 1000 LOWES MPL a = e ,t SERVICES COMPLIANCE MOORESVIIlE NC 28117mim • at 1 , Yam. y �. Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Off1u of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration data If found return to TYPE Sup'piement Caro Office of Consumer Affairs and Business Regulation iltiaturrlisa Expiration 1000 Washington Street -Suite 710 149088 ' 20A7.2l25 Boston.MA 02118 LOWES HOME CENTERS.t1C 1 NEXEDEES SOTO 1000 LOWES BLVD G:4r,.r.%..iassrF C74114*)` SERVICES COMPLIANCE Undersecretary Not valid without signature MOORESVILLE.NC 28t 17 Ci t y of Nor t ha npt on '•v " IVhssachuset t s ,5 ti 1 t ALEP14RIlieVT H1 LI AG I P CTI akS \ 212 IVtti n Street • Mini ci pal Building Nor t hanpt on, NA 01060 'reh, CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGLc 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 MGLc 111, S150A. The debriswill be disposed of in: 61/diLocation of Facility: 1) /`'� � P/)o o91_44a-� ())1066,,,,The , The debriswill be transported by: Name of Hauler: eLde Sit') ) Sgnature of Applicant: )714/11/2 Date: /7/2 t/ Commonwealth of Massachusetts Division of Occupational Licensure Board of Building R ulations and Standards ConSt OtiTS Visor CS-117055 gpires: 08/02/2025 KYLE R SEADLES ! .; 1 �, 14R PEACH aRCHARO ROAD PROSPECT _ 'ow 08712 /nip Commissioner S,..Let u:r.,_ Construction Supervisor Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of onclosod space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For Information about this license Call(617)727-3200 or visit www.mass.govldpi DATE(MIAIOWYYYV) AC D CERTIFICATE OF LIABILITY INSURANCE 05/23/2024 THIS CERTIFICATE IS ISSUED AS A MAT fER 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 Alexis Gerzabek Abbate Insurance Associates,Inc. PHONE t203)777-7229 I FAX (203)8E5-7503 (A/C,No,Est), (ABC.Noy 671 Stale SUee: agerzabek@abbaterns.com ADDRESS: INSURERS)AFFORDING COVERAGE NAIL a New Haven CT 06511 INSURER A: Acadia Insurance Company INSURED INSURER B East Coast MilwOrk,LLC INSURER C: 14R Peach Orchard Rd. INSURER D NSURER E Prospect CT 08712 INSURER F COVERAGES CERTIFICATE NUMBER: 24-25 COI REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR 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.UNITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ICY EXP LTRR TYPE OF MSURANCE I lSu SWVD POUCY NUMBER (1rAppYYYY) T(r400/YYYY) UIRTS X COMMERCIAL GENERAL LIABaITY EAO I OCCURRENCE $ 1.000 000 AGE RENTED I CLAIMS-MADE ®OCCUR PREMISES(Er aczwerce) $ 500.000 6CD E P;Any one arson, s 15,000 A Y 0'A5549377 06/04/2024 06/04/2025 PERSONA'A5(5'INJURY $ 1.000.000 (IFNL AGGREGATE LIMIT APPLES PER: GENERAL AGGREGATE $ 2,000.000 POLICY❑FM,- ❑LOC PRODUCTS-COIAP/OPAGG S 2.000,000 OTHER- $ AUTOMOBILE LIABILITY COMBINED SINGLE UMIT s 1.000,000 (Fa acS da it X ANYAIJTO BODILY INJURY IPer pe'son) $ A OWNED SCHEDULED y CAA5540378 06,04/2024 06/04/2025 eooe.Y INJURY I Per acacentl $ AUTOS ONLY AUTOS -, HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY �. AUTOS ONLY (Par aar• i )11' UMBRELLA LA LIAe x OCCUR EACH OCCURRENCE s 3,000.000 A EXCESS Use CLAIMS-MADE CUA5549378 06,04/2024 06/04/2025 AGGREGATE s 3.000,000 0E0 I I RETENTION S WORIERS COMPENSATION vl PER I 1DTH- AIOEMPLOYERS'LIASIL TY Y/N "I STATUTE 1 EREMPLOYERS' ANY PROPRETOFLPAR N=R.E7ECUTNE EL EACH ACCIDENT S •0� A EXCLUDED? [] NIA WCA5549380 06A4/2024 O610U2025 Illandnlony In IOUEL.DISEASE-EA BIPLOYEE $ 500.000 e Yea desale under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY(LET S 500,000 DESCRIPTION OF OPERATIONS/LOCATORS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more apace Is requked) Vendor Number 11878 Region 18 The General Liaoility(inciudng Products Liability)and Auto Liability include Lowe's Companies,Inc.and Lowe's Home Centers,LLC as additional Insureds as required by written contract. This insurance is primary and non-contributory over any other available insurance coverage.A Waiver of subrogation applies In favor of the additional nsured in respect to General&Auto Liability policies. 10 Days notice of cancellatiaon for non-payment of premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.NOTICE WILL BE DELIVERED W Lowe's Companies.Inc.and any and all subsanes ACCORDANCE WITH THE POLICY PROVISIONS. idi OCO_aye's Blvd. AUTHORIZED REPRESENTATIVE 1400resv:lle NC 28111 O 1961-201SACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD A cPRD® CERTIFICATE OF LIABILITY INSURANCE DATE (MMI4��)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 MARSH USA LLC NAME: Lisa Beam — 100 North Tryon Street,Suite 3600 PA/C NNo,Extk 1-704-374-8365 HE FAX No): Charlotte,NC 28202 E-MAIL ADDRESS: Lisa beam@marsh.com INSURER(S)AFFORDING COVERAGE NAIL CN 102776519-Loaves-Front-24-25 INSURER A: Liberty Mutual Fire Insurance Company 23035 INSURED INSURER B: Fireman's Fund Indemnity Cow I1380 Lowe's Companies,Inc tY and subsiclaries INSURER c: LM Inaaancac pc al o 33600 1000 Lowe's Boulevard Mooresville,NC 28117 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-005147621-21 REVISION NUMBER: 2 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 POUCY EFF POUCY EXP LTR TYPE OF INSURANCE INSD WV!) POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL UABILITY T82651294595074 04/01/2024 04/052025 EACH OCCURRENCE $ 3,000,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 3,000,000 MED EXP(Any one person) $ PERSONAL&ADV INJURY S 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 3,030,000 X POLICY PERCT LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: A AUTOMOBILE LIABILITY AS2651294595104 04/01/2024 04/012025 COMBINED SINGLE LIMIT $ 5,000,000 (Ea accident) X 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) $ B X UMBRELLA LIAB X OCCUR USZ00094624 04/01/2024 04/01/2025 EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED RETENTIONS S C WORKERS COMPENSATION WA565D294595014(AOS 04/012024 04/01/2025 PER OTH- C AND EMPLOYERS' ABILITY Y/N W('Sf (WI,51294595024 MN) 04/012024 04/01/2025X STATUTE ER LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT S 2,000,000 OFFICER/MEMBEREXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 2,000,000 It yes.describe under 2,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Excess Workers'Compensation EW565N294595064(FL) 04/01/2024 04/01/2025 (WC per statute) 3,000,000 A Excess Workers'Compensation EW265N294595034(AOS) 04/01/2024 04/01/2025 (WC pa statute) 3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION Lowe's Home Center,LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1000 Loses Blvd. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Mooresville,NC 28117 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ? czussF 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN1 027 765 1 9 LOC 1t: Charlotte ACCORD ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NASD INSURED MARSH USA LLC Lorwais Cmperiies,Inc. and srbsdanes POLICY NUMBER 1000 Lone's Balevad MocresvrIe,NC 2117 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 __- FORM TITLE: Certificate of Liability Insurance EXCESS WORKERS COMPENSATION(MO) Carney.Liberty Mutual Fre insurance Co Pdicy Number EW265N294595054 Elfeckve/E abon dales 04101/2024-04/01/2025 Limit(Per Statute)$3,000,000 EXCESS WORKERS COMPENSATION(MA) Carrier Liberty Mutual Fire Insurance Co Pdicy Number:EW265N294595044 E1Fechve/E>cabon dales 040112024-04/01/2025 Lunt(Per Stabile)$3,000,000 Workers'Compensation and Excess Workers'Cortpensabon pdiars include a self-insured relenhon of S2,000,000 The Automotie Liability pdicy evidenced above is subject to additional sett-insured retentions excess of limits shown for venous penis covered ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD