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24D-109 (2)
279 STATE ST BP-2019-0449 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block:24D- 109 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cate,goa: SOLAR ELECTRIC SYSTEM BUILDING PERMIT Permit# BP-2019-0449 Project# JS-2019-000707 Est.Cost: $1200.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: SUNRUN INC 080034 Lot Size(sg. ft.): 2308.68 Owner: PETERS SARAH E Zoning: URB(100)/ Applicant: SUNRUN INC AT: 279 STATE ST Applicant Address: Phone: Insurance: 734 FOREST ST STE 400 (978) 793-8584 WC MARLBOROMA01752 ISSUED ON:10/15/2018 0:00:00 TO PERFORM THE FOLLOWING WORK.-STRIP AND SHINGLE ROOF 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 10/15/2018 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Department use only City of Northampton Status of Permit: OCT0 201$ uilding Department curb Cut/Driveway Permit 1 212 Main Street Sewer/Septic Availability Room 100 WaterNVell Availability DEPT OF BUILDINGINSPECTIONS N rthampton, MA 01060 Two Sets of Structural Plans NORTHAMPTON,MAoWwne 41-4-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1-SITE INFORMATION 0-- I q — q y 1.1 Property Address: 279 State Street This section to be completed by office Map Lot Unit Zone Overlay District Elm St.District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Sarah E Peters 279 State Street Name(Print) Current MaUkV Address: 413-341-3410 Te see signed contract lephone Signature 2.2 Authorized Anent: Crajg Orn 734 Forest St STE 400 Mariborough,MA 01752 Name(P Current MaftV Address: �l 978-793-8584 Signal Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit appflcant 1. Building 1r 200 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5.Fire Protection 6. Total=(1 +2+3+4+5) 1,200 Check Number 01 This Section For Official Use Only Date Building Permit Number. Issued: Signature: !o Building Commissioner/Inspector of Buildings Date 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 Building Height Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved #of Parking Spaces - Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO ® DONT KNOW ® YES IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO i IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO 0 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 0 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all annlicablel New House [] Addition ❑ Replacement Windows Alterations) ❑ Roofing Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [p] Decks [p Siding[C]) Other[CIj Brief Description of Proposed Work:Strip existing roofing materials and install six feet of ice and water shield from the eave to the ridge.Finish with new asphalt composition shingles Alteration of existing bedroom Yes X No Adding new bedroom Yes ! X N Attached Narrative Renovating unfinished basement Yes N-No Plans Attached Roll -Sheet 6a.If New house and or addition to existing housing,complete the following: a. Use of building:One Family XTwo 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 budding 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, Sarah E Peters ,as Owner of the subject property hereby authorize Craig Orn/Sunrun to act on my behalf,in all matters relative to worts authorized by this building permit application. see signed contract W natum of Owner Date I, Craig Orn ,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. Craig Orn Print Name Signature of Owner/Age Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Craig Orn CS-080034 License Number 734 Forest St STE 400 Marlborough,MA 01752 1/22/19 Address Expiration Date i 978-793-8584 Slgnalure Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ Sunrun Inc. 180120 Company Name Registration Number 734 Forest St STE 400 Marlborough,MA 01752 10/13/18 Address Expiration Date �l Telephone 978-793-8584 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.......X No...... ❑ 11. - Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellina of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780. Sixth Edition Section 108.35.1. Qefinition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153(Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste 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. Address of the work: 279 State Street The debris will be transported by: Graham Waste The debris will be received by: 215 chief Justice cushing Way Cohasset,MA 02025 Building permit number: Name of Permit Applicant Craig Orn/Sunrun Date Signature of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 www massgov/dia 1N'orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeibly Name (Business/Organization/Individual):Sunrun Installation Services, Inc. Address:775 Fiero Lane, Suite 200 City/State/Zip:San Luis Obispo, CA 93401 Phone#:978-549-9438 Are you an employer?Check the appropriate box: Type of project(required): 1.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 ❑Building addition 4.[:]1 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 I I. Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.O I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.2]Roof repairs These sub-contractors have employees and have workers'comp.insurance. 6.❑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:Zurich American Insurance Company Policy#or Self-ins.Lic.#:WC013696004&WC013696104 Expiration Date:10/01/2019 Job Site Address:279 State Street City/State/Zip:Northampton,MAO 1060 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 thepains andpenalties ofperjury that the information provided above is true and correct. Signature: Date: Phone#:978-549-9438 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#: Craig Orn / 734 Forest Street, Unit 400, Marlborough, MA 01752 (978)793-8584 craig.orn@sunrun.com mapermits@sunrun.com Massachusetts Department of Public Safety Construction Supervisor Board of Building Regulations and Standards Restricted to- Unrestricted-Buildings of any use group which contain License:CS-080034 less than 35.000 cubic feet(991 cubic meters)of Construction Supervisor enclosed space. r, CRAIG M ORN 73 WALNUT ST OXFORD MA 01540 Failure to possess a current edition of the Massachusetts Mal— Expiration: State Building Code is cause for revocation of this license. Commissioher 0112212019 DPS Licensing information visit:WWW.MASS.GOVIDPS ''�iir �ntrturr•rnrwr/1�n�`r`l.�rc;�rrrhu;r/A Oft*of Conowna AHsfrs 4 auskme Rsgwown HOME lMPR01/EMENT CONTRACTOR Type: S�t card =8n Isiu teo120 14/19/2016 Sunrun hoblatio l $sNj tic. Cn*Om • 775 Fiero L!M' 2Q0 �---- San Luis Obispo,CK93401 lhrdecsecretmy �„� wnsar.Ys a 1w�yliwts-u unfnuyu�. Rogives fon nand for individual use Orly before the wq*aWn date. It found rstum to: offioe of Consumer Afteirs and Business Regulation 10 Park Plaza-Suits 6170 soaton,KA 02116 at vend without signature hips!/mail.9moe.camhnsiViaMnbooc/159*3oO53xlB4137projector=l 1M ® DATE(MM/DD/YYYY) AC� CERTIFICATE OF LIABILITY INSURANCE 9/12/2018 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 NAME: Arthur J. Gallagher&Co. PHONE 415 546-9300 PAX No):4I5-536-8499 Insurance Brokers of CA. Inc. License#0726293 E-MAIL 1255 Battery Street#450 ADDRESS: San Francisco CA 94111 INSURERS AFFORDING COVERAGE NAIC# INSURER A:Zurich American Insurance Company 16535 INSURED SUNRING-01 INSURER B:Navigators Specialty Insurance Company 36056 Sunrun Installation Services, Inc. INSURER C: 775 Fiero Lane,Suite 200 San Luis Obispo, CA 93401 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:899243400 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. ILEXP TR TYPE OF INSURANCE NR ADDL SUER POLICY NUMBER MM DD/YYYY MOLICY EFF M/DDY/ YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY LA18CGL2303211C 10/12018 10/12019 EACH OCCURRENCE $1,00.000 CLAIMS-MADE EK]OCCUR PREMISES Ea occurrence $1,000,000 X $50,000Retention MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X E� LOC PRODUCTS-COMP/OP AGG $2,000,000 POLICY[K] OTHER: Total Policy Limit $10,000,000 A AUTOMOBILE LIABILITY BAP915542505 10/12018 10/12019 COMBINED SINGLE LIMIT $2 000 000 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 acc dent UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION WC013696D04 10/12018 10/12019 X PER OTH- A AND EMPLOYERS'LIABILITY Y/N VVC013696104 10/12018 10/12019 STATUTE I ER ANYPROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) WC013696004-$25,000 Deductible;WC013696104-FL,HI,MA,NJ,NY,OR,VA,WI only.Named Insureds:Sunrun Inc.,Sunrun Installation Services Inc., Sunrun South LLC,AEE Solar,Inc.,Clean Energy Experts LLC,Sunrun Solar Electrical Corporation Evidence of Insurance. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Northampton 212 Main St AUTHORIZED REPRESENTATIVE Northampton MA 01060 y ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACUROIP CERTIFICATE OF LIABILITY INSURANCE °"Ta""'°umn o612&MI6 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO HTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BErEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certitkals holder is an ADDITIONAL INSURED,the poiloy(les)must be• n•d. N SUBROGATION 13 WAIVED,subject to Ow toms and conditions of the posey,ceNsin policies may require an andomemoft AInt on lhk cortMcate does no confer rights to On artttisaM holder In lieu of such s P00cu R OMACT WASLLA OS FOCUS INSURANCE PLUS INC 97 f7s<-703.0062 271 HIGH ST UNIT B LOWELL,MA 01852 am$ rlgMwRA I WE WORLD INSURANCE CPAMPANY 131" pNaM ; ARaEL LA TECTION INSURANCE EVOLUTION ROOFING CORP INSURANCE COMPANY 17370 208 PRATT AVENUE,APT 1121 DURANCE CO LOWELL MA,01851 COVERAGES CERTII<ICATE NUMBER: REVISION NUMBER: TNS IS TO CERM THAT THE POLNCMS OF INSURANCE LISTED BELOW HAVE WISH ENO TO IIBURED NAMED MOVE FOR THE POLICY PErAW RUCATM NOTWRI- TANUM ANY REOUVftWNT.TM OR COHOITION OF ANY CONTRACT OTHER 00M MEI IT WITH RESPIW TO WH M TM CERTIFICATE MAY BE ISSUED OR MAY PEffPJ „7HE BISURANCE AFFORDED BY THE POLICIESHErAM 13 SUBJECT 7O ALL 7HE YW%n. ONS EXCLUSI /MID CONDITIONS OF OF S"POLICES.LITS SHOM MAY HAVE.BEEN IIEDUCEO BY P CLAM NMI Twe ap plauRA IC[ MIS e0110RALUAwiY 1 uGE f t.m.Sw wrHrERCIAt®EMEMLL wjw s 100,00 OLAHMa.MADE a OCCUR Moa Orr «» S SANNPP8521030 00712016712019 pwoop AL a Aov wAw s 1.000,000 ML •E/wASSFAMTE $ MMWaATEUMITAPPUHUPW PRODUCTS-COMPOOPAea t X POLICY M M LOC Nr� ' AvrasionLE uAalurr AICO LY sasrtr trw om" s 100,000 ZCNW MM 1020074406 08/1112016 11/2019 GODLY eUrHY rw ago" s 300.000X �Alms A TCa $ 100.000 Cmw 7 X UM•AELLA HOOpJR OOCUr1EMCE f EaCEaa UAa AN06367S 06100/2018 1712019 REBATE i 3.000,000 s > .� oosrws"TaLwM AIM EISPLorrERs•LHAIiY Tim 1 A00.000 W—'— N NIA 117110 06�251201s 19 RA. ACCNNW : IN LL.OUNASE-EAEMPLOYI S 1.000.000 r 1.000.000 E.L.owEASE- ulaT s arselrrHHoll aP aPERAT101w r LoeATNNw rvaNrxss lAaaaw ACOAO»r,A/Nrwal RrarMa spnwd�.r arra apw nwr.4 CERTIFICATE HOLDER CANCELLATION SHOULD ANY of no ABOVE OESCIBM mum I CM4CEL.LED BEFORE THE Ex"MTO 4 DATE THEREOF. NOTICE LULL SE DELMEIM w SUNRUN ISTALLAnON SERVICE ACCORDANCE WI THE FOLIV FROWN1010. 734 FOREST ST SUITE 400 AUHraHgo Eo ! " !INFO BeR1181I.MA 94762 ACORD 25(2010105) 0Ip 2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo an registered marks of ACORD Av d CERTIFICATE OF LIABILITY INSURANCE 22/2018'"' THIS CERTIFICATE la 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 cwtNkste holder is an ADDITIONAL INSURED,the poNcy(ies)must be endorsed. I SUBROGATION IS WAIVED,subject to the tens and conditions of the policy,certain Policies may regain an endorsement. A statement on this certIftets does not confer rights to the certi tete holdw in lieu of such s. PRODewot =FT Norwell Risk South Eastern Insurance Group LLC Mm 77 Accord Bark Drive Unit al MAK 0 Norwell MIL 02061 rce Insurance CONVOW INSUMI D ,Arch Insurance Group, Inc. Graham Waste Services Inc 215 Chief Justice Cushing 1W Cohasset IMA 02025 COVERAGES CERTMATE Nt1MIIER:17-is REVISION NUMHER: THIS M TO CERTIFY THAT THE POLICIES OF MNIANCE LISTED BELOW HAVE KEN ISSUED TO THE INSURED HIAAIED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN01 ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY SE=UED OR MAY PERTAN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 13 SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIU.LISTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. new MM TYPE OP wN1IRANCEPOLICY NIAM111111tLeare GENERAL WAMLITY 9ACH 1000000 X COWERCIAL Q819M LIANLITY = 100,000 A CAIMs4mw ®occum 2/31/2017 2/31/2018 MEDIMP ww 3 5000 1000000 010411MIL ASIMMAT4 4 200000 GENLAGGREGATE Leer APPLES PER: PRODUCTS-COIPIOP An s xacluded X POLICY $ AUTOYDaLE UAeLUT LOW 2 1,000,000 A ANY AM ODDLY KAMPwP 4 AALL OWNW LR X /31/2017 su /31/2010 90oLYleerpr ""No s X HIRED MHOS X MJTOS Is. >< 1,000, X I MOWLLA Lw oeotllt „ , 51000,000 C ww"Lar 0=' 10012400 AGGREGATE $ 5,000,000 DIED XMM1e, 2/31/2017 2/31/2010 r ommis ff D ALOYww LIAI LffT X IO X I 1,090,000 OFF CEM+EMRR EXCLUDlDt NIA EL E11CN ADE�ENT i p�,M.t,ryM leeeoo2 7/01/2010 7/01/2e1e E.L POPM.5A M w araw www OF OPEIIATN" -LL 010114#0011 FCC" a0r DE9CRWn0N OF OPERATION*/LOCA=W I VENw M(Amd ACORO tel.Ae/8wd Rwwb=w 0"8e—a M CERTIFICATE HOLDER SHWLD ANY of THE ABOVE DESCRIBED POLICIES N CANCELLED WPM THE EXPIRATION DATE TH ERROF, NOTICE WILL SE DELIVERED IN Sun Run Solar ACCORDANCE WITH THE POLICY PROVISIONS. 775 Fiero Lane Suite 200 AunlORtaDREPRESBITATNE San Luis Obisipo, C7► John 1Coegel/ABOWSS ACORD 23(2010105) 0 INS-2010 ACORD CORPORATION.All rights reserved. INO"Ammnnnim rt,.ernwn nema sn,t Inn,%am ranletara,t merlre^f ernwn