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11C-026 (7) 4 STOWELL ST BP-2019-0447 GIs#: COMMONWEALTH OF MASSACHUSETTS MW:Block: I IC-026 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: SOLAR ELECTRIC SYSTEM BUILDING PERMIT Permit# BP-2019-0447 Proiect# JS-2019-000706 Est.Cost: $3300.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: SUNRUN INC 080034 Lot Size(sa.ft.): 8494.20 Owner: MIENTKA GISELE M&MARGARET A MIENTKA&FRANCIS A MIENTKA Zoning:URA(100)/ Applicant: SUNRUN I N C AT. 4 STOWELL ST Applicant Address: Phone: Insurance: 734 FOREST ST STE 400 (978) 793-8584 WC MARLBOROMA01752 ISSUED ON.1011512018 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 RECEIV f E- Um Department use only 1.Ary of Northampton Status of Permit: Wilding Department Curb Cut/Driveway Permit OCT 1 O 2018 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability *587-1240 ampton, MA 01060 Two Sets of Structural Plans DEPT.OF BUN.DING INSP TIONS NORTHAMPTON.MA a 4Fax 413-587-1272 Plot/Ske Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1-SITE INFORMATION A t 9 '`�qr7 1.1 Property Address: 4 Stowell Street This section to be completed by office Map Lot Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Margaret Mientka 4 Stowell Street Name(Print) Current Mailing Address: 413-584-1344 see signed contract Telephone Signature 2.2 Authorized Agent: Craig Orn 734 Forest St STE 400 Marlborough,MA 01752 Name(Print/, � � Current Mailing Address: F 978-793-8584 Signature z Telephone C ION 3-6TIMATED CONSTRUCTION.COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 3,300 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee �s (-/0 0(14. Mechanical(HVAC) 5.Fire Protection 6. Total=(1 +2+3+4+5) 3,300 Check Number p1 This Section For Official Use Only Date Building Permit Number. Issued: Signature: Building Commissionedlnspector of Buildings Date i L i ; 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 bidg&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 ® YES 0 IF YES: enter Book Page and/or Document 11 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 0 Obtained 0 , 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 0 NO 0 IF YES, describe size, type and location: E. Will the construction activity disturb(Gearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO Q 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 ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [p] Decks [p Siding[Oj Other[lam 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 Of Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa. If New house and or addition to existing housing,complete the following: a. Use of building:One Family X 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, Margaret Mientka as Owner of the subject property hereby authorize Craig Orn/Sunrun to act on my behalf,in all matters relative to work authorized by this building permit application. see signed contract A ture 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/ t 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 978-793-8584 Signature �) Tel hone 9.Re-gistered H ImprovernMContractor: Not Applicable ❑ Sunrun Inc. 180120 Company Name Registration Number 734 Forest St STE 400 Marlborough,MA 01752 10/13/18 Address Expiration Date (r-==�_____TeIephone 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 Dwellings 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 108.3.5.1. Definition 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: 4 Stowell 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 tignature of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents 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 Please Print Legibly 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): l.❑I am a employer with employees(full and/or part-time).* 7. E]New construction 2.M 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. El Demolition 3.R I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 Q 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 I L❑Electrical repairs Or additions proprietors with no employees. 12.[:]Plumbing repairs or additions 5.Q I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.[Z]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: 4 Stowell Street City/State/Zip:Northampton,MAO 1053 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 and penalties o ury that the information provided above is true and correct. Si nature: C - Date: toA 41 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 4 CRAIG M ORN 73 WALNUT ST OXFORD MA 01540 Failure to possess a current edition of the Massachusetts Expiration: State Building Code is cause for revocation of this license. Commissio or 0112.212019 DPS Licensing information visit:WWW.MASS.GOVIDPS "-' /7ri.RJJfumrrcw�f�i Oft*of Conevow Affairs i auk Reguie on HOME IMPROVEMENT CONTRACTOR Type: Supplement Gard 10/1312016 Surrun kmadotion, Inc. Orn • 775 Fiero t,enetUI6206 �i�►—` San Luis ObkVo,Ck 60401 lhrdersecretar}t WR U PAMMYe 1.:PWlil{w�p..`--I.ci�IN►urun Rswevedon valid for Indmdud use 0rdy bNbre the up roWn date. 9 found return 10: ofoce of Consumer AfdNre and Business Regutaticn 10 Park Plaza-Sutta 6170 Boston,MA 02116 �v;ld utsignature ttWhnall.google.canhnalULOMnbmd15Ad3e063bdB413?projector=l 1n DATE(MM/DDIYYYY) A�o® 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 CONTACT NAME: Arthur J.Gallagher&Co. PHONE 415-546 9300 AX No):415-536-8499 Insurance Brokers of CA. Inc. License#0726293 AC E-MAINo.LExti: 1255 Battery Street#450 ADDRESS: San Francisco CA 94111 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A;Zurich American Insurance Company 16535 INSURED SUNRINC-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. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM LICY EFF POLICY EXP LTR/DD/YYYY MM DD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY LA18CGL2303211C 10/12018 10/12019 EACH OCCURRENCE $1,000,000 DAMAGE TO RENT D CLAIMS-MADE 1XI OCCUR PREMISES Ea occurrence $1,000,000 X $50,000Retenton MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY ]JE 0 F LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: Total Policy Limit $10,000,000 A AUTOMOBILE LIABILITY BAP915542505 10/12018 10/12019 COMBINED SINGLE LIMIT $2000000 Ea accident 1X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WC013696004 10/12018 10/12019 X STATUTE ERH A AND EMPLOYERS'LIABILITY Y/N WC01'96104 10/12018 10/12019 ANYPROPRIETOR/PARTNER/EXECUTIVE r—yN/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 0 y ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Aa CERTIFICATE OF LIABILITY INSURANCE 2/22018 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: N the cortificate 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). PRODUCER Norwell Risk south Eastern Insurance Group LLC 77 ]accord Park Drive Unit B7 cOVERAqE Norwell Kh 02061 Commerce 2nSUX&0ce COMILRY ENSURED rAume3hrch Insurance Group, Inc. Graham Waste Services Inc RC: 215 Chief Justice Cushing Rwy INSURER 0; Cohasset NI► 02025 1 INSURER P! COVERAGES CERTIFICATE NUMBER:17-15 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 VMMCH 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. MR TYPE OF NWJ ANCE 1111JOR POLICY NUMBER A&MM&K LOM GENERAL UAMRnY EACH OCCURRENCE $ 1000000 DAVASE TU RENI ED X CelaIERCIAL GENERAL LvmLrn, o i 100,000 CLAIMS-MADE FOOCCUR 4/31/2017 2/31/201* MED EXP aM : 5000 t AM INJURY 100000 GENERAL AGGREGATE $ 200000 GEWL AGGREGATE LOW APPLIES PER: PRODUCTS.COMPro►AGG i Included X I POLICY 3114"Lau = AUTOMOIR.E UAIIRM dd.. O 0 ANY AUTO SO LY wURY MW P«.anl $ AALLOWNED UT x SCHEDULED 11=11 JU 2/31/2017 2/31/2010 DOOLYINRY(Petaodow) f x. AUTOO HUED AUT08 x i cam f 31,000 iUMBRELLA LIM OCCUR EACII OCCURRENCE 51000,000 gxcenLIAs CL*A44AAM LX10012400 AGGREGATE f 51000,000 Z 10,00 2/31/2017 2/31/2010 t RlaRs COIMENEATION x x MWWRW LIABILITY PRDrNeETORlPI11NTNMIE%ECTWE Y/ NIAE.L EACH ACCIDENT f 1 00 00 ICCnNAM4WEXCLUDED? L�JI I1t0t0027/01/201* 7/01/2019 pha3Aa I M Nlll EIDISEASE-EAEMPLOYE f 11000,000 V Oaaoee undr E.L.OIEEASE•POLICY LIMIT, 11000,000 OFI T DESCRIPTION OF OPERATIONS I LOCATIONS I VEINCI Ee(Athd3%CORO lot."tele 3N Ramrka s3M3ad334.I Stere epee Is re**M► CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE MU MATN)N DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Sun Run Solar 77S Piero Lane Suite 200 AUTMORi>SDREPIIEeENTATNE San Luis Obisipo, CA John ICoegel/11PONSR ACORD 25(2010105) 011189-2010 ACORD CORPORATION. All rights reserved. IN902S37ntnncim The arnan name enel Irwin er&ranie4eroro merit*of ar:rian ,4co v' CERTIFICATE OF LIABILITY INSURANCEM*Mpul ooff" 06t2W2018 THIS CWTFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO JUGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEN, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT "N THE ISSUING INSURER(S� AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: M the certificate holder Is an ADDITIONAL INSURED,the poiioy(ies)must be reed If SUBROGATION IS WANED,s s*d to the terms and conditions of the poky,certain policies may require on endorsement. A sts I ret on this c*rd ats does not confer rights to the certill"te holder In lieu of such e s Paooucue WASLLA SANTOS FOCUS INSURANCE PLUS INC 97a-34444000 978.703.0062 271 HIGH ST UNIT B LOWELL,MA 01852 AprOq DDy�IypE NAIL s sNININtERA; WESWORLD INSURANCE CPAMPANY 113196 mwMEo Daum a: ARBELLA OTECTION INSURANCE EVOLUTION ROOFING CORP DIwm c: NAUTILIU 14SURANCE COMPANY 17370 206 PRATT AVENUE.APT Ni RSKWAut 0: AMGUARO INSURANCE CO LOWELL MA,01851 E: I F: COVERAGES CERTIFICATE NUMBER: I REVISION NUMBER: THS is TO COW"THAT THE P==8 OF MJR ANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NA IED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIR111MENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH MEIPECT TO WHCH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES SCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCIEL U ITS SHOWN MAY HAVE BEEN REDUCED BY P CLAIMS. am IYPa OF POLICY NtINNOR MUM LAM es►mw.UAWurY &4c"oowwmkf 1,000.000 X COMMOWW OE NEM IJAswm f 100100 CLAaAiMnQ N7 OCCUR MoD DIF ew IS 3,000 NPP8524030 05/1712018 712019 PEPOOKOL&ADV INANIT f 1,000,000 ofAIDnALAsataGATE f 2.000.000 6MAGOINIMULASTAPPUESPDC PRODUCTS-00M/APA00 f X M= Lor IS AUr00101I E UAas_mr ANY Aura eaolLY s1JunY lP«pwai S100-OW ALLOYMM X 1010074408 08M U2018 11/2019 GODLY rAANRv IP.r«M+rq s 300.000 NiTas Ix "WID AUTOS X AUTOS f 100,000 X Vvww.L^L" , N UMAENCE _ S WO MLUMM H� ANOM75 0810612018 1712019 AOWnEOATE f 3,000.000 f 3.000AW WroESEales oorraREATtoNarias _ AND MMMOVERa'UA§LlrY ANY PRo1rSETO IWEXECUIIVE Y N E1 EACH ACC10aNIT s 1.000.000 oR"cat"D fD1 1lOt N NIA 117110 06/2512018 06/28/2019 p�N,y�NIO E.L.ONIiASE-EA tIMPU)Ya f 1.000.000 s + � 1,000.000 E.4 EIISEAfE•POLICY tarn f DEBCR WM N OF OPIR YMO 1 LOCATIOW I VENIt S(ARwN A0008 tel.Ar/Mk1 A I Mwb t.E MM"b"19 MWAM4 CERTIFICATE HOLDER CANCELLATIONII SHOULD ANY OFTIE ABOVE DESCRIBED POLICIES BE CANCELLI BEFORE THE EXPIRATiON DATE THEREOF. NOTICE WILL BE DELIVERED IN SUNRUN ISTALLATION SERVICE ACCORDANCE WI iH THE POLICY PROVISIONS- 734 FOREST ST SUITE 400 AU"1001 c RSIM ESFNTA71VE MARIMRUGI 1.MA 044162 ACORD 23(2010105) A 1P8 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1