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32C-057
BP-2022-0154 20 HAMPTON AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32C-057-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2022-0154 PERMISSIONIS HEREBY GRANTED TO: Project# WINDOW/DOOR Contractor: License: SAMBRICO LLC DBA VISTA HOME Est. Cost: 292275 IMPROVEMENT 111478 Const.Class: Exp.Date:01/21/2023 HAMPTON HOUSING ASSOCIATES LIMITED Use Group: Owner: PARTNERSHIP Lot Size (sq.ft.) SAMBRICO LLC DBA VISTA HOME Zoning: CB Applicant: IMPROVEMENT Applicant Address Phone: Insurance: 2097 RIVERDALE ST 413-382-0249 UB-2E072183-21 W SPRINGFIELD, MA 01089 ISSUED ON:02/22/2022 TO PERFORM THE FOLLOWING WORK: 177 REPLACEMENT DH WINDOWS, 3 PICTURE WINDOW, 77 PATIO DOORS, 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: Gas: Final: Final: Rough Frame: Rough: Fire Department Driveway Final: Fireplace/Chimney: Final: Oil: Insulation: • Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: i Q �� : • Fees Paid: $2,071.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner File #BP-2022-0154 APPLICANT/CONTACT PERSON:SAMBRICO LLC DBA VISTA HOME IMPROVEMENT 2097 RI VERDALE ST W SPRINGFIELD, MA 01089 4 1 3-3 82-0249 PROPERTY LOCATION 125 PLEASANT ST MAP:LOT 32C-057-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $2,071.00 . Type of Construction: 177 REPLACEMENT DH WINDOWS, 3 PICTURE WINDOW, 77 PATIO DOORS, New Construction Non Structural Renovations n Addition to Existing O r J Accessory Structure �( Building Plans Included: Owner/ StatementorLicense 3 sets of Plans/Plot Plan THISFOLLOW ING GACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN ORMATION PRESENTED: Approved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan MajorProject: Site Plan AND/OR SpecialPennit 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 I ft.; i n b , 1 // li • - /1 I/ova, Sign ture of Building Official i 10 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 Of ice of Planning&Development for more information. r The Commonwealth of Massachiiise is F E B 1 6 2022 I Office of Public Safety and Inspectior4 Massachusetts State Building Code(780 CM ) DF0T OF eAl. ID ,,ire C rio Building Permit Application for any Building other than a One+-o TMA"Family W /� (This Section For Official Use Only) Building Permit Numberi3 ' / e Applied: Building Official: / rp NI SECTION 1:LOCATION arty ..'' fir 0 Mil No.and Street City /T��r ry �j Zip Code OtDUO Name of Building(if applicable) Assessors Map# Block#and/or Lot # SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building 0 Repair 0 Alteration ❑ Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other Specify: 0 { Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No 0 Is an Independent Structural Engineerin Peer Review required? _ �/V Yes 0 N Brief Description of Proposed Work: � "1 r t Q rY P'Q( Ve.',4 ,�a� ill�" b . P1Cfl1 rt inl\exclnu/S "'fit) S pa"ti P al-to o doors , 1 . 2 p a.•,el 3 e AriS SECTION 3:COMPLETE THIS S TION IF E TING BUILDING UNDERGOING RENOVATION A. ITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) Total Area(sq.ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business 0 E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-1 ❑ I-2 0 I-3 0 I-4 0 M: Mercantile 0 R: Residential R-10 R-2 lY R-3 0 R-4 0 S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA 0 IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ IV CI VA VB SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: A trench will not be Licensed Disposal Site 0 Public 0 Check if outside Flood Zone 0 Indicate municipal 0 required 0 or trench or specify: Private 0 or indentify Zone: or on site system 0 permit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable 0 Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed❑ Yes 0 or No 0 Yes 0 No 0 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner \weh\ .V0 c O 1o(00 Name(Print) L. No.and Street City/Town Zip \ ccZ\kO5 C.. C C.\\L) Property Owner Contact Informa on: foQv D 0, 9 -536-Ooat) _ - \10S \1 b5..\(wctv,@ Aouut itle Telephone No.(business) Telephone No. (cell) e-mail address • C CiP If applicable,the property owner hereby authorizes: annbr►c6 Lt_c, aan Qu-c-tau, P,-. LJ.R.s4- Seco. i4 0/6F? Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here❑. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor \mbri co 791 V 15rt \off 1(Ylrv-e..me nfi ompany Name tan fUdit C - III (f1 3 " CS L Name of Person Re Responsible for Construction j License No. and Type if Applicable 045 611 1�--+v`�- ll- t3L St)nnS-CA QX 1i1 A 016 2S- Street Address City/Town State Zip 41 cati 9,511 413 I 1 y 6 I ith A V 1 M eta home 1m v attn t. t b'v, Telephone No.(business) Telephone No. (cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of e • suance of the building permit. Is a signed Affidavit submitted with this application? Ye No 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT EE Item Estimated Costs: (Labor and Materials) ppyy0 Total Construction Cost(from Item 6)=$ 1.Building 91 a 7 0 5. Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate municipal�c or)=$ 3.Plumbing $ G1 4.Mechanical (HVAC) $ Note:Minimum fee=$ I (contact municipality) 5.Mechanical (Other) $ Enclose check payable to �/'U "' 6.Total Cost a 1 a i� , bt (contact municipality)and write check number here ir SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this a lication is true and accurate to the best of my knowledge and understanding. i :s., 1 t q5cfn MWvr Ile &CYVIca VinnotiA c`k 4''' 31ba3%1 94 ti I 2a C t, 9trilantsraimat5TrVvprt. nTiitle01013 g e Telehono.vt5 Date ,c_ Street Address City/Town State Zip Email Address ( Q-ov`{m .F-. f IT1, = a/99./9 , Ct Municipal Inspector to fill out this section upon application approval: I D' Nameate 1.. The C'anrnrontsealth of.u%sltchusetts la�; • r Department of Industrial Accidents 1 Congress Street,Suite 100 J1 Boston,MA 02114-2017 wwltamus's.gnv/dia 'ti t.vkcrs'('ompetrwtion losowwww Alfldavlt:BuildrridContractursfEkctricians,''i'Iuinhers. TO BE FILED WITN THE PE:RMITfl!ti(:At'"171tiRIII. Applicant Information Please Print Eceibh Name(13usincss t irh:anwatiun'individttall: 1\11 S� 4 � `ep r o, /' - Addres4J3Q'1 12.1V e "C C.t VC_ CityfStateziM 1 M A ado, Phone#:J`"'1 te6) 9-8p� 0(aq `-4 Are yell MS esrplloyee Cheek the s inprrprtste how Tw prof project(required): 1.❑lam a cngaunytr Kids riip,la+y.c (lull andtM part-unmet.• 7" 0 New t:tittstrtuuatn 2C1 1 airs a'a;k pnlpiscrtar in p iericr.nf"lnla and has.c au.einplsrtiet's wurklrag tar pia.ata K. 0 ReinUllehnl airs capacity. rut,wioilers'civilla.u4sutnncc icyna:col.J 9. ❑ Demolition 30 I am a luaeffiaiai9aLf tlktmg all murk myself II.'du*osiers'comp insurance nsyuncrl.l 10❑ 13ui1ding addition 4.0 1 our a lluilk,srntier and%dl be hunt etudits:Aar.to rtanduct all"sunk on ms prtis rty. I w til ensure that all carrra:tun other tuts yieekets"ewnnens aissni usruranu:ant are sine 11.0 Electrical rc^p ttr ter additions prcrtxaettles wtth n o evnpluyces. ,,,,,,,,���-yyy;;; 12.0 Plumbing repairs or additions ,�I an4 a eneral cuntractur and I kaur land the cob-cwtuactors Limed sin iI Ntac$rrrl Aker. . 13❑Roof oit'mtetc„ laesc sari-cuntracwri haw onplr,wcrs anti Noe"sinkers'camp.ussuramuct ttOther t4.0 144e arc a comas:shim and its officers ias c eatc-renied their pall tat then,+uts per!Wit r. 14. I42. •Ii 41:and we hasc nu crtyahsyees.L u workers'comp.asurance required" t °Ain applicant that checks Ixn rI rust also rill out the set tluur WOW sttuovtmg her workers'conspcnsatiun pert initurntahon ° I hintuuw tiros who sut*anat this:striation uwhr.atinrr Miry are thorny all work and then Insu twtasidc contractors mine sutmtit a trews atfut.i rt ntitltc:tit ar suet s,ntractors that chccds tits but must att:aclaud an auhuonal shut shuwsing the mom 01 du sttt+ actors anti slur wtau tier cot mot Music cittattc,hare csiiploy ccs. II the mute contractors tour c-lr.l:Ay ties.daf.-u nuns pros ldl'acts workers'asap.potic,number I ain an employer that is providing workers'compensation insurance for my employees. Below is the policy and Jab cite information. Insurance Company Name: Policy#or Self-ills.Lic.#: y�� Epiration Date: lob She Atddres2O H(' ir }1 lA , " --C ^State' Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration dote).Ot` ILO Failure to secure coverage as required under MGL c. 152,(125A 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 ferns of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement nray be forty artkd to the Mice ice of Investigations of the DIA for insurance coverage verification. I do hereby tlfjr under the pain ties ofeerjury that the information provided above is true awaicorrect Signature � C'—.� !)ate: - -a / / U 1 Phone P: / I • J / U - _3, / Official use only Do not write In this area,to be completed by city or town official ('itsi or Town: Permitll.icensr# Issuing:tuthorit, (circle one): I. Board of health 2. Building Department 3.('ilsfl"uunn Clerk 4.Electrical Inspector 5. Plumbing Inspector ta,Oilier t onlact Person: Phone##: CITY OF NORTHAMPTON SETBACK PLAN 0- MAP: LOT: LOT SIZE: REAR LOT DIMENSION: REAR YARD SIDE YARD SIDE YARD FRONT SETBACK FRONTAGE City of Northampton f,f"' Massachusetts �,,s :. t W DEPARTMENT OF BUILDING INSPECTIONS i 212 Main Street • Municipal Building vti 1� Northampton, MA 01060 ,:NV �`-o CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 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 MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: I 1-e 'n P---41- , �'� i (� 0'�-Q'6.3. Y The debris will be transported by: --ii �� a Name of Hauler: ()USA- ---1 -`t r--CL, cittAA .3 Signature of Applicant: titctle, Date: L//c 'tooZ Initial Construction Control Document ) To be submitted with the building permit application by a \\\ / Registered Design Professional for work per the ninth edition of the .0:4 to Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Date: al L.;\ Property Address: 9.3 \(\;\riQ -ir' G r vt-a , Orr- CI Of0() Project: Check(x) one or both as applicable: New construction Ficieting Construction)C Project description: Pala cjo g27/1 eCL 1 MA Registration Number: Expiration date: ,am a registered design professional,and I have prepared or directly supervised the preparation of all design pLrns,computations and specifications concerning1: Architectural Structural Mechanical Fire Protection Electrical 'i Other: for the above named project and that to the best of my knowledge, information, and belief such plans„ computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,,I shall submit field/progress reports(see item 3.)together with pertinent comments,, in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a 'Final Construction Control Document'. Enter in the space to the right a"wet" or / / electronic signature and seal: Phone number: ,D1 Email: -)vu 1,(•-k.P)\',10 Q.A-\--‘ c et-- Building Official Use Only Building Official Name: Permit No4 Date: Note 1.Indicate with an'7,e."project design plans„computations and specifications that you prepared or directly supervised If'other'is chosen,provide a description. Version.01_01_2018 Appendix,1 Construction Documents are required for structures that must comply with 780 CMR 107. The checklist below is a compilation of the documents that may be required. The applicant shall fill out the checklist and provide the contact information of the registered professionals responsible for the documents. This appendix is to be submitted with the building permit application. Checklist for Construction Documents* Mark"x"where applicable No. Item Submitted Incomplete Not Required 1 Architectural 2 Foundation 3 Structural 4 Fire Suppression 5 Fire Alarm(may require repeaters) 6 HVAC 7 Electrical 8 Plumbing(include local connections) 9 Gas(Natural,Propane,Medical or other) 10 Surveyed Site Plan(Utilities,Wetland,etc.) 11 Specifications 12 Structural Peer Review 13 Structural Tests&Inspections Program 14 Fire Protection Narrative Report 15 Existing Building Survey/Investigation 16 Energy Conservation Report 17 Architectural Access Review(521 CMR) 18 Workers Compensation Insurance f 19 Hazardous Material Mitigation Documentation 20 Other(Specify) 21 Other(Specify) 22 Other(Specify) *Areas of Design or Construction for which plans are not complete at the time of application submittal must be identified herein.Work so identified must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the authority having jurisdiction. Registered Professional Contact Information Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date Name(Registrant) Telephone No. e-mail address Registration N umber Street Address City/Town State Zip Discipline Expiration Date Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date Please follow this link for construction control forms to be used by Registered Design Professionals. AccoRD CERTIFICATE OF LIABILITY INSURANCE DATE(MMDD/Y YY) 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 David R Jerry Neill&Neill Insurance Agency Inc PHONE 413-7324137 FAX 413-7316629 662 Riverdale Street (A/C.No.EMI: MC,No): West Springfield,MA 01089 E-MAIL ADDRESS: dj@neillandneill.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Western World Insurance Co. 13196 INSURED Vladimir Duducal INSURERS: Chubb chu V&D Home Improvement 776 North West Street INSURER C: Feeding Hills,MA 01030 INSURER D: 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 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 SUER LTR TYPE OF INSURANCE JNSD WVD, POLICY NUMBER POLICY YT POLICY EXP A V COMMERCIAL GENERAL LIABILITY (M/10/2 21 (0/10pIYYYYI LIMITS NPP8747203 10/10/2021 10/10/2022 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100,000 CLAIMS-MADE V OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 5,000 PERSONAL&ADVINJURY $ 1,000,000 GEN'LVIR - POLICY AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 ! CT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO _ BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY )AUTOS ONLY AUTOS (Per accident $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAB OCCUR — EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ _ $ B WORKERS COMPENSATION 6S62UB-1K95803 04/11/2021 04/11/2022PER AND EMPLOYERS'LIABILITY Y/N V I STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? 1-7N/A E.L.EACH ACCIDENT $ 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 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) allysonc@vistahomeimprovement.com CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAT•N DATE THEREOF, NOTICE WILL BE DELIVERED IN VISTA HOME IMPROVEMENT ACCORDANC• 'TH THE POLICY PROVISIONS. 1346 ELM STREET WEST SPRINGFIELD,MA 01089 AUTHORIZED-E-A. ' AVE 1 .01'1 • a I ©1988-2015 ACORD CORPORAT . All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD A DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 05/28/2021 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 David R Jarry Neill&Neill Insurance Agency Inc PHONE FAX 662 Riverdale Street (A'C.No,Est): 413-732 4137 (A/C Nor 413-731 6829 West Springfield,MA 01089 ADDRESS: dj@neillandneill.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Western World Insurance Co. 13196 INSURED New England Home Improvement INSURER B: Chubb Insurance Co CHU 43 Booth Road Enfield,CT 06082 INSURER C: INSURER D: 1 INSURER E: INSURER F: I 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 EFF POLICY EXP LIMITS LTR ,INSQ_WVD POLICY NUMBER IMMIDDIYYYYI IMMIDD/YYYY) A J COMMERCIAL GENERAL LIABILITY NPP8745978 05/26/2021 05/26/2022 EACH OCCURRENCE $ 300,000 DAMAGE TO RENTED CLAIMS-MADE Iv OCCUR PREMISES Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 300,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 600,000 VPOLICY { I PRO-jE LOC PRODUCTS-COMP/OP AGG $ 300,000 II OTHER: _ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accidentl ANY AUTO BODILY INJURY(Per person) $ — OWNED r SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) S UMBRELLA LIAB _ OCCUR ' EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION 6S62UB-9F68699-6 �05/06/2021 05/06/2022 STATUTE ER AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? n N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under 500,000 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 requlred) Emailed to:cassied@vistahomeimprovement.com CERTIFICATE HOLDER CANCELLATION VISTA HOME IMPROVEMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2097 RIVERDALE STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN WEST SPRINGFIELD,MA 01089 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESeNTAtIVE t �' i . 4 .. - C 8-101 O •Ir• 1.-Alil rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC SAMBRICO LLC Registration: 162058 Expiration: 01/02/2023 D/B/A VISTA HOME IMPROVEMENT 2097 RIVERDALE ST WEST SPRINGFIELD, MA 01089 Update Address and Return Card. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:LLC before the expiration date. If found return to: Registration gxuiratiort Office of Consumer Affairs and Business Regulation 162058 01/02/2023 1000 Washington Street -Suite 710 SAMBRICO LLC Boston,MA 02118 D/B/A VISTA HOME IMPROVEMENT BRIAN RUDD 2097 RIVERDALE ST WEST SPRINGFIELD,MA 01089 Undersecretary Not valid without signature ,` ,.. ' 1 ' ' 0111r t' . Ith of Massachusetts Division of Professional Licensure Etc :: . ,' Building Regulations and Standards \ t III ConstrttetfithiSt)Orvisor __CS- 11147a. 01 /21 / 2023 ANRUDO 7,-*, flasamo In COYOTE C CIRCLE 0 -'- -..„FEEDING HILLS MA 01030 ,4,4 t .'4.1*‘%.,.. v . , 4 4.-A , \ '"/Vh' 41 • i ' SS11:1° Commissioner • * Tr, . j I -- SERVICE AGREEMENT This Agreement is made as of the 13th day of October 21121, by and between Federal Management Co., Inc., a Massachusetts corporation(hereinafter referred to as"Agent"),acting as agent for Hampton Housing Associates(hereinafter referred to as"Owner"),and Sambrico LLC dba Vita Home Improsement. (hereinafter referred to as"Contractor"or"Vendor"). In consideration of the mutual covenants hereinafter contained,the parties hereto agree as follows: 1. APPOINTMENT Agent appoints Contractor to perform certain services,as hereinafter set forth, at the Premises as defined in Section 2 and Contractor accepts said appointment,all subject to the terms and conditions set forth in this Agreement. 2. THE PREMISES The Premises referred to in this Agreement consist of Hampton Court :apartments,20 Hampton Uenuc, Northampton, Ma 01060. Contractor at all times shall keep the Premises free from accumulation of waste materials or rubbish caused by its operations. Upon the completion of its work hereunder,Contractor shall promptly remove from the Premises all tools,equipment and surplus materials belonging to Contractor or any of its employees. 3. DUTIES OF CONTRACTOR The duties of Contractor under this Agreement shall consist of w indow replacement sere ices. see attached outline of scope of work in accordance with the specifications attached hereto as 1:‘Whit A and made a part hereof. All services to be furnished hereunder shall be performed in a good and workmanlike manner in accordance with the requirements of applicable law to a standard equal to or exceeding the standards of the window replacement industr in the State of Massachusetts region, and shall be performed by appropriately trained and skilled personnel. In particular,Contractor shall pay all sales, use and similar taxes applicable to its services hereunder and shall secure at its expense any permits, licenses or inspections necessary for the proper execution and completion of said services. Where available, Contractors shall provide cost and benefit information to the Agent for more efficient, less toxic,or otherwise environmentally preferable product and service alternatives. 4. EMPLOYEES Contractor may at its discretion and under its supervision, hire such employees as may be required in order to carry out Contractor's obligations under this Agreement. Contractor shall at all times enforce strict discipline and good order among its employees and shall not employ on the Premises any person not properly skilled in the task assigned to him or her. It shall be Contractor's responsibility to provide and pay for all labor, materials,equipment,tools,machinery and other facilities necessary with respect to its services hereunder,except for such materials and equipment that are the responsibility of the Owner to provide as expressly set forth in F:shihit II.Contractor will be solely responsible for all costs associated with its employees' taxes, sick time, vacations, workers compensation insurance, benefits, personal time, uniforms,and training. The parties acknowledge that Contractor is an independent contractor. Contractor warrants and represents that is has complied, and agrees that it will continue to comply, with all federal, state and local laws regarding business permits and licenses that may be required for it to perform the work under this Agreement. Neither Contractor nor its employees are eligible to participate,and shall not participate, in any of Owner's or Agent's pension, health or other benefit plans, if any. 5. COMPENSATION Contractor shall submit invoices to Agent setting forth the specific services performed under this Agreement during the applicable billing period, including the dates and such other detail as Agent may request. Owner shall pay Contractor for services rendered at the rates set forth in Exhibit 13, attached hereto and made a part hereof, as compensation in full for, and following the satisfactory completion of, its services hereunder. 6. INDEMNITY The Contractor agrees to indemnify, save harmless,and defend Owner and Agent,their agents, servants,and employees,and hold it and them harmless from any and all lawsuits,claims, demands, liabilities, losses and expenses, including court costs and attorneys' fees, for or on account of any injury to any person,or any death at any time resulting from such injury,or any damage to any property, which may arise or which may be alleged to have arisen out of or in connection with the work covered by this contract or Contractor's failure to comply with its obligations hereunder. 7. INSURANCE Contractor shall, upon notice from Agent or any designated insurance representative of Agent, maintain such amount and type of insurance as Agent or such representative may reasonably stipulate, including without limitation coverage as set forth in Exhibit C of this document,attached hereto and made a part hereof. 8. WARRANTY Contractor shall promptly correct any work performed hereunder which fails to conform to the requirements of this Agreement so long as Contractor is notified thereof within a period of three business days following the completion of its services hereunder or within such longer period of time as may be prescribed by law. 9. NOTICES All notices required or permitted to be given hereunder shall be in writing and shall be hand delivered or sent by certified mail addressed to Contractor at \ ista Home l mpro ement. 2097 Rix erdalt. Road. %%est Springfield, \la 01 109 Brian Rudd. And to Agent at 536 Granite Street, suite 301, Braintree Ma 02184, Attention: Peter Lewis,or to such other address of which either party has duly notified the other. I O. TERMINATION AND REMEDIES This Agreement shall terminate automatically on June 311. 2022, unless extended by the parties in writing. 2 If Contractor shall fail to perform its duties under this Agreement, Agent may terminate this Agreement by notice to Contractor, specifying in reasonable detail the respects in which Contractor shall have failed to perform its duties and designating a date not less than five(5)days after the giving of such notice on which this Agreement shall terminate. Any such termination shall be without prejudice to all other remedies available to Agent. If Contractor shall fail to perform its duties under this Agreement, Agent shall have the right to procure substitute service provider without prior notice to Contractor. Contractor shall be liable to Agent for any and all damages resulting from any such failure to perform, including but not limited to any costs incurred by Agent for such substitute services in excess of the amounts that would have been earned by Contractor hereunder for the same services. II. DISPUTE RESOLUTION At the sole option of Agent,any controversy,dispute or claim between Contractor and Agent related in any way to this Agreement or the Premises may be determined by a separate action in court or by a separate arbitration in accordance with the Commercial Arbitration Rules of the American Arbitration Association then pertaining, including its rules for Expedited Arbitration whenever available, whichever the Agent may elect in its sole discretion. Any award rendered by the arbitrator or arbitrators shall be final and judgment may be entered upon it in accordance with the applicable law in any court having jurisdiction. 12. MISCELLANEOUS a. This Agreement constitutes the entire agreement between and shall be binding upon the parties hereto and their successors and assigns, provided,however,that this Agreement may not be assigned by Contractor without the prior written consent of Agent. This Agreement may not be changed orally, but only in writing signed by the party to be charged thereby. b. The waiver by either party of a breach of any provision of this Agreement shall not operate, or be construed,as a waiver of any subsequent breach. c. This Agreement may be executed in two or more counterparts,each of which shall be deemed an original but all of which together shall constitute one and the same instrument. d. This Agreement shall be governed by and construed and enforced in accordance with the law of the State of Massachusetts without regard to its conflict of laws principles. e. The headings have been inserted for convenience only and are not to be considered when interpreting the provisions of this Agreement. f. Be aware all of the Schochet Companies and Federal Management Co., Inc properties are SMOKE FREE which will be enforced. If your employees is found to be smoking on the property the employee will be removed from the property. 3 •t s edera)Nlan4ger. -Ql9ttaUy l99tzed by Peter Lewis Peter Lewts Date:2021.1 1.04 H' `t:r o- 17:19.02•04'00' Peter Digitally signed by Peter Lewis Date:2021.11.17 Lewis 16:08:14-05'00' EXHIBIT A Input scope of work,Description of work and attach the proposal from the contractor 1 • , . ''' ,.,,, is a HOME IMPROVEMENT U� EXTERIORp E RI_ Ips DOORS GUTTERS ROOFING BATHROOMS SIDING DECKING WINDOWS SUNROOMS III MO ! t 1, 4 -'1:1 ' Ilk k., ' . IIII II ESTIMATE PREPARED EXCLUSIVELY FOR: Hampton Court Apartments 20 Hampton Ave Northampton ma 0': USA COVERING MA, CT, SOUTHERN VT AND SOUTHERN NH 1.888.597.2323 VISTAHOMEIMPROVEMENT.COM �E?_°-�:,�FF ` AMP 3 ' BBB FULLY LICENSED • FULLY INSURED R ACCREDITED ik/40ESTIMATE DETAILS Vista Home Improvement will supply 170 - 42" x 63" Double hung Windows 7 — 30" x 48 " Double hung Windows 3 — 40" x 38" Picture Windows 70 — 3 panel Patio doors 107" x 80" 7-2 Panel patio doors 60" x 80 All white on white with half screens in the windows and full sliding screen for the patio doors . All windows will have Vent latches . Free screen Replacement Free Glass Replacement Lifetime Service Warranty Total Price $292.275.00 WEL ADMIRALS (ireenSic ' ., Dtsc CASH/CHECKS WELCOME FAR(; -�--- BANK " .,...�� 100%FINANCING AVAILABLE COVERING MA, CT, SOUTHERN VT AND SOUTHERN NH elk 1.888.597.2323 VISTAHOMEIMPROVEMENT.COM �t S'FF Mr EPA BBB FULLY LICENSED • FULLY INSURED ACCREDITED ESTIMATE DETAILS Scope of Work 1: Building permit and fees are included 2: Disposal is included—we will place a dumpster on site 3: Storage container on site for materials 4: New interior stops not painted 5: exterior caulking and capping if needed color TBD W}LI ADMIRALS riI"� (;retnSk‘ VISA •�srerc. p ,rye CASH/CHECKS WELCOME FARG:; -BANK �°.- • ,,,.�� ter' 100%FINANCING AVAILABLE COVERING MA, CT, SOUTHERN VT AND SOUTHERN NH 1.888.597.2323 VISTAHOMEIMPROVEMENT.COM _ BEPJA FULLY LICENSED • FULLY INSURED �'Fi fii F ccat_:,tc EXHIBIT B SCHEDULE OF RATES A. Pricing ++ • Total cost of project: tit i • 1/3 due upon acceptance to be considered initial deposit: �~ $97,425.00 • 1/3 due uponproject commencement: -?fir. - $i 1 4,2 5 . �J • Final 1 t 3 due upon project completion: - • State and local taxes not included and will be added if applicable Digitally signed B. Peter by Peter Lewis Supplies Date: Lewis 211 6:os:a5 6:08:45 0 7 soo Agent will supply electric, , for use by Contractor. Contractor will supply all r other supplies,equipment and materials for performance of the services. 2 Contractor will use only supplies,equipment and materials supplied or approved by Owner. EXHIBIT C Vendor/Supplier Insurance Requirements Vendor shall procure at Vendor's expense and maintain with respect to and for the duration of this Contract,the Insurance policies described below with reliable, financially sound Insurers with an AM Best rating of not less than A-and with policy limits not less than those indicated. Vendor shall immediately notify its'underwriters and shall furnish all necessary information concerning any occurrence which may give rise to a claim under any of the insurance policies described below. None of such Insurance shall be cancelled,materially altered or amended without 30 days prior written notice having been furnished to Peter Lewis, Federal Management Co., Inc., 536 Granite Street suite 301, Braintree ma. 02184. Vendor agrees to have its insurance carrier(s)furnish to Federal Management Co., Inc., Schochet Associates,The Schochet Companies and Hampton Housing Associates an Acord form or similar Certificate(s)evidencing insurance coverage in accordance with the requirements set forth herein. The acceptance of a Certificate with less than the required amounts shall not be deemed a waiver of these requirements. Each applicable insurance policy shall contain an endorsement naming verbatim the following as additional insureds with respect to the performance of this Contract: Federal Management Co., Inc. Schochet Associates The Schochet Companies Hampton Housing Associates Specifically,the wording of the endorsement must name all of the foregoing as additional insureds as respects any liability arising out of Vendor's work whether such work be by or for Vendor. ISO Form CG2010(Additional Insured-Owners, Lessees or Contractors),or its equivalent, is acceptable. Alternatively, ISO Form CG2026(Designated Person or Organization)may be used. 1. Workers Compensation Insurance in full compliance with all applicable State and Federal laws and regulations. Such insurance shall be endorsed to include Employers Liability with minimum limits of$500,000 by accident and $500,000 policy limit. 2. Commercial General Liability Insurance with minimum limits of$1,000,000 per occurrence and$2,000,000 in the aggregate for Bodily Injury and Property Damage to include coverage sufficient for the exposures inherent in fulfilling this Contract, including but not limited to Products,Contractual,Advertising and Personal Injury liability. 3. Automobile Liability Insurance covering owned,non-owned, hired and leased automotive equipment with minimum limits of$1,000,000 combined single limit per accident for Bodily Injury and/or Property Damage. 4. Umbrella/Excess Liability Insurance with minimum limits of$5,000,000 each occurrence/aggregate to be in excess of Employers Liability,Commercial General Liability, Automobile Liability and other such insurance coverage as may be mutually agreed. Such insurance shall be"following form"of the underlying insurance. 1 Vendor agrees to waive subrogation against Federal Management Co., Inc. Schochet Associates, Inc., The Schochet Companies and Owner,their agents,employees, subsidiaries and assigns on all liability, Workers Compensation and any other applicable insurance policies, or to obtain such waiver from its insurance carrier if required by the carrier to do so. 2 ACC) CERTIFICATE OF LIABILITY INSURANCE DATE IMMIOD(YYYY 4 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 endorsement(s). PRODUCER CONTACT WM J MIS WILLIAM MISS INSURANCE AGENT PHO NE No,Es!; (413)568.6111 FAX (413)572.9191 156 ELM STREET ADORESS. BILLbBILLMISINSURANCE.COM ADDRE WESTFIELD. MA 01085 INSURERS►AFFORDING COVERAGE NAIC I INSURER A NAUMAS INS 56915 INSURED INSURER 8 SAMBRICONISTA HOME IMPROVEMENT INSURER C INSURER 0 2097 RIVERDALE RD INSURER E WEST SPRINGFIELD,MA 01089 INSURER F• COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE JSTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMEN',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. raft LTTRa C O s POLICY MJ _ryNWpp ullP rrinn 1 LIMITSTYPE OF INSURANCE GENERAL UABRUTY EACH OCCURRENCE S 1,000,000 DAMAGE TGRENTED X CCMME� IM GENERAL LIABILITY PREMISES;Ed oaam-roe) S 100•000 C:A MS-MADE X:OCCUR MED EXP(Any one oenonl 5,000 X X G3679203 08/01/2021 08,0112022 PERSONAL a ADv INJURY s 1,000,000 GENERAL AGGRF ATC_ s 2.000.000 FM1.AGGREGATE UNIT APPLIES PER PRODUCTS..COMP/OP AGG i 2.000,000 X FOLK/ ',ES X LOC S AUTOMOBILE LIABILITY COMBu41O SI ZO. I$T tea x1;34e li i ANYAJTC BOOILY'NJLRY I Pe,persa^t S ALL AUTO ED ASC OLILED 301:WY INJURY II'e-acuaenl! S NON-OWNED TY)ANAGE $tiiRE6 AUTOS NOt S —.------- S X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 5.000,000 X EXCESS LIAR _ CLAIMS-MADE AC-298997 01-28-2021 01-28.2022 AGGREGATc s 5,000.000 oeo X RETENTIONS 10,000 s WORKERS COMPENSATION VIIt STATU- DTI, AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER AV+.MU,RILIUR,PARTVER/EXECUTNE E.L EACH ACCIDENT S OP FI.CERiMEE MBE EXCLUDED/ D N/A (Mandatory M NH) E L OISEA%-EA EMPLOYEE L DESs.CRIPTION OF OPERATIONS below E I DISEASE-POLICY LINT S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarl,a Schedule,if more space u required) Hampton Housing Associates Limited Partnership The Schochet Companies,Federal Management Co.Inc and Schochet Associates are to be named as additional Insured with respects to all operations of the named insured CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Hampton Housing Associates Limited THE EXPIRATION DATE THEREOF_ NOTICE WILL BE DELIVERED IN Partnership The Schochet Companies ACCORDANCE WITH THE POLICY PROVISIONS, Federal Management Co.Inc AUTHORIZED REPRESENTATIVE • and Schochet Associates ACORD 25(2010/05) s 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD i e-nk/l CERTIFICATE OF LIABILITY INSURANCE f DATE(MM/DD/YYYY) ` Mil412021 TI4S.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. 14 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 and endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsementts). PRODUCER CONTACT NAME: SOUTHWICK INS AGENCY INC PHONE FAX P 0 BOX 100 (A/C.No,Ext): (A/C,No): E-MAIL SOUTHWICK,MA 01086 ADDRESS: 28}KC INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: IR.^CV'FLIRS PROPER Pi CASC:AI.fl'COMPANY OF A.MERI( I SAMBRICO LLC DBA VISTA HOME.IMPROVEMENT INSURER B: INSURER C: INSURER D: 2097 RIVERDALE STREET INSURER E: WEST SPRINGFIELD,MA 01089 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. PNSR ADD SUB POLICY£FF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER IMMIDDIYYYY) (Wm IYYYY) UNITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 1 CLAIMS MADE 0 OCCUR PREMISES(Ea occurrence) MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $ El POLICY a PROJECT 0 LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ - SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) .�- NON-OWNED AUTOS PROPERTY DAMAGE $ _ (Per accident) _ UMBRELLA UAB _OCCUR EACH OCCURRENCE $ EXCESS LIAB _CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ • RETENTION $ $ , A WORKER'S COMPENSATION AND y WC STATUTORY OTHER EMPLOYER'S LIABILITY YIN UB-2E072'83.21 03/12/2021 03/12/2022 LIMITS ANY PROPERITORIPARTNER/EXECUTIVE y N/A E.L EACH ACCIDENT r $OFFICERIMEMBER EXCLUDED'? 500,000 (Mandatory in NH) E L DISEASE-EA EMPLOYEE $ 500,000 If yes,desrnbe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 1,000 000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS HIIS REPLACES ANY PRIOR CIiRTIFICArE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE AND SCHOCHET ASSOCIATES CERTIFICATE HOLDER CANCELLATION I IAMP7-ON HOUSING ASSOCIATES LIMITED PARTNERSHIP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED TH}:SCIiCX Ni:T COMPANIES,FEDERAL MANAGEMENT CO.IN BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 HAMPTON AVENUE', AUTHORIZED REPRESENT VE / NORTHAMPTON,MA 01060 �1^-a.c L.e-•--.- ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. All rights reserved.