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30A-081
BP-2022-0440 16 HIGH MEADOW RD COM MONWEALTH OF MASSACHUSETTS Map:Block:Lot: 30A-081-001 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-2022-0440 PERMISSIONISHEREBYGRANTED TO: Project# KITCHEN/BATH RENO Contractor: License: Est. Cost: 310000 THE TUCKER GROUP LLC 107919 Const.Class: Exp.Date:09/24/2023 Use Group: Owner: KELLEY KELLEY, JOHN E & KATRINA FRALICK Lot Size (sq.ft.) Zoning: SR/WSP Applicant: THE TUCKER GROUP LLC Applicant Address Phone: Insurance: 60 SCHOOL ST (413)387-7381 7PJUB-4N82783-2-21 HATFIELD, MA 01038 ISSUED ON:04/28/2022 TO PERFORM THE FOLLOWING WORK: KITCHEN/BATH RENO 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: I ; s 1 q r I ' I Fees Paid: $2,015.O0 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner ✓ 1, 5 The Commonwealth of Massachusetts// APR 2 6 202 F R 1 ,. Board of Building Regulations and Standards Z `, ,,,, V/ Massachusetts State Building Code,J780'CMP,;; :Hu- NIC ALITY r.,,,v -..,_,� I/SE Building Permit Application To Construct,Repair,Renovate Or�D`etr>bil o*c;po; isecj Mar 2011 One-or Two-Family Dwelling ' ------ it This Section For Official Use Only Buildin Permit Number:Q P. a›— �o Date Applied: l�c-v'i.., ss y-2$ ZOZZ o �l Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: i i 1.2 Assessors Map&Parcel Numbers 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 i Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1, Owner'of Record: A.oNu q i1 tttw P t tL 1v\ )tj, MA o too(c 0 Name(Print) City,State,ZIP tip ill -A tt Wm...) 1U,. 8 5f j- 5 31- 1 I S t, .bot4 ae 1!%t td,lr-y .G$ No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building? Owner-Occupied 0 Repairs(s) 0 Alteration(s) kl Addition 0 Demolition ❑ Accessory Bldg. 0 Number of Units Other 0 Specify:_ Brief Description of Proposed Work2: kl.1'CL k ic,P ,Mo tit I<I't& fSA-r 12e.10w C t, SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 2 5 t) 0oO 1. Building Permit Fee: $ Indicate how fee is determined: I 0 Standard City/Town Application Fee 2.Electrical $ 219(6 819, 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 1 (91(900. 2. Other Fees: $ 4.Mechanical (HVAC) $ 1 ( GOO 9 List: 5.Mechanical (Fire Suppression) $ , Total All Feesii '6 e0 Check No. Check Amount, t 6.Total Project Cost: $ 51 d( OW, 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 'p1 i t A /29 17OL3 l 4vt rj D j i,1,v10 License Number Expiration Date Name of CSL Holder (AOC L ST I List CSL Type(see below) 0 No.and Street d v Type Description 1 _ _Y( R I ` U (� v Unrestricted(Buildings up to 35,000 Cu.ft.) �� R Restricted l&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding ,ff SF Solid Fuel Burning Appliances 413 .36/-13M i-Ow`61e ckbl iktoA t.,(�p1M I —Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) (��2 6127 I zo L1, Ca-a40 1 L,LC IBC Registration Number Expiration Date HIC Company Name or HIC Registrant Name I bu 5Gi4oL 5r• +otk4 to dctc(lµo • (-OA& No.and Street Email address [w, Nlk Olo3S City/Town,State,ZIP Telephone SECTION 6:WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes )11 No .❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize 1 l k, 17IhDl't& to act on my behalf,in all matters relative to work authorized by this building permit application. UAt1 4 612Z Print Owner's Name( lectronic Signature) Date SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. rttkoduk s E. A-9 tva 4 l«l z 1. Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" City of Northampton Ar9A+- ; � Massachusetts to* VA Az DEPARTMENT OF BUILDING INSPECTIONS �. 212 Main Street • Municipal Building 1J Northampton, MA 01060 s1j1+ r)11; 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: The debris will be transported by: Name of Hauler: Di5N5x1, � Z1ilC�� 1 kL bt�6 Signature of Applicant: , � Date: 4110 200, Commonwealth of Massachusetts Division of Professional Licensure Board of Budding R lations and Standards Co . isos S ?07919 Expires:09/2412023 THOMAS DAD UN� 60 SCHOOL STREET , HATFIELD MA,01038 Commissioner 4 " Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC Registration: 179682 THE TUCKER GROUP LLC. Expiration: 08/27/2022 60 SCHOOL ST HATFIELD, MA 01038 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 Expiration Office of Consumer Affairs and Business Regulation 179682 08/27/2022 1000 Washington Street -Suite 710 THE TUCKER GROUP LLC. Boston,MA 02118 THOMAS DADMUN 60 SCHOOL ST z�mGf�oli' HATFIELD, MA 01038 Undersecretary Not valid without signature rt 0 DATE(MMIDD/YYYY) AG Rt CERTIFICATE OF LIABILITY INSURANCE 2022 _ oz/z2/DD/Y 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 Scott King,CIC NAME: King&Cushman Inc. PHONE E N (413)584-5610 FAX NO: (413)584-9322 P.O.Box 447 ADDR sking@kingcushman.com ADaREss: 9@ 176 King Street INSURER(S)AFFORDING COVERAGE NAIC d Northampton MA 01061 INSURER A: National Grange Mutual Insurance Co INSURED INSURER B: The Tucker Group LLC,DBA:Dadmun Design&Construction INSURER C: 60 School St INSURER D: INSURER E: Hatfield MA 01038 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2222204634 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. 1NSR ATYPE OF INSURANCE j p SUER POLICY NUMBER POLICY DIYYYY) (MM DD/YYYY LIMITS LTR INSA,BYO. ( ) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 i tO CLAIMS-MADE X OCCUR PREMISES Eaooccwnence) $ 500,000 MED EXP(Any one person) $ 10,000 A MPT4694Q 11/13/2021 11/13/2022 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JJEECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: FITRV $ 5,000 AUTOMOBILE LIABILITY 'COMBINED SINGLE LIMIT $ (En acadent) ANY AUTO BODILY INJURY(Per person) $ OWNED ----- SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTYOAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAB lt_ OCCUR W EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER AND EMPLOYERS'LIABILITY Y I N STATUTE ERH ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E L,EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED'? (Mandatory In NH) E..L DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts is�. i, Department of Industrial Accidents =_,gin_ . 1 Congress Street,Suite 100 •;=:�:i-_ Boston, .i A 02114-2017 www mass.goti/dia .. '4y`u kern'Compensation Insurance Affidavit: Bu`►IdersiCtintrstctorturEketricianslPlumherx. TO Ht.l IEE:1)WITH`I`li1 PERMl4`l'ING At ITIORITV. toolieattt Information -}- Please Print t.eitihiv Name Hiusincss`fkvaauatiow hniuluat): 1 . eW _ J,c) t L G C Address: (20 SClol. St. City/State'Zip:_ 4-A-1'1 t,9+..�.M A ©I 0_ r,. Phone#: itt 3-b,7-?M5( Are ion an empkryrr?Cheek she appropriate Iws: Type of project(required): 1.0 I am a cnrptoyet with _,,,,employs tfult and or pan-nine)" 7, 0 New Construction 20 i Jul a sole pnaprii+1Or or partnership and have no employers wade fur me in K_ r Remodeling any capacity.No Wtirke rs'comp.imamate rcytatcd_j 9_ $ Demolition 30 I ant a lann earwraer doing all work myself.[No wixkcrx`comp.insurance n-gwxial.l 41.0 I am a homeowner'and will be ostaracxors to ruaducx alt work on myI Building)addition hiring pnaprrty- I will ensure that all conara1ors either hove:workers'eort pensaticm insurance cr are sole I I a Electrical repairs or additions prirysrietors with no employees_ 12_®Plumbing repairs or additions ...S1M 1 am a general contractor and I have hired the aaab-cuntrarwtz hated on the ailadi d sheet. These sub-contractors.hate employers and have vaorkers'comp.itutaranec.; ( I Roof repairs 14_0 Other h.®We are a aarrpoxzdiun and lb officers bait exert-melt their right of exemption per Wit.a. 1$2.§tot l.and we have no a rrtluvecs.[Nu workers`camp.insurance required.) "Any applicant that chocks.Ises.-t must also tell out the srctirt below showing their winters"eamptw aiws policy iritarnuatirn.. 'Homeowners who submit this stfid;aist an.healing they are doing alt work and then his oanide eontrar:tors must submit a now affidavit indicating aaw.h. :Contractors that check this ko.mast arts.he.h an.ablstiunai sheet shcnying the name of the mitrcanaraatyws and state whether or not these entities love rrahlo,,,c>_ It th sub-ecmtraetors lase employees.they latest proside their workers"comp.policy nwnber. i am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site inlarmatiun. Insurance Company Name: - Y114l‘h,l-lciZ;`; Policy#or Self-ins.Lie.#: .W..1.0(5 - 41J b 6 3`i - 2,2- Expiration Date: z/2,4 (2 2...3 lob Site Address: (( (Or (4id to F'D, City/State/ZipCity/StaterZip:,,,,,,,PmtirArtertot OA 0106 o Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to pure coverage as required under M.CiL c_ 152.§25A is a criminal violation punishable by a fine up to SI,500.110 and/or one-year imprisonment,as well as civil penalties in the form ofa STOP WORK ORDER and a tine of up to S250.00 a day against the s iulator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coscrage verification. ... . j I do hereby�certify er the )ns,ond penalties of perjury that the irr,/armaroa,rr hrrrrrided al8aaa s,a,is true att►rf Signature: n,.uv-'2 c• (j C. Date: 'T( '1 ZO L - Phone 4: 4 1 1). .:-1 . 1 b( Official use only: Do nut write in this area,to be completed by city or town official ('its or Town: Permitiiicense# Issuing Authority Icircle one): 1.Board of Health 2. Building Department 3.City,Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone*: of � NOTICE NOTICE TO TO EMPLOYEES EMPLOYEES OEM — Svc` The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS LAFAYETTE CITY CENTER, 2 AVENUE DE LAFAYETTE, BOSTON, MA02111 (617) 727-4900 — www.mass.gov/dia As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I (we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: THE TRAVELERS INSURANCE COMPANIES NAME OF INSURANCE COMPANY P.O. BOX 4614 BUFFALO, NY 14240-4614 ADDRESS OF INSURANCE COMPANY (7PJUB-4N82783-2-22) 02-26-22 TO 02-26-23 POLICY NUMBER EFFECTIVE DATES KING & CUSHMAN INC 95 PIONEER KNLS FLORENCE MA 01062 NAME OF INSURANCE AGENT ADDRESS PHONE # o TUCKER GROUP LLC, THE DBA 60 SCHOOL ST _ DADMUN DESIGN AND CONSTRUCTION HATFIELD MA 01038 EMPLOYER ADDRESS EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS 002715 W20P1G15 TO BE POSTED BY EMPLOYER DADMUN Design + Construction Project Address: SubContractor List 16 High Meadow Rd 4/22/2022 Florence, MA 01062 Subcontractor: Has Employees: Yes No Geryk Plumbing & Heating X James Elkins Electrician X Brian Polan X Powers Air, Inc. X SDL Home Improvement X Northern Granite X Summerlin Flooring X Rightway Drywall X Executive Painting X Cortina Tile X ACo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 05/24/2021 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 Cyndie Henderson CISR,CPIA NAME: Webber&Grinnell PHONE (413)586-0111 FAX (413)586-6481 IA/C,No,Ext): (A/C,No): 8 North King Street ADDRIESS: chenderson@webberandgrinnell.com INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURERA: Citizens Ins America/Hanover 31534 INSURED INSURER B: Allmerica Financial Benefit/Han 41840 John T.Geryk Plumbing&Heating,LLC INSURER C: Massachusetts Bay Ins/Hanover 22306 89 Oak Street INSURER D: INSURER E: Florence MA 01062 I INSURER F: COVERAGES CERTIFICATE NUMBER: Master Exp 11/2021 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 10,000 A ZBNH092909 11/15/2020 11/15/2021 PERSONAL&ADVINJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4'000'000 RO- POLICY 'L LOC PRODUCTS-COMP/OPAGG $ 4,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED X SCHEDULED AWNH9175601 11/15/2020 11/15/2021 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED N/ NON-OWNED PROPERTY DAMAGE $ _ AUTOS ONLY /". AUTOS ONLY (Per accident) Underinsured motorist BI $ 100,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X STATUTE X ERH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 C OFFICER/MEMBER EXCLUDED? N N/A WDNH09187001 03/12/2021 03/12/2022 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 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 required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Dadmun Design&Construction ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street AUTHORIZED REPRESENTATIVE Hatfield MA 01038 1.1,1l -D �\ 1 �l ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) ACGRD CERTIFICATE OF LIABILITY INSURANCE 05/24/21 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 NAME: Hannah O'Shea Bresnahan Insurance Agency,In (A/CC,No,Ext): 413-536-0536 ONE FAX No): 413-534-4291 100 Whiting Farms Road AIL ADDRESS: hoshea@bresnahaninsurance.com Holyoke,MA 01040 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Mapfre/Commerce Insurance Co. INSURED INSURER B: James Elkins INSURER C: 2 Williams Street INSURER D: Holyoke,MA 01040 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY 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 ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE $ 1,000,000 TED CLAIMS-MADE X OCCUR PREMISESO(Ea occurrence)l $ 100,000 MED EXP(Any one person) $ 5,000 A 8008030003716 05/05/21 05/05/22 PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PEr 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(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Proof 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. Dadmun Design&Construction 60 School St. Hatfield,MA 01038 AUTHORIZED REP ATIVE 01603 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD id DATE(MMIDD/YYYY) ACC)R� CERTIFICATE OF LIABILITY INSURANCE 04/11/22 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 CON IAC( NAME: Dale A Frank Insurance Agency,Inc. iA/C No,Ext): 413-665-8324 FAX No): 413-665-1280 PO Box 455 E-MAIL C ADDRESS: info@DaleFrankInsurance.com Sunderland,MA 01375 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Main Street America INSURED INSURER B: Brian Polan INSURER C: 26A Elm Cir South Deerfield,MA 01373 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 TYPE OF INSURANCE ADDLSUBR POLICY EFF POLICY EXP W /Y LIMITS LTR INSR VD POLICY NUMBER (MM/DDYYY) (MM/DDIYYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE TO RENTED $ 1,000,000 CLAIMS-MADE OCCUR PREMISES Ea occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 A MPP0949K 11/05/21 11/05/22 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- JECT 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(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN DADMUN Design&Construction ACCORDANCE WITH THE POLICY PROVISIONS. Tom Dadmun 60 School Street AUTHORIZED R , SENTATIVE - t Hatfield, MA 01038 ©198 -2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AC� DATE(MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 04/12/2022 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 Judy Pashko NAME: Complete Benefit Solutions PHO No,Ext): (800)684-5470 FAX No): (413)538-5761 One Carando Drive,Suite 1 E-MAIL Ipas p p yhko com fete a rollsolutions.com ADDRESS: @ INSURER(S)AFFORDING COVERAGE NAIC# Springfield MA 01104 INSURERA: NorGUARD 31470 INSURED INSURER B: Brian M.Polan,DBA Brian Polan Carpentry INSURER C: 26A Elm Circle INSURER D: INSURER E: South Deerfield MA 01373 INSURER F COVERAGES CERTIFICATE NUMBER: CL2241203950 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 :R POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JE T LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB _ OCCUR EACH OCCURRENCE• $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY Y/N 100,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE Y NIA BRWC280793 09/08/2021 09/08/2022 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (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 I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Tom Dadmun ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street AUTHORIZED REPRESENTATIVE Hatfield MA 01038 / o ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AC CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 11/5/2020 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 JudyPashko NAME: Pettengill Insurance Agency (AIC No.Est): (413)532-8800 FAX No): (113)538-5761 460 Newton Street E-MAIL ashko@co fete a rollsolutions.com ADDRESS: jpashko@completepayrollsolutions.com P Y INSURER(S) AFFORDING COVERAGE NAIC# South Hadley MA 01075 INSURERA:MAPFRE INSURED INSURER B: Drew E. Powers dba Powers Air INSURERC: 96 Cold Hill Road INSURERD: INSURER E: Granby MA 01033 INSURER F: COVERAGES CERTIFICATE NUMBER:CL2092303249 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 W LIMITS LTR INSD VD POLICY NUMBER (MM/DD/YYYY) IMM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE A CLAIMS-MADE x OCCUR PREMISESO(Ea o currrrence) $ 100,000 8008030006939 8/5/2020 8/5/2021 MED EXP(Any one person) $ 5,000 PERSONAL BADV INJURY $ 1,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ - ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ _ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS _ AUTOS (Per accident) - - _ $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE For Proof of Coverage THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 'Linda Zurlino/LZ f1? 2 AO ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) Ar�L DATE(MM/DD/YYYY) l' CERTIFICATE OF LIABILITY INSURANCE 12/02/2020 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 �NAME:NTAC1 Cyndie Henderson CISR CPIA _ Webber 8 Grinnel; (PHOONE +e 13)586.0111 T PAX (413)588.6481 -� I EAM{�ILo,Eat). _., (A/C,No): 8 North King Street I ADDREss cnendersongwebterandgrinnell.com I INSURERS)AFFORDING COVERAGE 1 NAIC a Northampton MA 01060 INsuRER A: Selective Ins Co of S Carolina 19259 INSURED INSURER B: Selectve Ins Co of Southeast 39926 SDL Home Improvement Contractors,Inc 1 INSURER C: _ 24 Chestnut Street INSURER D: INSURER E Hatfield MA 01038 1 INSURER F: • COVERAGES CERTIFICATE NUMBER: Master Exp 2022 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. NOTVNTHSTANDING 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 ADDLSUBRI ' POLICY EFF ' POLICY EXP LTR TYPE OF INSURANCE IN$D WVD POLICY NUMBER - j(MM/ODNYYY) I I(MMiCEVYYYY) LIMITS x!COMMERCIAL GENERAL LIABILITY EACH 1 CURRENCE Is 1•000.000 t j ( DAMAGE TO RrNTEC 500,000 CLAIMS MADL X OCCUR PREMISES IEa occurrence) 5 i MED E XP uAf^y one person S ?5,000 A '. S2291509 01/01/2021 01/01/2022 PERSONAL BADVINJURY 1000.000 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER I GENERAL AGGREGATE PRO- 3,000,000 POLICY i,IECT LOC I PRODUCTS-COMP4U''PAGG S j OTHER S ...___...._.,�,.» .AUTOMOBILE LIABILITY t;OMENFD SINGLE LIMIT S 1.000.000 (Ea accdenf 'ANY AUTD BODILY INURY(Per person) 5 A OANED X SCHEDULE.0 A9105420 01/01/2021 O1/D112022 BODILY INJURY+,Perna lens $ AUTOS ONLY AUTOS X HIRED N/ NON-OWNED ' PROPERTY DAMAGE $ AUTOS ONi r AUTOS ONLY t(Per eccdent) I Underinsured motorist RI s 100.000 v'UMBRELLA LIAR rr•' "' 1,000.000 /�_! OCCUR I •EACH OCCURRENCCEi:.�......,,.____..5 A I EXCESS LIAR �(CLANS-MADE Ms-MAD'c ' S2291509 01/0112021 ( 01/01/2022 AGGREGATE 5 1.000.• 000 I DED I R ENTiON$ S WORKERS COMPENSATION XPERTUTE X ER 07~' STA SAND EMPLOYERS'LIABILITY Y/N ,, 500.000~ hNY PRGPRi'c':�eR-PA RTNER;EXEGJTIvE E.L.EACH ACCIDENT B OFFICER•'MEMBER ECLUDED" Y� N 1 A WC9024456 02:2312021 02.r23l2022(Mandatory in NH) i 1 E.I. DISEASE�EA EMPLOYEE �$ y00 DD0 if yes.<Macnba undo' i 500,COC DESCRIPTION�F OPERATIONS beiova 1 i E.I..-ISF„ASE-POLICY LIMIT 5 1 ) 3 DESCRIPTION OF OPERATIONS/LOCATIONS r VEHICLES IACORD 101,Additional Remarks Schedule,may be attached i1 more space is required) The Workers Compensation policy does not include coverage for Paul Schmidt Kendrick Dempsey and Douglas Schmidt. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN DADMUN Design+Construction ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street AUTHORIZED REPRESENTATIVE Hatfield �6�' t� '.1/t •-, ' G 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD A�'d 02110/2021 n02 CERTIFICATE OF LIABILITY INSURANCE DATEIMYYY) � � 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 Denise Sawicki NAME: Amherst Insurance Agency Inc PHONE Mit.Eat): (413)253.5555 lad,Nol (413)256-8354 20 Gatehouse Rd ADDRESS: dsawicki@natnanagencies.com PO.Box 48 INSURER(SI AFFORDING COVERAGE NAIC a Amherst MA 01002 INSURER A: Charles River Insurance INSURED INSURER B: Floors By Summerlin,Inc.,DBA: Summerlin Floors INSURER C 322 College Street INSURER D: ' INSURER E: Amherst MA 01002 INSURER F: 1 COVERAGES CERTIFICATE NUMBER: CL212303458 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. ILSR TYPE OF INSURANCE ADD)SU WVD POLICY NUMBER MMIODIYYYY )MM/DD/YYYY) LIMITS POLICY EFF POLICY EXP LTR INSO t ) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE 10 RENTED 300.000 CLAIMS-MADE X C'CCUR PREMISES(Ea occurrence) 5 MED EXP(Any one person) $ 5,000 A 08SBAAE0296 12/21/2020 12/21/2021 PERSONAL 8ADvINJURY g 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE S 2,000,000 POLICY PRO- LOC PRODUCTS•COMP/OPAGO S 2,000.000 JECT OTHER- _ S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000.000 (Ea accident) ANY AUTO BODILY INJURY(Per perser-0 S A OWNED X SCHEDULED 08UCBA7913 12/21/2020 12/21/2021 BODILY INJURY(Far acudenli S AUTOS ONLY AUTOS Ni, HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per acodenl) Medical payments S 5,000 X UMBRELLA LIAR OCCUR EACH OCCURRENCE S 1,000,000 — A EXCESS LIAR CLAIMS-MADE 08SBAAE0296 12l2112020 12/21/2021 AGGREGATE 5 1,000.000 DED XI RETENTION 5 5,000 5 WORKERS COMPENSATION PER OTH- STATUTE ER AND EMPLOYERS'UABIUTY Y/N ANY PROPRIETOR/PARTNER/EXECUTI VE E.L EACH ACCIDENT $ 1,000.000 A W OFFICER/MEMBEREXCLUDED? Y N/A O8ECAESFC7 12/21/2020 12/21/2021 (Mandatory in NM) E L DISEASE•EA EMPLOYEE $ 1,000'000 II yes,describe under 1.000,000 DESCRIPTION OF OPERATIONS baler/ E L.DISEASE-POLICY LIMIT $ i DESCRIPTION OF OPERATIONS/LOCATIONS i VEHICLES (ACORO 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Tom Dadmun 60 School Street AUTHORIZED REPRESENTATIVE p� Hatfield MA103c '' -'V. L JC]•-1�.1 G+�...; C.19B8-2015 ACORD CORPORATION, All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD �' AC()R£7" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) Ir,l f 03/31/21 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 NAME: Cecilia Olsen Dale A Frank Insurance Agency,Inc. (A/cc,No,Ext): 413-665-8324 ONE FAX No): 413-665-1280 PO Box 455 E-MAIL info DaleFranklnsurance.com Sunderland, MA 01375 ADDRESS: @DaleFranklnsurance.com AFFORDING COVERAGE NAIC# INSURER A: RPS INSURED INSURER B: Rightway Drywall Inc. INSURER C: Brian Johnson INSURER D 206 Coles Meadow Road Northampton,MA 01060-1111 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLBUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE RENTED CLAIMS-MADE OCCUR PREMISESO(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A WS411028 01/20/21 01/20/22 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PE� 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(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB _OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE . E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN DADMUN Design+Construction ACCORDANCE WITH THE POLICY PROVISIONS. Tom Dadmun 60 School St AUTHORIZED REPRESENTATIVE Hatfield,MA 01038 Cecilia Olsen ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4/12/2021 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 CONTAC r CLTEAM oveera a ou com NAME: g Sr P• Koverage Insurance Group 'q PHONE Ext). 860-745-4222 FAX No): 860-741-6901 657 Enfield Street ADDRESS: CERTIFICATE@koveragegroup.com INSURER(S)AFFORDING COVERAGE NAIC 0 Enfield CT 06082 INSURER A: UTICA FIRST INS CO 15326 INSURED INSURER B EXECUTIVE PAINTING& INSURER C: 10 SOUTH ROAD INSURER D: INSURER E: ENFIELD CT 06082 INSURER F: COVERAGES CERTIFICATE NUMBER: 001 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. ILTR buisti POU EFF POLICY EXP TYPE OF INSURANCE NSD WVD POLICY NUMBER (MM/DDY/YYYI) (MM /Y/DDYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ I,000,000 UCLAIMS-MADE X OCCUR PREMISES(EatINI occurrence) $ 50,000 MED EXP(Any one person) $ 5,000 A ART513998201 02/13/2021 02/13/2022 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY n ECT n LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMI I $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED -SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPtKIYUAMAI,E $ AUTOS ONLY _AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER r-H- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Tom Dadmund ACCORDANCE WITH THE POLICY PROVISIONS. 60 School Street AUTHORIZED REPRESENTATIVE Marie Reyey Hatfield MA 01038 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ■� CORTTIL-01 MHENDERSON ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDmvY) 3/12/2021 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 Mary Henderson NAME: People's United Insurance Agency,Inc. PHONE FAX One Monarch Place, 12th Fir (A/C,No,Ext):(413)327-7516 (AK,No):(413)327-7516 Springfield,MA 01144 it"o'Ess:Mary.Henderson@AssuredPartners.com INSURERS)AFFORDING COVERAGE NAIC 0 INSURER A:Merchants Mutual Insurance Co 23329 INSURED INSURER B: Cortina Tile of West Springfield INSURER C: 1645 Riverdale Street INSURERD: West Springfield, MA 01089 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD IMM/DD/YYYYI (MM/DD/YYYY), A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR BOPI071849 3/30/2021 3/30/2022 AMGOEENccTErDenceL $ 500,000 MED EXP(Any one person) $ 5,000 PERSONAL S ADV INJURY $ Included GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY I X I jECT LOG PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOSO ONLY AUTOSNO BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS ONLY (reOff scent)D AMAGE A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE CUP9146566 3/30/2021 3/30/2022 AGGREGATE $ 1,000,000 DED I X RETENTION$ 10,000 $ A WORKERS COMPENSATION X PER ATUTE 0TH AND EMPLOYERS'LIABILITY WCA1033448 3/30/2021 3/30/2022 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE R YNN N/A E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ _ 500,000 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 required) Proof of Insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE DADMUN Design+Construction THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Tom Dadmun 60 School Street — Hatfield,MA 01038 AUTHORIZED REPRESENTATIVE peaftee Whited ladaltagee 749eaef, Tee. ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD