Orange County NC Website
DocuSign Envelope ID:813A5323-29B6-4DDD-A2B8-22B7F4A4A68C <br /> AGENCY CUSTOMER ID: <br /> LOC#: <br /> /"''nwil <br /> A 0 ADDITIONAL REMARKS SCHEDULE Page 2 of 2 <br /> AGENCY NAMED INSURED <br /> Willis of Massachusetts, Inc. Clean Harbors Environmental Services, Inc. <br /> and its affiliates <br /> POLICY NUMBER 42 Longwater Drive <br /> See Page 1 Norwell, MA 02061 <br /> CARRIER NAIC CODE <br /> See Page 1 See Page 1 EFFECTIVE DATE: See Page 1 <br /> ADDITIONAL REMARKS <br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br /> FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance <br /> INSURER AFFORDING COVERAGE: ACE American Insurance Company NAIC#: 22667 <br /> POLICY NUMBER: COO G27416603 002 EFF DATE: 11/01/2016 EXP DATE: 11/01/2017 <br /> ADDITIONAL INSURED: N <br /> SUBROGATION WAIVED: N <br /> TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: <br /> Contractors Pollution Liability Each Claim $10,000,000 <br /> All Claims $10,000,000 <br /> SIR $250,000 <br /> INSURER AFFORDING COVERAGE: ACE American Insurance Company NAIC#: 22667 <br /> POLICY NUMBER: COO G27416603 002 EFF DATE: 11/01/2016 EXP DATE: 11/01/2017 <br /> ADDITIONAL INSURED: N <br /> SUBROGATION WAIVED: N <br /> TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: <br /> Professional Liability Each Claim $10,000,000 <br /> All Claims $10,000,000 <br /> SIR $250,000 <br /> ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br /> SR ID: 14657638 BATCH: 336246 CERT: W2449677 <br />