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DocuSign Envelope ID: 88A54057 -CC31- 4328 - 9012- 2B021842D3E4 <br />AGENCY CUSTOMER ID: <br />LOC #: <br />ADDITIONAL REMARKS SCHEDULE <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 />,DDITIONAL REMARKS <br />Page 2 of 2 <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 <br />POLICY NUMBER: COO G27416603 002 EFF DATE: 11/01/2016 <br />ADDITIONAL INSURED: N <br />SUBROGATION WAIVED: N <br />TYPE OF INSURANCE: LIMIT DESCRIPTION: <br />Professional Liability Each Claim <br />All Claims <br />SIR <br />EXP DATE: 11/01/2017 <br />LIMIT AMOUNT: <br />$10,000,000 <br />$10,000,000 <br />$250,000 <br />NAIC #: 22667 <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 />