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DocuSign Envelope ID:OB6A4D70-3138-422C-98BF-EA253C4BCA84 <br /> AGENCY CUSTOMER ID: <br /> LOC#: <br /> AC"J?o 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 USA <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 004 EFF DATE: 11/01/2018 EXP DATE: 11/01/2019 <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 /> INSURER AFFORDING COVERAGE: ACE American Insurance Company NAIC#: 22667 <br /> POLICY NUMBER: COO G27416603 004 EFF DATE: 11/01/2018 EXP DATE: 11/01/2019 <br /> TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: <br /> Contractor's Pollution Liability Each Claim $10,000,000 <br /> All Claims $10,000,000 <br /> SIR $250,000 <br /> INSURER AFFORDING COVERAGE: Indian Harbor Insurance Company NAIC#: 36940 <br /> POLICY NUMBER: PECO04203905 EFF DATE: 11/01/2018 EXP DATE: 11/01/2019 <br /> TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: <br /> Pollution Legal Liability Each Claim $10,000,000 <br /> Aggregate $10,000,000 <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: 16932852 BATCH: 923985 CERT: W8597802 <br />