Laserfiche WebLink
AGENCY CUSTOMER ID: <br />LOC #: <br />f,� RAnnITInN01 RFMARKS SCHMULF <br />Page 2 Of <br />k� <br />AGENCY NAMED INSURED <br />Willis Towers Watson Northeast, Inc. Safety Kleen Systems 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 71 <br />ADDITIONAL <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: Starr Indemnity 6 Liability Company <br />POLICY NUMBER: 1000005138 (MA, FL) EFF DATE: 11/01/2022 EXP DATE: 11/01/2023 <br />TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: <br />Workers Compensation E.L. EACH ACCIDENT $2,000,000 <br />6 Employers Liability E.L. DISEASE - EA EMP $2,000,000 <br />Per Statute E.L. DISEASE-POL LMT $2,000,000 <br />INSURER AFFORDING COVERAGE: Starr Indemnity S Liability Company <br />POLICY NUMBER: 1000679513221 EFF DATE: 11/01/2022 EXP DATE: 11/01/2023 <br />TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: <br />Auto Liability (MA) CSL (Ea accident) 5,000,000 <br />Any Auto, Owned Autos only, MCS-90 <br />Hired Autos only, Non -owned Autos only <br />INSURER AFFORDING COVERAGE: ACE American Insurance Company <br />POLICY NUMBER: COO G27416603 008 EFF DATE: 11/01/2022 EXP DATE: 1110IY2023 <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: ACE American Insurance Company <br />POLICY NUMBER: COO G27416603 008 EFF DATE: 11/01/2022 EXP DATE: 11/01/2023 <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 />NAIC#: 38318 <br />NAIC#: 22667 <br />NAIC#: 2266' <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: 23228082 BATCH:2718361 CERT: W26427780 <br />