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An application was received from Barlo Signs representing Wusong Road, requesting permission for a projecting illuminating sign at the premises numbered 2 Bennett Street. approval has been received from Inspectional Services, Department of Public Works, Community Development Department and abutter

APP 2021 #47·Council meeting Dec 6, 2021·22 pages·📄 Original PDF (city portal)
OFFICE OF THE CITY CLERK CAMBRIDGE CITY HALL, 795 MASSACHUSETTS AVENUE CAMBRIDGE, MASSACHUSETTS 02139 PHONE [phone removed] FAX [phone removed] DONNA P. LOPEZ PAULA M. CRANE CITY CLERK DEPUTY CITY CLERK Cambridge, ___________________, 20________ To the Honorable, the City Council of the City of Cambridge: EACH PETITION MUST BE ACCOMPANIED BY A DRAWING OF PROPOSED SIGN, INDICATING DESIGN AND DIMENSIONS AND LOCATION ON PREMISES. The undersigned respectfully prays that ______________________________________________________ (NAME OF BUSINESS) be granted permit to erect a sign of the following specifications in front of premises located at _______________________________________________________________________________________ (ADDRESS) Type of Sign: ____________________________________________________________________________________ (state whether electric or otherwise and material used in construction) Reading matter to go on Sign: _______________________________________________________________________________________ ___________________________________________________________________________________________ Size: _______________________________________ Weight: _____________________________________ Public Way Obstruction: A.________________________________________ B._______________________________________ (Give exact distance sign is to extend over sidewalk) (Also exact distance from bottom of sign to sidewalk) Height Above Grade: Bottom: ______________________________ Top: ___________________________________ NOTICE - REGULATIONS [Section 12.08.010 Municipal Code – Encroachments onto Streets] Section 1212.0 State Building Code – Projecting Signs] x A projecting sign shall be constructed wholly of incombustible materials. x All signs must meet requirements of Zoning Ordinances and Building Code. x Note: Section 12.12.220 provides in part “every owner who maintains a . . . structure in or over a street. . . .shall do so only on the condition that such maintenance shall be considered as an agreement on his part to keep the same and the covers thereof in good repair and condition, at all times during his ownership, and to indemnify and save harmless the City against any and all damages, cost or expenses which it may sustain, or be required to pay by reason of such. . .structure.” PROPERTY OWNER OR AUTHORIZED AGENT HEREBY STATES THAT INFORMATION IS TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND UNDERSTANDING UNDER PAINS AND PENALTY OF PERJURY. ________________________________________________________________________________________/____________ (Property owner or authorized agent) (Address) (Tel. No.) _______________________________________________________________________________________/_____________ (Business owner) (Address) (Tel. No.) 2 Bennett St. Cambridge MA 02138 [phone removed] rope pertrty y ow owne n r or ___ ________ _ ___ i ner) WUSONG ROAD 2 BENNETT ST FACE REPLACEMENT TO AN EXISTING PROJECTING SIGN/ALUMINUM ELEC N/A WUSONG ROAD 2'7'' X 10' 20 LBS 9'2'' 19'2'' X ____ ___ X (Bus u ininess s ow owner) BARLO SIGNS, JENN ROBICHAUD 158 GREELEY ST HUDSON NH 0305[phone removed] 2'7'' 9'2'' NOV 18 21
City of Cambridge, Massachusetts Bond ........................................ Know All Persons by These Presents, That we........................................................................................................................................................................................... .......................................................................................................................................................................................................... ............................................................................. ........................................................................................ as principal and ...................................................................................................................................................................................................... ............................................................................................................................................................... as surety are holden and stand firmly bound unto the CITY OF CAMBRIDGE, in the sum of Five Thousand Dollars ($5000.00) to be paid to the said CITY OF CAMBRIDGE; to which payment, well and truly to be made, we and each of us do bind ourselves, our Heirs, Executors and Administrators, Successors and assigns, jointly and severally, firmly by these presents. The condition of this obligation is such that WHEREAS an application for a permit for use of sidewalks has been made to the City Council of said City by the said ................................................................................................................................................................................................... ................................................................................................................................................................................................... Now Therefore, if the said.............................................................................................................................................. .............................................................................................. shall faithfully observe and keep each and all the agreements, stipulations, conditions, specifications, and provisions on his/her part to be kept and performed, contained in said permit and in every and all such permits hereafter issued to the said ......................................................................................................................................................................... and i n each and every extension of the same, according to the full intent and spirit of said permit and the ordinances of said City n ow relating, or that m ay relate thereto and shall indemnify and save harmless the City of Cambridge from all liabilities and expense whatsoever which the City may incur an d suffer arising out of the issuing of such permits and all e xtensions of the same, and shall make no default therein;. then this obligation shall be null and void; otherwise it shall be and remain in full force and effect, IN WITNESS WHEREOF, we have here to set our hands and seals, this....................................... (Date) Executed in the presence of......................................................................................................... (Principal) ......................................................................................................... (Witness) The within named sureties are satisfactory................................................................................. (City Auditor) Form of bond approved............................................................................................................... (City Solicitor) A-frame sign / Sandwich Sign - Wusong Road, LLC. Jason Doo and Thomas Brush Owners of Wusong Road, LLC. Traveler's Insurance 12 Month Term Bond - $5,000.00 Wusong Road, LLC Sandwich Sign and/or A-Frame Sign June, 20, 2021 Jason Doo Thomas Morgan Existing Overhanging Sign
LAN DLO RD AUTHORIZATIO N FOR PERMTT(S), VARTANCE(S), HEARTNG(S) < MUST BE SIGNED BY TANDLORD OR OWNER OF THE PROPERTV ON WHICH SIGNAGE IS BEING INSTALLED > This document verifies that you are authorizing BARLO SIGNS to install signage on your property pursuant to the attached drawings as well as authorizing BARLO SIGNS to secure all related permits required by the local municipalities. Barlo Signs cannot apply for permits or hearings until we receive the LANDLORD or PROPERW OWNER'S authorization to do so. f I hereby N.H., to authorize dn Authorized Representative of Barlo Sians of Hudson, APPLY FOR PERMITS for this site and to APPEAR BEFORE THE PLANNING BOARD and/or SrGru REVIEW BOARD the ZBA for this site. f t tr"r"by authorize BARLO SIGNS to install signage on my property exactly as shown in drawing #21o4ore1s 3 Date* 4130121 Sign location address: 2 Bennett St, Cambridge, MA 02138 Property Owner's Signature: Printed Name: Company Name: Address: or-Vnslz c -\ (Ltc- rol I -.Fn<-d.uqa,n t C-o"* b.^"cLc" c . rr?-\ atr AA, Phone number: Date Signed: We connot apply for permits or hearings until we receive your authorization. Thank you! . Wusong Road Job 4. 20180 Reference JOB NAME FILED (T)Templates / POA. 11.18.16. REV 8'2'19 by CW
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C I T Y O F C A M B R I D G E Community Development Department IRAM FAROOQ Assistant City Manager for Community Development SANDRA CLARKE Deputy Director Chief of Administration KHALIL MOGASSABI Deputy Director Chief of Planning 344 Broadway Cambridge, MA 02139 Voice: [phone removed] Fax: [phone removed] TTY: [phone removed] www.cambridgema.gov To: Board of Zoning Appeal From: Harvard Square Advisory Committee Date: September 7, 2021 Re: 2 Bennett Street - Exterior Improvements Overview The Harvard Square Advisory Committee (the “Committee”) met on Thursday, August 26, 2021 to discuss the application by Jason Doo of Wusong Road for various exterior improvements. The meeting was conducted pursuant to the provisions of Section 20.50 of the Cambridge Zoning Ordinance in advance of the applicant’s request for a variance from the Board of Zoning Appeal (BZA). Committee members present were Allison Crosbie, Lauren Curry, Kari Kuelzer, Sara Li, Steven Ng, Alexandra Offiong, and Nicola Williams. After discussion, the Committee decided unanimously to forward a report to the BZA with a positive recommendation. Proposal Description The applicant proposes to install signage, a fence, bollards, and lighting on and around the existing building at 2 Bennett Street. The project requires a variance from the BZA because Section 20.55.1.1 of the Zoning Ordinance states that no sign on the outside of a building may extend higher than 20 feet above grade; the applicant proposes one wall sign that measures 24 feet 6 inches above grade. The project has already received a Certificate of Appropriateness from the Cambridge Historical Commission, which is attached. The use of the building will remain unchanged as it will continue to be a restaurant. Committee Comments Members of the Committee were overwhelmingly supportive of the applicant’s overall proposal. Many Committee members noted that the proposal shows a careful attention to detail and is informed by the particular challenges of the site. They appreciated the applicant’s decision to locate the entrance of the restaurant on Mt. Auburn Street and found that the proposed exterior improvements will help draw people to the site. Committee members found that the variance for the wall sign on Mt. Auburn Street facing the garage was appropriate. They believed that locating the sign within the architectural brickwork of the building is a sensitive solution and provides crucial visibility for the business. Committee members noted that the scale and context of the building necessitates the size and placement of the proposed sign. They also appreciated that the lease restricts the use of illumination to business hours.
2 Bennett Street – Report to Board of Zoning Appeal September 7, 2021 Page 2 of 2 Committee members suggested that the applicant revise their proposal to include additional materials that show the necessity of granting zoning relief. Some members recommended including a neighborhood-scale map, site plan, and/or aerial photograph to put the site in context. Others recommended also including a key plan that identifies where all the proposed signs are located. Given the Committee’s discussion, a motion was made and seconded to forward a report to the BZA with a positive recommendation that the BZA grant the requested variance on the condition that illumination is restricted to the hours of the business’s operation. All seven members present voted in favor. Respectfully submitted for the Committee, Sarah Scott Associate Zoning Planner Community Development Department
CAMBRIDGE HISTORICAL COMMISSION 831 Massachusetts Avenue, 2nd Fl., Cambridge, Massachusetts 02139 Telephone: [phone removed] Fax: [phone removed] TTY: [phone removed] E-mail: histcomm@cambridgema.gov URL: http://www.cambridgema.gov/Historic Bruce A. Irving, Chair, Susannah Barton Tobin, Vice Chair; Charles M. Sullivan, Executive Director Joseph V. Ferrara, Chandra Harrington, Elizabeth Lyster, Caroline Shannon, Jo M. Solet, Members Gavin W. Kleespies, Paula A. Paris, Kyle Sheffield, Alternates CERTIFICATE OF APPROPRIATENESS Property: 112 Mt Auburn St / 2 Bennett St Applicant: Conductor’s Building LLC 20 University Rd. Cambridge, Mass. 02138 Attention: Jason Doo Wusong Road 2 Bennett St Cambridge, Mass. 02138 Thomas Brush Felipes Taqueria 21 Brattle St Cambridge, Mass. 02138 The Cambridge Historical Commission hereby certifies, pursuant to the Massachusetts Historic Districts Act (MGL Ch. 40C) and the Cambridge Historical Buildings and Landmarks Ordinance (Cambridge City Code, Ch. 2.78), that the work described below is not incongruous to the historic aspects or architectural character of the building or district: Install signs, fence, bollards, and lights for new Wusong Road restaurant. 1. Install a cedar fence panel with sign, menu board, and LED lights 2. Install an illuminated wall sign on the east wall of the building, pending zoning approval 3. Re-face the existing projecting sign on the Bennett Street end of the building, pending MBTA access to the sign 4. Install 3 pagoda shaped bollards on the Mt Auburn Street side of the building, set back from the busway exit point. 5. Install lantern shaped lights on either side of the Mt Auburn Street entry door
Case 4599: 112 Mt Auburn St / 2 Bennett St Certificate of Appropriateness, page 2 Work is to be carried out as indicated in the drawings titled, “Wusong Road – Sign Proposal,” and dated received on July 1, 2021. Approval was granted on the condition that construction details and final location of signs be reviewed and approved by Historical Commission staff. All improvements shall be carried out as shown on the plans and specifications submitted by the applicant, except as modified above. Approved plans and specifications are incorporated by reference into this certificate. This certificate is granted upon the condition that the work authorized herein is commenced within six months after the date of issue. If the work authorized by this certificate is not commenced within six months after the date of issue, or if such work is suspended in significant part for a period of one year after the time the work is commenced, then this certificate shall expire and be of no further effect; provided that, for cause, one or more extensions of time, for periods not exceeding six months each, may be allowed in writing by the Chair. Case Number: 4599 Date of Certificate: July 28, 2021 Attest: A true and correct copy of decision filed with the offices of the City Clerk and the Cambridge Historical Commission on July 28, 2021 . By Bruce A. Irving/slb , Chair. ********************************************************************** Twenty days have elapsed since the filing of this decision. No appeal has been filed . Appeal has been filed . Date , City Clerk
The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114 www.mass.gov/dia Workers’ Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual):______________________________________________________ Address:__________________________________________________________________________ City/State/Zip:_____________________________ Phone #:________________________________ *Any applicant that checks box #1 must also fill out the section below showing their workers’ compensation policy information. † Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ‡Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees, they must provide their workers’ comp. policy number. I am an employer that is providing workers’ compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:____________________________________________________________________________ Policy # or Self-ins. Lic. #:__________________________________________ Expiration Date:____________________ Job Site Address: City/State/Zip:______________________ Attach a copy of the workers’ compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone #: Official use only. Do not write in this area, to be completed by city or town official. City or Town: ___________________________________ Permit/License #_________________________________ Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other ______________________________ Contact Person:_________________________________________ Phone #:_________________________________ Type of project (required): 7. New construction 8. Remodeling 9. Demolition 10 Building addition 11. Electrical repairs or additions 12. Plumbing repairs or additions 13. Roof repairs 14. Other____________________ 1. I am a employer with _________employees (full and/or part-time).* 2. I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers’ comp. insurance required.] 3. I am a homeowner doing all work myself. [No workers’ comp. insurance required.] † 4. I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers’ compensation insurance or are sole proprietors with no employees. 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers’ comp. insurance.‡ 6. We are a corporation and its officers have exercised their right of exemption per MGL c. 152, §1(4), and we have no employees. [No workers’ comp. insurance required.] Are you an employer? Check the appropriate box: 2 28 21 Barlo Signs International Inc 158 Greeley Street Hudson, NH 0305[phone removed] 35 Signage The Travelers Insurance Co 7PJIB 2E89553 2 18 04/28/2022 ALL JOBS LOCATED IN- CAMBRIDGE MA [phone removed]
Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers’ compensation for their employees. Pursuant to this statute, an employee is defined as “...every person in the service of another under any contract of hire, express or implied, oral or written.” An employer is defined as “an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer.” MGL chapter 152, §25C(6) also states that “every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required.” Additionally, MGL chapter 152, §25C(7) states “Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority.” Applicants Please fill out the workers’ compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers’ compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers’ compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under “Job Site Address” the applicant should write “all locations in ______(city or town).” A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Department’s address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114 Tel. # [phone removed] ext. 7406 or 1-877-MASSAFE Fax # [phone removed] www.mass.gov/dia Revised 02-23-15
06/14/2021 FIAI/Cross Insurance 1100 Elm Street Manchester NH 03101 Lynn Blanchard, CIC,CISR [phone removed] [phone removed] [email removed] Barlo Signs International, Inc. 158 Greeley Street Hudson NH 03051 Citizens Ins Co of America 31534 21-22 GL & BA A ZBVA186256 01/01/2021 01/01/2022 1,000,000 100,000 10,000 1,000,000 2,000,000 2,000,000 A AWVA164300 01/01/2021 01/01/2022 1,000,000 Medical payments 5,000 For Permit Purposes Only. Refer to policy for exclusionary endorsements and special provisions. City of Cambridge, MA 795 Massachusetts Avenue Cambridge MA 02139 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME: CONTACT (A/C, No): FAX E-MAIL ADDRESS: PRODUCER (A/C, No, Ext): PHONE INSURED REVISION NUMBER: CERTIFICATE NUMBER: COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $ PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOS AUTOS ONLY NON-OWNED SCHEDULED OWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT ER OTH- STATUTE PER LIMITS (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) POLICY EFF POLICY NUMBER TYPE OF INSURANCE LTR INSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $ EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $ PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $ EACH OCCURRENCE DAMAGE TO RENTED $ PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME: CONTACT (A/C, No): FAX E-MAIL ADDRESS: PRODUCER (A/C, No, Ext): PHONE INSURED REVISION NUMBER: CERTIFICATE NUMBER: COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N/A SUBR WVD ADDL INSD 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. $ $ $ $ PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS AUTOS AUTOS NON-OWNED HIRED AUTOS SCHEDULED ALL OWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT ER OTH- STATUTE PER LIMITS (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) POLICY EFF POLICY NUMBER TYPE OF INSURANCE LTR INSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $ EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $ PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $ EACH OCCURRENCE DAMAGE TO RENTED $ PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD N/A N/A 06/14/2021 CROSS INSURANCE - MANCHESTER 1100 ELM ST NH 03101 Jill Charnley [phone removed] [email removed] MANCHESTER BARLO SIGNS INTERNATIONAL INC NH 03051 TRAVELERS PROPERTY CAS CO OF AM 25674 158 GREELEY STREET HUDSON 665218 N/A N/A N/A A 7PJUB2E89553221 04/28/2021 04/28/2022 1,000,000 1,000,000 1,000,000 N/A Workers’ Compensation benefits will be paid to Massachusetts employees only. Pursuant to Endorsement WC 20 03 06 B, no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires, or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued (unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage - Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. City of Cambridge MA 795 Massachusetts Avenue Cambridge MA 02139 Daniel M. Crowley, CPCU, Vice President – Residual Market – WCRIBMA
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