An application was received from Daniel Brennan representing Life Alive Organic Cafe, requesting permission for a projecting sign at the premises numbered 22 JFK Street approval has been received from Inspectional Services, Department of Public Works, Community Development Department and proof of abutters mailing has been provided

City of Cambridge, MA 11/09/2022 197906 Sign/Awning Permit Status: Active Date Created: Oct 6, 2022 Primary Location Applicant 22 Jfk St Daniel Brennan [email removed] Cambridge, MA 02138 50 Holt Road Owner: Andover, MA 01810 ALLIARA, LLC [phone removed] 1188 CENTRE ST. NEWTON CENTRE, MA 02459 General Information What option best describes this application? Sign(s) and Awning(s) Description of Proposed Work Replace existing blade sign with new slightly larger blade sign. Install awning/vestibule at rear door at rear of building on private property Estimated Cost of Awning(s) in dollars 9,640 Estimated Cost of Sign(s) in dollars 4,665 Describe any existing signs or awnings that will remain (including the size of the remaining signs/awnings). (1) wall sign "Life Alive Organic Cafe" 10-3/4"H × 106"W Cambridge City Council approval may be required. Will one or more of the proposed signs extend six (6) inches into the public sidewalk? Yes You must submit a Projected Sign Application and Abutter's Form (https://viewpointcloud.blob.core.windows.net/profile- pictures/City_Clerk_Sign_Awning_Application_Wed_Jan_02_2019_15:28:46_GMT+0000_(Coordinated_Universal_Time) pdf) to the City Clerk's Office. Sign Information Sign Text Life Alvie Organic Cafe Down Under School of Yoga Illumination Type of Sign Natural Projecting Height of Sign (feet) Width of Sign (feet)

3.8 2.3 Area of Sigh (square feet) 8.9 Height from the ground to the top of the sign (feet) 9.8 Height from the ground to bottom of the sign (feet) 7.5 Weight of the sign (Ibs) Sign Material 30 Aluminum Vinyl Faced Projection from the Building (inches) 36 Width of Building Facade for Associated Use (feet) 25 Is the sign an accessory to a first floor store? Yes Awning Information Width of Awning (feet) Height of Awning (feet) 6.8 1.5 Height from the ground to the top of the awning (feet) 9.75 Height from the ground to bottom of the awning (feet) 8.25 Awning Material Weight of the awning (Ibs) Aluminum frame with fabric 50 Projection from the Building (inches) 60 Contractor Contractor Name DAVID J RANDA Address 8 Cider Hill Lane Telephone E-mail [phone removed] [email removed] License Expiration Date License Number 03/15/2024 CS-076718 Contractor's Signature Date Signature of Licensed Contractor DAVID RANDA 10/04/2022 Community Development Approval

Sign conforms to requirements of Article 7.000 Sign requires a variance from the Board of Zoning Appeal Comments Exempt under Article 7.000 City Clerk Internal Bond Number Attachments (pa) LifeAlive_22 JFK-CamMA_BladeSign_La.pdf 'Uploaded by Daniel Brennan on Oct 6, 2022 at 3:16 pm pdf Contract of Cost.pdf Uploaded by Daniel Brennan on Oct 6, 2022 at 3:16 pm pdf WC Aff -COl.pdf Uploaded by Daniel Brennan on Oct 6, 2022 at 3:23 pm pdt) Landlord Authorization.pdf Uploaded by Daniel Brennan on Oct 6, 2022 at 3:17 pm pdf Awning Frame Drawing.pdf Uploaded by Daniel Brennan on Oct 6, 2022 at 3:24 pm (par; Existing blade sign photos.pdf Uploaded by Daniel Brennan on Oct 25, 2022 at 8:05 am pat 22 JFK St CNA conforming blade sign for Life Alive and Down Under Yoga,pdf Uploaded by Sarah Burks on Oct 26, 2022 at 4:41 pm pat City Clerk obstruction permit app completed.pdf Uploaded by Daniel Brennan on Nov 8, 2022 at 2:39 pm History Date Activity Oct 4, 2022 at 7:45 am Daniel Brennan started a draft of Record 197906 Daniel Brennan added attachment Awning Frame Drawing.pdf to Record 197906 Oct 6, 2022 at 3:24 pm Daniel Brennan submitted Record 197906 Oct 6, 2022 at 3:42 pm Oct 6, 2022 at 3:42 pm approval step Review for Completenesswas assigned to Branden Vigneault on Record 197906 Oct 12, 2022 at 9:27 am Daniel Brennan added a guest: [email removed] to Record 197906 Oct 17, 2022 at 10:28 am Branden Vigneault approved approval step Review for Completeness on Record 197906 Oct 17, 2022 at 10:28 am approval step Historical Commissionwas assigned to Eric Hill on Record 197906 Oct 17, 2022 at 10:28 am approval step Community Development Plan Reviewwas assigned to Daniel Messplay on Record 197906 Oct 17, 2022 at 10:28 am approval step Department of Public Works Reviewwas assigned to Brian McLane on Record 197906 Eric Hill unassigned approval step Historical Commission from Eric Hill on Record 197906 Oct 17, 2022 at 1:33 pm Eric Hill assigned approval step Historical Commission to Sarah Burks on Record 197906 Oct 17, 2022 at 1:33 pm Oct 18, 2022 at 7:42 am Brian McLane approved approval step Department of Public Works Review on Record 197906 Daniel Brennan added attachment Existing blade sign photos. pdf to Record 197906 Oct 25, 2022 at 8:05 am Oct 25, 2022 at 10:38 am Daniel Messplay approved approval step Community Development Plan Review on Record 197906 Sarah Burks added attachment 22 JFK St CNA conforming blade sign for Life Alive and Down Under Yoga,pdf Oct 26, 2022 at 4:41 pm to Record 197906 Oct 26, 2022 at 4:41 pm Sarah Burks approved approval step Historical Commission on Record 197906

Date Activity Oct 26, 2022 at 4:41 pm approval step City Clerk Reviewwas assigned to Lori Perez on Record 197906 Daniel Brennan added attachment City Clerk obstruction permit app completed.pdf to Record 197906 Nov 8, 2022 at 2:39 pm Timeline Label Due Date Status Activated Assignee Completed Review for Completeness Compiete Oct 6, 2022 at 3:42 pm Oct 17, 2022 at 10:28 am Branden Vigneault Complete Brian McLane Oct 18, 2022 at 7:42 am Oct 17, 2022 at 10:28 am Department of Public Works Review Complete Daniel Messplay Community Development Plan Review Oct 25, 2022 at 10:38 am Oct 17, 2022 at 10:28 am Oct 26, 2022 at 4:41 pm Historical Commission Complete Sarah Burks Oct 17, 2022 at 10:28 am Lori Perez City Clerk Review Active Oct 26, 2022 at 4:41 pm - Inactive City Council Approval Bond Inactive Inactive Sign Permit Fee - Inactive Building Inspector Review inactive Sign Permit

CITY OF CAMBRIDGE PERMANENT SIGN OR STRUCTURE THAT WILL OBSTRUCT THE PUBLIC WAY MORE THAN SIX INCHES Cambridge, OCTOBER 31 _ 2022 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 Life Alive Organic Cafe (NAME OF BUSINESS) be granted permit to erect a sign of the following specifications in front of premises located at 22 John F. Kennedy St, Cambridge, MA 02138 (ADDRESS) Type of Sign: Nonilluminated Double Sided Blade Sign-Digitally Printed Viny! Background with Matte Lamination (state whether electric or otherwise and material used in construction) Reading matter to go on sign:_ Life Alive Organic Cafe Down Under School of Yoga Size:_ Weight: 30 pounds 28" x 46" Public Way Obstruction: (Also exact distance from bottom of sign to sidewalk) (Give exact distance sign is to extend over sidewalk) 7-6" 11'-4" Bottom: Top: Height Above Grade: NOTICE - REGULATIONS Section 1212.0 State Building Code - Projecting Signs] [Section 12.08.010 Municipal Code - Encroachments onto Streets] • A projecting sign shall be constructed wholly of incombustible materials. • All signs must meet requirements of Zoning Ordinances and Building Code. 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. [phone removed] N Nathan Wong, on behalf of Alliara, LLC c/o NCP Management Co, PO Box 590179, Newton Centre, MA 02459/ (Address) (Tel. No.) (Property owner or authorized agent) Alexandra Chan, Life Alive Cafe, 765 Massachusetts Ave, Cambridge, MA 02139 / [phone removed] (Tel. No.) (Business owner) (Address)

ABUTTERS FORM FOR SIGN/AWNING PERMIT Date 10-28-22 To Whom It May Concern: 1834 REALTY, INC. C/O CAMBRIDGE SAVINGS BANK 1374 MASSACHUSETTS AVE CAMBRIDGE, MA 02138 As Owner of Agent of Cambridge, _of the approval Massachusetts, I do hereby declare my disapproval installment of: Canopy over the sidewalk entrance: Awnings over the windows: update existing with new Nonilluminated Double Sided Blade Sign attached drawing Projecting sign 22 John F. Kennedy St, Cambridge, MA 02138 of said property. _Date Signed: Address: please email response to [email removed] ABUTTERS: PLEASE COMPLETE FORM WHETHER OR NOT YOU APPROVE OF THE REQUESTED SIGN/AWNING AND RETURN IT TO THE APPLICANT WITHIN SEVEN (7) DAYS FOR INCLUSION IN THE APPLICATION. SIGN/AWNING APPLICANT: PLEASE FILL IN DATE THAT FORM WAS DELIVERED TO ABUTTER (TOP RIGHT OF THIS FORM)

ABUTTERS FORM FOR SIGN/AWNING PERMIT To Whom It May Concern: DANA CHAMBERS ALLIANCE Date 10-28-22 CAMBRIDGE SAVINGS BANK 81 WYMAN ST Cambridge, As Owner of Agent of WALTHAM, MA 02451 of the approval Massachusetts, I do hereby declare my disapproval installment of: Canopy over the sidewalk entrance: Awnings over the windows: update exisjitsign. Nonluminated Double Sided Blade Sign of said property. 22 John F. Kennedy St, Cambridge, MA 02138 Date Signed: Address: please email response to [email removed] ABUTTERS: PLEASE COMPLETE FORM WHETHER OR NOT YOU APPROVE OF THE REQUESTED SIGN/AWNING AND RETURN IT TO THE APPLICANT WITHIN SEVEN (7) DAYS FOR INCLUSION IN THE APPLICATION. SIGN/AWNING APPLICANT: PLEASE FILL IN DATE THAT FORM WAS DELIVERED TO ABUTTER (TOP RIGHT OF THIS FORM)

ABUTTERS FORM FOR SIGN/AWNING PERMIT Date 10-28-22 To Whom It May Concern WAUGH BUILDING LLC C/O ROCKMONT MANAGEMENT CO., INC. P.O. BOX 440433 _Cambridge, As Owner of Agent of SOMERVILLE, MA 02145 of the Massachusetts, I do hereby declare my disapproval approval installment of: Canopy over the sidewalk entrance: Awnings over the windows: update existing with new Projecting sign: Nonilluminated Double Sided Blade Sign 22 John F. Kennedy St, Cambridge, MA 02138 of said property. _Date Signed: Address: please email response to [email removed] ABUTTERS: PLEASE COMPLETE FORM WHETHER OR NOT YOU APPROVE OF THE REQUESTED SIGN/AWNING AND RETURN IT TO THE APPLICANT WITHIN SEVEN (7) DAYS FOR INCLUSION IN THE APPLICATION. SIGN/AWNING APPLICANT: PLEASE FILL IN DATE THAT FORM WAS DELIVERED TO ABUTTER (TOP RIGHT OF THIS FORM)

212 U.S. Postal Service* • No CERTIFIED MAIL® RECEIPT •Yes El Addresses Domestic Mail Only C. Date of Delivery 1716 Restricted Delivery For delivery information, visit our website at www.usps.com • Signature Confirmation™ • Registered apresse • Deliverged Mall Restricter • Signature Confirmation walthom MA 02451 Domestic Return Receipt Certifled Mail Fee* 03073 $4.00 - 0073 Bak agent 5542 06 [Rolurn Recolpt (hardcopy) • Roturn Recelpt (electronic) Poemark 000 • Certified Mail Restricted Delivery -571 •Adut Signalura Required a Hore • Adult Signature Restricted Delivery $. Restricted Delivery Postage $0.60 bò rotal Postage and Fees $7.85 10/23/2024 COMPLETE THIS SECTION ON DELIVERY B. Received by (Prin D. Is YES, or a desery ardes below: Sent 7 • Certifled Mail Restricted Delivery • Adult Signature D Collect on Delivery • Adult Signature Restricted Delivery • Certified Mall® 3. Service Type allat on Delivery Restricted Delivery cumbrige SAvI an hambers All'ance Bank Sireel and Apt. No., or 7017 8.1 City, Stale, 2|p+42* Waltham MA 08457 PS Form 3800, April 2015 PSN 7530-02 Sce Reverse for Instructions U.S. Postal Service CERTIFIED MAIL RECEIPT Domestic Mail Only For delivery information, visit our website at www.usps.com Cambridge MA OR Cartilled Mail Fee - 0973 54.00 Extra Services & Fees (chock box, sad tea appropriatey •Ratusn Recept (handcopy) $0.00 • Return Recept (electronic) Postmark 7017 2680 0000 5542 1723 s10,00 • Cortified Mall Rastricled Dalivery Here: -0.00 • Adult Signaturo Required 9590 9402 7061 1225 9147 67 10.00 • Adult Signature Restricted Delivery $ so that we can return the card to you. or on the front if space permits. 1374 Massachusetts Ave Co Cambridge Savings Dan K Cambridçe MA 02138 1834 Realty Inc Postage • Print your name and address on the reverse 1. Article Addressed to: • complete items 1, 2, and 3. • Attach this card to the back of the mailpiece, SENDER: COMPLETE THIS SECTION 2. Article Number (Transfer from service label) PS Form 3811, July 2020 PSN 7530-02-000-9053 $0=50 Total Postage and Fees 70207022 2680 $7.35 No GoLumbridge Sexing Banks 7017 DJ Addressee • Agent is it, 74 Mass Ave 02138 ambridse MA Delivery PS Form 3800, AprIl 2015 PSN7 See Reverse fo Signature Confirmation Restricted Delivery 3 Registered Mall Hestr • Priorty Mail Express® D Registered Mall™M • Signature Confirmation Domestic Return Receipt U.S, Postal Service? CERTIFIED MAIL® RECEIPT Domestic Mail Only NOV - 22022 For delivery information, visit our website at www.usps.com Someryi Te, MA 02,44 CSB Certifled Mall Fea $4.00 If YES, enter delivery address below: 5542 • Is delivery address different frath Rat Extra Services & Fees (check box, add feats oppropriate) Service Type A. Signature COMPLETE THIS SECTION ON DELIVERY B. Received by (Printed Name) over $500) •Raturn Recept (hardcopy) • Certified Mail@ • Collect on Dellvery Restricted Delivery • Adult Signature Restricted Dellvery • Certified Mail Restricted Delivery • Collect on Delivery • Adult Signature D Insured Mail • Insured Mail Restricted Delivery DRatur Receipt (electronic) $40.00 Postmark C] Cortiled Mall Restricted Dolivery $$0,00 Haro •Adult Signaturo Required 0000 30. 00 • Adult Signature Restricted Delivery $ Postage LO $11.60 Total Postage and Fees 10X28/20:2 $7.85 Sent To iss yo Rockmont Manoron, r City, Siale, 2IP+4* PO Box 440,433 PS Form 3800, April 2015 PSN 7530-02-000-0017. See Reverse for Instructions 9590 9402 7061 1225 9148 11 so that we can return the card to you. or on the front if space permits. • Complete items 1, 2, and 3. 1. Article Addressed to: • Print your name and address on the reverse Ding Chambers Alliance • Attach this card to the back of the mailpiece, SENDER: COMPLETE THIS SECTION 2. Article Number (Transfer from service label) ; PS Form 3811, July 2020 PSN 7530-02-000-9053

CAMBRIDGE HISTORICAL COMMISSION 831 Massachusetts Avenue, 2nd Fl., Cambridge, Massachusetts 02139 Telephone: [phone removed] Fax: 617349 3116 TTY: [phone removed] E-mail: histcomm@cambridgema.gov URL: http://www.cambridgema.gov/Historic SLOGEHISTO Bruce A. Irving, Chair, Susannah Barton Tobin, Vice Chair; Charles M. Sullivan, Executive Director Joseph V. Ferrara, Chandra Harrington, Elizabeth Lyster; Jo M. Solet, Yuting Zhang, Members Gavin W. Kleespies, Paula A. Paris, Kyle Sheffield, Alternates COM CERTIFICATE OF NONAPPLICABILITY Property: 22 JFK Street Applicant: Alliara, LLC, owner, 0/b/0 Life Alive and Down Under Yoga, tenants Attention: Daniel Brennan, DPB Permits The Cambridge Historical Commission hereby certifies, pursuant to Chapter 2.78, Article III of the Code of the City of Cambridge and order establishing the Harvard Square Conservation District, that the work described below does not involve any activity requiring issuance of a Certificate of Appropriateness or Hardship: Replace the existing blade sign with a larger non- illuminated blade sign that still conforms to the zoning requirements of Art. 7.00. 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 If the work authorized by this certificate is not commenced issuance. within six months after the date of issuance or if such work is suspended in significant part for a period of one year after the time the work is commenced, such certificate shall expire and be of no further effect; provided that, for cause, one or more extensions of each may be allowed in time for periods not exceeding six months writing by the Chair. Case Number: 4881 Date of Certificate: October 26, 2022 Attest: A true and correct copy of decision filed with the and the Cambridge Historical Commission office of the City Clerk on October 26, 2022. By Charles M. Sullivan/sto, Executive Director. Twenty days have elapsed since the filing of this decision. No appeal has been filed • Appeal has been filed Date _, City Clerk

ALLIARA, LLC NEWTON CENTRE, MA 02459 C/O NCP MANAGEMENT CO., P.O. BOX 590179, October 5, 2022 Sent via electronic mailing only City of Cambridge Community Development Department 344 Broadway Cambridge, MA 02139 RE: 22 John F. Kennedy Street, Cambridge, MA Landlord/Ownership approval Life Alive/Down Under Yoga signage submission Dear Sir or Madame: Alliara, LLC is the title holder of the property known as and located at 18-28 John F. Lennedy Street, Cambridge (the "Property"). Alliara, LLC, as Landlord, and Life Alive Café LC as Tenant are parties to that certain Lease Agreement for the ground floor retail premises a the Property known as 22 John F. Kennedy Street (the "Leased Premises"). Life Alive Café, LLC has submitted to the City of Cambridge certain blade and wall ignage applications and certifications produced by ViewPoint Sign and Awning, respective! eceived October 4, 2022 (dated June 24, 2022). This letter shall hereby serve as Alliara, LLC' approval of said submissions to the City of Cambridge. For any further questions or concerns, kindly contact Nathan Wong at nathan(@nopmgmt.com. Thank you for your consideration. Very truly yours, Alliara, LLC By: Nathan Wong Authorized Signatory

Lile Alive Z2 JKF Combridge, He Hole Patter for Panel Permanently Mounted Bracket Mounted to Aluminum Plate Silicone Sealed to Replacement) 17 ½"x2"x1/4" (thick) Stainless Steel (TBD) (ViewPoint to Maintain Panel Replacement or Help Prevent Sleeve Anchors Inner Sign Frame for Water Proof & Future Tenant Corrosion Fascia (TBD) Assumed Masanty Description: Jeff Kross Logo/Typeface: Account Monoger: Supplied by Customer - Aluminum plate and gussets. - Aluminum horizontal brackets. Scale: 1" = 1' - Digitally printed contour cut vinyi graphics. (Dry 1) Double sided non iluminated blade sign. Designer. - Inner aluminum tube frame for bracket attachment. | Mathew Hoard - Aluminum face ponels with aluminum skinned returns. 1062.22 225 28" Elevation: #12722.2 (Qty 1) Blade Sign ORGANIC CAFE Colors: Retums- Bracket- (Same Art Both Sides) LIFE ALIVE Revisions: Installation: Background - DOWRSUNDER By Viewpoint. Square Footage: 45 13/16 × 28" = 8.9 sq.ft. 45 13/16" pointed Black painted Black Revisions: Background with Matte Lamination to be White Gloss All White Graphics Vinyl (contour cut) Digitally Printed Vinyl digitally printed at 720 dpi on 3M I1 80c Controltac vinyl with White Graphics-Orecal 751-010 White opaque vinyl 3M 8520 Clear Matte over-laminote. Side View: -6'→ Scale: 1"= 1' See window band Retums drawing for details. Plate Gussets THIS PROPOSAL DRAWING CONTAINS ORIGIMAL ELEMENTS .063 Aluminum Skinned UNAUTHORIEI DUPUCATIOH OR REPRODUCHION IS PROHIBITED. Proposed: CREATED BY VIEWPOINT SIGH AND AHHING, ALL RIGHTS RESERVED. 1/2" (thick) Aluminum 1/4" (thick) Aluminum 1/8" Aluminum Face Panels Bra: xets it wantal Support ¡ taila is UNDER THIS PROPDEAL DRAWING CONTAINS ORIGINAL ELEMENTS CREATED BY VIEWPOINT EIGN AND AWNING AUSPICHIE RESERVEDE SIGN AND AWNING Existing: LIFE ALIVE ORGANIC CAFE ViewPoint [phone removed] FAX [phone removed] Customer Approval LIFE ALIVE marria Acd. Monager Approval 7-6 Producion Approval Blade Sign UNAUTHORIZED DUPLICATION OR REPRODUCTION IS PROHIBITED

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ViewPoint SIGN aND AWNING 9-15-22 35 Lyman Street Northboro, MA 01532 [phone removed] [phone removed] Fax Ms. Alexandra Chan [email removed] Life Alive www.ViewPointSign.com 22 JFK St. Cambridge, MA 02138 INTERIOR/EXTERIOR SIGNAGE Electric Dear Alexandra, Architectural Dimensional Wayfinding Estimate for the revised blade sign and the rear canopy structure for Channel Letters the Harvard Square project. LED/Neon Electronic Message Centers Digital Graphics $7,570 Rear canopy, door, aluminum frame, Ferrari fabric. $2,070 Rear canopy installation. AWNINGS $3,385 New replacement blade sign. 54" high × 33" across. Commercial $1,280 Blade sign installation. Backlit Canvas Plus tax on manufactured product. Retractable Assumes daytime installation. SIGN SERVICE Plus Police Detail and Parking permits as required. ARCHITECTURAL METAL FABRICATION VEHICLE GRAPHICS MEMBERS Massachusolts Sign Associalion Jefticy wass Rhode Island Sign Association International Sign Associalion Northeast Stales Sign Association North East Canvas Products Association Industrial Fabrics Associallon International UL LISTED FABRICATORS

Job: Life Alive Location: Job Number: 12722.1 Account Manager Designer: Dax: 3,2022 .020 Clear Fabric .020 Clear Revisions: 82° \ Reisions: 81". ¡Opening 42° Opening Custom stormdoor 42"×B1" Open left oide handle 42° Fabrie 19" .020 Clear L020 Clear THIS PROFOSAL DRAHING CONTAINS ORIGINAL BLEKENTS CREATED BY VENPOINT SIGN AND ANNERG AL RIGHTS RESERYED. 36° Fabric .020 Clear .020 Clear 13/4" | 81° ViewPoint [phone removed] SIGN AND AWNING FAX [phone removed] Fabric Color: Pacific Blue Fabric: Weathertyte Canopy (ustamer Aprovd Door handle on the left .O20 Clear panels upper portion of panel. Rigid Side panels: 1" Alum. Staple Extrusion Fabric portion Weathertyte Canopy Pacific Blue Storm Door: 42" Width × 81" Tall, Custom build Ard. Horeger Aproval Frame: 1" Alum, staple extrusion.125 wall thickness Poles for door : 1"X 2" Alum. Sqr.. 125 wall thickness Job Description: 1 Shed canopy w/ rigid sides & storm door Producion Approval canbede EOSANDEAWING ONANE CHISINANE EMENE CEES O AMEWPON SIEN AND AWAN N CENTE EIVO UN IOCPR HOMOE ICOPUCMOK ROMENEDS

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The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Lafayette City Center 2 Avenue de Lafayette, Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Expansion Opportunities dba Viewpoint Sign & Awning Address: 35 Lyman St. Phone #: [phone removed] City/State/Zip: Northboro, MA 01532 Are you an employer? Check the appropriate box: Type of project (required): 40 4. • I am a general contractor and I 1. I am a employer with 6. •] New construction have hired the sub-contractors employees (full and/or part-time).* listed on the attached sheet. 7. • Remodeling 2. D 1 am a sole proprietor or partner- These sub-contractors have ship and have no employees 8. • Demolition employees and have workers' working for me in any capacity. 9. Building addition comp. insurance.t [No workers' comp. insurance 10. Electrical repairs or additions 5. We are a corporation and its required.] officers have exercised their 11.D Plumbing repairs or additions 3. L I am a homeowner doing all work right of exemption per MGL 12.D Roof repairs myself. [No workers' comp. c. 152, §1(4), and we have no insurance required.]* 13.M Other Signs employees. [No workers' comp. insurance required.] I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: The Travelers Indemnity Co of CT Policy # or Self-ins. Lic. # UB3R279540-22-14-G Expiration Date: 9/14/2023 Job Site Address: 22 JFK St. City/State/Zip:_ Cambridge, MA attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date) Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that 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 f perjury that the information provided above is true and correct. Date: 10/4/2022 Signature: David Randa [phone removed] Phone #: Official use only. Do not write in this area, to be completed by city or town official. Permit/License # City or Town: Issuing Authority (check one): 10 Board of Health 2L1 Building Department 3L]City/Town Clerk 4.0 Electrical Inspector 5L Plumbing Inspector 6.Other Contact Person: Phone #:_

ACORD® CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERER FIGHTS UPON THE CERTIFICATE HOLDER THE 172022. 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. CONTACT Elizabeth Bortone F.M. Wailey Insurance [phone removed] No, Ext): [phone removed] (AC, No): E-MAIL 475 High Street ADDRESS: [email removed] INSURERS) AFFORDING COVERAGE NAIC # 25658 Dedham The Travelers Indemnity Company MA 02026 INSURERA: 25674 INSURED Travelers Property Casualty Company of America INSURER B: The Travelers Indemnity Co of CT 25682 Expansion Opportunities Inc INSURER C: DBA ViewPoint Sign & Awning INSURER D: 35 Lyman Street, Suite 1 INSURER E: Northborough MA 01532 INSURERE : CERTIFICATE NUMBER: 2022 REVISION NUMBER: 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. POLICY NUMBER EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED OCCUR CLAIMS-MADE $ 300,000 PREMISES (Ea occurrence) $ 5,000 MED EXP (Any one person) A Y-630-3R279552-IND-22 09/14/2022 09/14/2023 PERSONAL & ADV INJURY $ 1,000,000 $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE LOC POLICY X PRO. JECT PRODUCTS- COMP/OP AGG $ 2,000,000 OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $ 1,000,000 (Ea accident) BODILY INJURY (Per person) X ANYAUTO OWNED SCHEDULED BODILY INJURY (Per accident) BA-3R254754-22-14-G 09/14/2022 09/14/2023 A AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY Per accident AUTOS ONLY UMBRELLA LIAB $ 10,000,000 X OCCUR EACH OCCURRENCE EXCESS LIAB CUP-3R285546-22-14 / 09/14/2023 09/14/2022 $ 10,000,000 CLAIMS-MADE _AGGREGATE DED X RETENTION $10,000 WORKERS COMPENSATION 107* XI TATUTE T AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE $ 1,000,000 NIA EL EACH ACCIDENT 09/14/2022 UB-3R279540-22-14-G N 09/14/2023 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE S 1,000,000 $ 1,000,000 E.L. DISEASE - POLICY LIMIT ErIN DOOPERATHONS below DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Cerificate Holder is included as addilionat insured in regards to General Liability per Blanket Additional Insured - Form CGD458 (02/19). CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Cambridge Dept. of Public Works 147 Hampshire Street AUTHORIZED REPRESENTATIVE MA 02139 Cambridge Eligates M. Botere © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 25(2016/03)