An application was received from Carol Fournier representing Oak Bistro, requesting permission for a projecting flag pole sign at the premises numbered 1287 Cambridge Street approval has been received from Inspectional Services, Department of Public Works, Community Development Department and abutter response and proof of mailing has been provided

11/29/2023 City of Cambridge, MA Applicant 239671 Primary Location Sign/Awning Permit & Carol Fournier 1287 Cambridge St Status: Active 2 [phone removed] Cambridge, MA 02139 Submitted On: 8/23/2023 @ [email removed] Owner A 922 Main Street KKM2 LLC, Waltham, MA 02451 21 BLUEBERRY LANE LEXINGTON, MA 02420 General Information What option best describes this application?* Sign(s) Description of Proposed Work* Installing One Blade Sign Above Entrance Estimated Cost of Signs) in dollars * 500 Describe any existing signs or awnings that will remain (including the size of the remaining signs/awnings).* Painted Wall Lettering on the Facade 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) to the City Clerk's Office. Sign Information Sign Text* Oak Bistro Illumination* Type of Sign* Natural Projecting Width of Sign (feet)* Height of Sign (feet)* 1.5 1.2

Area of Sign (square feet)* Height from the ground to the top of the sign (feet)* 18 10.3 Height from the ground to bottom of the sign Sign Material* (feet)* Plastic Material with Metal Posts 7.9 Projection from the Building (inches) Weight of the sign (Ibs)* 14 20 Is the sign an accessory to a first floor store?* Width of Building Facade for Associated Use (feet)* Yes 39 Contractor Contractor Name* CAROL A FOURNIER Address* 26 Armory Street APT 2 E-mail* Telephone* [email removed] [phone removed] License Expiration Date* License Number* 10/07/2024 CS-116103 Contractor's Signature Date* Signature of Licensed Contractor* 08/23/2023 Carol Fournier Community Development Approval a Sign conforms to requirements of Article 7.000 & Sign requires a variance from the Board of Zoning Appeal - - A Comments

Activity Date Carol Fournier added attachment 2324 Master WC Certificate - 8/23/2023, 1:20:38 Seaver Construction Inc.pdf to Record 239671 PM Carol Fournier submitted Record 239671 8/23/2023,1:21:42 PM approval step Review for Completenesswas assigned to Branden 8/23/2023,1:21:43 PM Vigneault on Record 239671 approval step Community Development Plan Reviewwas assigned to 8/23/2023,1:21:43 PM Daniel Messplay on Record 239671 Branden Vigneault approved approval step Review for Completeness 8/30/2023,10:04:43 on Record 239671 AM Olivia Ratay assigned approval step Community Development Plan 9/14/2023,9:43:54 Review to Evan Spetrini on Record 239671 AM Olivia Ratay assigned approval step Community Development Plan 10/5/2023, 11:12:17 AM Review to Daniel Messplay on Record 239671 11/15/2023,2:32:14 Carol Fournier added attachment 1287.zip to Record 239671 PM Carol Fournier added attachment SIGN CERT FORM 2019_filledin 3 11/16/2023, 1:32:36 (1) signed dm.pdf to Record 239671 PM Daniel Messplay approved approval step Community Development 11/16/2023,1:42:23 Plan Review on Record 239671 PM approval step Department of Public Works Reviewwas assigned to 11/16/2023,1:42:24 Brian McLane on Record 239671 PM Brian McLane approved approval step Department of Public Works 11/20/2023,5:27:37 Review on Record 239671 AM approval step City Clerk Reviewwas assigned to Lori Perez on Record 11/20/2023,5:27:38 239671 AM Timeline Due Assignee Completed Label Activated Date Branden / Review for 8/30/2023, 8/23/2023, 10:04:43 AM Vigneault Completeness 1:21:43 PM / Community Daniel 11/16/2023, 8/23/2023, Development Plan Messplay 1:42:23 PM 1:21:43 PM Review Brian 11/20/2023, / Department of 11/16/2023, McLane Public Works Review 5:27:37 AM 1:42:24 PM 11/20/2023, Lori Perez / City Clerk Review 5:27:38 AM / City Council Approval / Bond / Building Inspector Review Carol $ Sign Permit Fee Fournier E Sign Permit

OFFICE OF THE CITY CLERK CAMBRIDGE CITY HALL, 795 MASSACHUSETTS AVENUE CAMBRIDGE, MASSACHUSETTS 02139 PHONE [phone removed] FAX [phone removed] DIANE P. LEBLANC PAULA M. CRANE CITY CLERK DEPUTY CITY CLERK Wednesday Aug 3 Cambridge, 3, 2023 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 Oak Bistro (NAME OF BUSINESS be granted permit to erect a sign of the following specifications in front of premises located at 1287 Cambridge st, MA 02138 (ADDRESS) Type of Sign: Vinyl flag pole sign, exterally lit (state whether electric or otherwise and material used in construction) Reading matter to go on Sign: Oak Bistro 1ft 2in x1ft 6in Size: Weight: 20lbs Public Way 1ft 3in Obstruction: 9ft 9in (Give exact distance sign is to extend over sidewalk) (Also exact distance from bottom of sign to sidewalk) 9ft 9in Height Above Grade: Bottom: Top: 1Oft 3in NOTICE - REGULATIONS [Section 12.08.010 Municipal Code - Encroachments onto Streets] Section 1212.0 State Building Code - Projecting Signs] • A projecting sign shall be constructed wholly of incombustible materials. • All signs must meet requirements of Zoning Ordinances and Building Code. • Note: Section 12.12.220 provides in part "every owner who maintains a... structure in or over a street.. shall de 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. [phone removed] authorized agent) (Property (Address) (Tel. No.) 1287 Cambridge St, Cambridge ma 02138 ,[phone removed] (Business op (Address) (Tel. No.)

OFFICE OF THE CITY CLERK CAMBRIDGE CITY HALL, 795 MASSACHUSETTS AVENUE CAMBRIDGE, MASSACHUSETTS 02139 PHONE [phone removed] FAX [phone removed] DIANE P. LEBLANC PAULA M. CRANE CITY CLERK DEPUTY CITY CLERK Wednesday Aug 3 Cambridge, 3,2023 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 Oak Bistro (NAME OF BUSINESS) be granted permit to erect a sign of the following specifications in front of premises located at 1287 Cambridge st, MA 02138 (ADDRESS) Type of Sign: Vinyl flag pole sign, extemally lit (state whether electric or otherwise and material used in construction) Reading matter to go on Sign: Oak Bistro 1ft 2in x1ft 6in Size: Weight: 20lbs Public Way Obstruction: 9ft 9in A. 1ft 3in B. (Give exact distance sign is to extend over sidewalk) (Also exact distance from bottom of sign to sidewalk) 9ft 9in Height Above Grade: Bottom: Top: 10ft 3in NOTICE - REGULATIONS [Section 12.08.010 Municipal Code - Encroachments onto Streets] Section 1212.0 State Building Code - Projecting Signs] • A projecting sign shall be constructed wholly of incombustible materials. • All signs must meet requirements of Zoning Ordinances and Building Code. • 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. Km ho [phone removed] (Property g or authorized agent) (Address) (Tel. No.) 1287 Cambridge St, Cambridge ma 02138 ,[phone removed] (Business (Address) (Tel. No.)

OFFICE OF THE CITY CLERK CAMBRIDGE CITY HALL, 795 MASSACHUSETTS AVENUE CAMBRIDGE, MASSACHUSETTS 02139 PHONE [phone removed] FAX [phone removed] TTY/TDD [phone removed] PAULA M. CRANE DIANE P. LEBLANC CITY CLERK DEPUTY CITY CLERK ABUTTERS FORM FOR SIGN/AWNING PERMIT 08/15/2023 Date To Whom It May Concern: Oak Bistro As Owner of Agent of Cambridge, × Approval of the Massachusetts, I do hereby declare my disapproval approval installment of: Canopy over the sidewalk entrance: _ Awnings over the windows: X Projecting sign: of said property. Date 08/15/2023 Signed: Address: 1287 Cambridge St, Cambridge Ma 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) Reset Form Print

FASTSIG-03 NDUMONT DATE (MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 7/12/2023 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 THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. 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 endorsements). PRODUCER License # 1780862 NAMEACT HUB International New England (AC, No): [phone removed] (AC, No, Ext): [phone removed] 300 Ballardvale Street Wilmington, MA 01887 ADDRESS: NAIC # INSURER(S) AFFORDING COVERAGE INSURER A : Massachusetts Manufacturing Self-Insurance Group, Inc. 34320 INSURED INSURER B: INSURER C: Fast Signs, Mehta Signs & Graphics Inc 922 Main Street INSURER D: Waltham, MA 02451 INSURER E: INSURER F: CERTIFICATE NUMBER: REVISION NUMBER: NOTWITHSTANDING ANY REQUIREMENT, 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. NSR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS-MADE OCCUR MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRODUCTS - COMP/OP AGG LOC OTHER: COMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ BODILY INJURY (Per accident) AUTOS ONLY ROPERTY DAMAG $ $ $ OCCUR UMBRELLA LIAB EACH OCCURRENCE CLAIMS-MADE EXCESS LIAB $ AGGREGATE RETENTION $ $ DED WORKERS COMPENSATION A X STATUTE X IND EMPLOYERS' LIABILITY YIN 1/1/2023 1/1/2024 20005100196000 1,000,000 $ E.L. EACH ACCIDENT N/ A Y 1,000,000 E.L. DISEASE - EA EMPLOYEE $ describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Leary Field Fieldhouse The following officers are excluded on the policy: Shishir Mehta Amishi Mehta CANCELLATION CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE DATE THEREOF, DELIVERED IN NOTICE WILL BE EXPIRATION Seaver Construction Inc ACCORDANCE WITH THE POLICY PROVISIONS. 215 Lexington Street Woburn, MA 01801 AUTHORIZED REPRESENTATIVE Sadag Beasory © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD

Blade sign Proposed PROJECTING Sign (including signs on awnings) 1'6" 1'2" 1.75 sq ft X Dimensions: Area in Square feet: Natural X Internal Illumination: _ External 10'3" Height (from ground to the top of the sign):_ 1. COMPLETE WHEN SIGN IS ACCESSORY TO A FIRST FLOOR STORE _ Area of signs allowed accessory to store: Length in feet of store front facing street: (a) _39' sqft 19.5' sqft 39 sq ft outside (1 x a) , behind windows (0.5 x a) Area of all existing signs on 26 sq ft the store front to remain (including any freestanding sign):_ • Area of additional signs 13 sqft permitted: 2. COMPLETE FOR ANY OTHER SIGN _ Area of signs allowed accessory to Length in feet of building facade facing street: (a) • Area of the building facade: outside (1 x a) - behind windows (0.5 x a) all existing signs on the building facade to remain (including any freestanding sign: Area of additional signs permitted: SUMMARY OF LIMITATIONS FOR PROJECTING SIGNS (see reverse side for more general summary of the sign regulations; review Article 7.000 of the Zoning Ordinance for all zoning requirements.) AREA: 13 square feet maximum. HEIGHT ABOVE THE GROUND: 20 feet but below the sills of second floor windows. ILLUMINATION: Natural or external only. NUMBER: one per store plus one per entry to the remainder COMMUNITY DEVELOPMENT DEPARTMENT CERTIFICATION x NO Sign conforms to requirements of Article 7.000: YES Sign requires a variance from the Board of Zoning Appeal: YES 7.16.22.B Relevant sections: COMMENTS: _Proposed naturally illuminated projecting sign meets the dimensional and illumination requirements of Article 7. Date: 10/18/23 CDD Representative

DE 0154 Here Postmark USE 11/14/2023 $11,00 $0.00 40.00 $0.00 $0.66 $4.35 CRONAH0115 PSIS CAMBRIDGE MA 02139 6-8 OAKLAND ST UNIT 2 For delivery information, visit our website at wwi CERTIFIED MAIL® RECEIPT 5. THE 8 OAKLAND STREET #2 REALTY TR Domestic Mail Only U.S. Postal Service™ • Certified Mall Restricted Delivery • Adult Signature Restricted Delivery $ • Return Receipt (hardcopy) • Return Receipt (electronic) • Adult Signature Required otal F MOSCHETTI, ANDREW R. TRS Postage Certified Mail Fee Extra Services & Fees (check box, ad tea of are opiate) Street City, si DOOL PU 316U 7647 2798

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0154 Postmark $0.00 $0,00 $0.00 $4.35 $0.66 C/O RESOURCE CAPITAL GROUP SOMERVILLE MA 02143 17 IVALOO ST., STE 100 IVES FUTURAMA RENTALSS 126.14/2023 CERTIFIED MAIL® RECEIPT U.S. Postal Service™ Domestic Mail Only • Certified Mail Restricted Delivery • Adult Signature Restricted Delivery $ • Return Receipt (electronic) • Adult Signature Required For delivery information, visit our website at www. • Return Receipt (hardcopy) Certified Mail Fee Sent To Postage Cily, state, Zil Total Postage Street and Apt $5.01 7020 3160 00012798 7562

Here Postmark • 9998 11/14/2023 Sep Rever $0.00 $0.00 $0,00 $0.66 CAMBRIDGE MA 02139 1245-1273 CAMBRIDGE ST MICHAEL JOSEPH SEXTON HOFFMAN, LINDSEY DAY Combri due MA 02189 U.S. Postal Service™ CERTIFIED MAIL® RECEIPT For delivery information, visit our website at www.usps.com® Domestic Mail Only • Adult Signature Restricted Delivery S • Return Receipt (hardcopy) • Adult Signature Required • Certified Mail Restricted Delivery • Return Receipt (electronic) Extra Services & Foes (check box, add foe i (Opriate) Sent To Certified Mail Fee $4,35 PS Form 3800 Postage Total Postagi Street and Apl UNIT 1269-2 City, State, Zi 45.01 7579 T00O 8622 09TE 0202

Here 6. 01 Postmark 13714/2023 $0.00 $0.00 $0.00 $0.00 FICIAL USE #0.66 74.05 1259 CAMBRIDGE ST UNIT 2 CAMBRIDGE MA 02139 U.S. Postal Service™ CERTIFIED MAIL® RECEIPT For delivery information. visit our website at www.usps.com". Domestic Mail Only • Retum Receipt (electronic) • Adult Signature Required • Adult Signature Restricted Delivery $ •Return Receipt (hardcopy) • Certified Mail Restricted Delivery Postage Extra Services & Fees (check box, add fee aslappropriate) Certified Mail Fee PS Form 3800, April 2015 PSN 7530-02-000:9042/002220 Sent To Total Postage ar JENKINS, JONAH JAY City, state, Zip. Street and Apt. 1 20206 2260 0001 2898 73

L0154 Here Postmark 11/1422023 $0.00 $0.00 $0.00 MP: 02180 $4.35 $0.66 19 CHESHIRE ST UNIT L KEVIN BIRMINGHAM LIVING TR BIRMINGHAM KEVIN TRS Jama PICEn U.S. Postal Service™ CERTIFIED MAIL® RECEIPT For delivery information, visit our website at www.usps.com® Domestic Mail Only • Adult Signature Required • Return Receipt (hardcopy) • Adult Signature Restricted Delivery S • Certified Mail Restricted Delivery • Return Receipt (electronic) Sent To Extra Services & Fees (check box, add fee as appropriate Total Postage Certified Mail Fee Postage Street and Apt. $5.01 ally, Staie, ZiF JAMAICA PLAIN MA 02130 7616 2798 7020 316

01 0154 Here Postmark USE 40.001 $0.00 40.00 $0.00 $4.35 GEARIN: SEAN & STACEY HESE /14/2023 269 RUSSETT RD CHESTNUT HILL MA 02467 CERTIFIED MAIL® RECEIPT For delivery information, visit our website a Domestic Mail Only U.S. Postal Service™ • Certified Mail Restricted Delivery • Adult Signature Restricted Delivery $ • Return Receipt (electronic) • Adult Signature Required • Return Receipt (hardcopy) Extra Services & Fees (check box, add fee is appropriate) Certified Mail Fee Postage City, state, Z Sent To Total Postag $5.01 Street and Af 2798 3160 0001 E292

20154 Here Postmark 11/14/2023 $0.00 $0.00 $0,00 $4.35 1267-3 CAMBRIDGE ST PASTEINAK, SEDALIA CAMBRIDGE MA 02139 Combri dae MA 02159 For delivery information, visit our website at www.usps.com U.S. Postal Service™ CERTIFIED MAIL® RECEIPT Domestic Mail Only • Certified Mail Restricted Delivery • Adult Signature Restricted Delivery $. •Adult Signature Required • Return Receipt (hardcopy) • Retum Receipt (electronic) Sent To Extra Services & Fees (check box, add fee as appropriate) Total Postage Certified Mail Fee Postage Street and Apt City, State, zip $5.01 П9ТF ПРП 7630 2798

10'3" to top of blade sign g'g" to bottom of blade sign BLADE SIGN VINYL FLAG ON POLE 1"2" X1"6" USES EXISTING EXTERNAL LIGHTING DIMENSIONS OF BLADE SIGN: 39' wide FRONT VIEW DAK BISTRO 10'3" to top of blade sign g'g" to bottom of blade sign SIDE VIEW

922 Main Street FASTSIGNS. ESTIMATE Waltham, MA 02451 Make Your Statement [phone removed] EST-39480 www.fastsigns.com/401 Payment Terms: Dear Customer Created Date: 7/12/2023 DESCRIPTION: Oak Bistro - Cambridge Ma Jta Architecture Installed: Bill To: Jta Architecture Elaine Blais 343 Medford Street 1287 Cambridge St, Somerville, MA 02145 Cambridge, MA 02138 US US Salesperson: Shishir Mehta Requested By: Elaine Blais Email: [email removed] Work Phone: [phone removed] UNIT PRICE AMOUNT QTY Product Summary NO. $295.00 $295.00 Double Sided Banner Pole Sign - Non Illuminated 1 1 Banner - 18oz - 1.1 Part Qty: 1 Width: 18.00" Height: 36.00" Sides: 2 $82.85 1 $82.85 Logo for Door 2 Vinyl RTA - Die Cut RTA - White 2.1 Part Qty: 1 Width: 12.00"' Height: 12.00" Text: Oak Bistro Logo $0.00 Permit Fee - Final Cost TBD $0.00 3 Permit - 3.1 4 $375.00 $375.00 Permit Aquiring Fee Permit Acquisitions - 4.1 - Retail Price: $0.00 $475.00 5 Installation $475.00 Generated On: 7/12/2023 6:32 PM Page 1 of 2

Install - 5.1 - # of Hours: 1 Text: Installation - Fastsigns of Waltham is always very careful and diligent when we work but will not be responsible for any damage that happens to the wall/signs during the removal/installation process. Fastsigns of Waltham will not be responsible for painting and patching any walls, wallpaper, or any other fixture that is damaged during the removal. Fastsigns will also not be responsible for any clean-up (i.e. mopping, vacuuming, dusting) after the installation/removal but we will be responsible for removing any refuse that was used for the installation/removal. $1,227.85 Subtotal: Taxes: $23.62 Unfortunately all commodity pricing has increased over the last few months. Grand Total: $1,251.47 We are doing our best to manage the price increase of materials without passing it to our customers, but please be advised that all Estimates are valid for 30 days from the day of the quote. To pay the bill online. Please click on the link below https://bit.ly/FS_Waltham_Payment 7/23/23 Date: Signature: Водишим. Estimates are valid for 30 days from the quoted date Page 2 of 2 Generated On: 7/12/2023 6:32 PM

DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE ACORD® 7/6/2023 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. 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 endorsements). CONTACT Sharon Ackerman PHONE Stanton Insurance Agency Inc. [phone removed] No, Ext): (A/C 781) 89317516 230 Second Ave #105 DREss: [email removed] NAIC # INSURERS) AFFORDING COVERAGE Waltham MA 02451 INSURERA: Great American Insurance Company 16691 INSURED INSURER B: Arbella Protection Ins Co 41360 Mehta Signs & Graphics Inc, DBA: FastSigns INSURER C: 922 Main Street INSURER D: INSURER E: Waltham MA 02451 INSURER F: COVERAGES CERTIFICATE NUMBER:MASTER 2023 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 EFF TYPE OF INSURANCE WVD LIMITS POLICY NUMBER COMMERCIAL GENERAL LIABILITY 1,000,000 $ EACH OCCURRENCE DAMAGE TO RENTED CLAIMS-MADE OCCUR 100,000 PREMISES (Ea occurrence) PAC3743424 x 1/9/2024 1/9/2023 $ 10,000 MED EXP (Any one person $ 1,000,000 PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: 2,000,000 GENERAL AGGREGATE PRO POLICY LOC x $ 2,000,000 PRODUCTS - COMP/OP AGG $ EPLI OTHER: 10,000 COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $ 1,000,000 (Ea accident) $ BODILY INJURY (Per person) _ ANY AUTO ALL OWNED $ 1020113702 BODILY INJURY (Per accident) AUTOS 1/9/2024 1/9/2023 AUTOS NON-OWNED $ AUTOS HIRED AUTOS GK collision & comprehensive 60,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE 2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE 2,000,000 UMB3743426 1/9/2023 1/9/2024 10,000 DED X RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TATUTE T YIN ANY PROPRIETOR/PARTNER/EXECUTIVE $ EL. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? N/ A (Mandatory in NH) $ EL DISEASE - EA EMPLOYEE SCRIPTION OF OPERATIONS belc E.L. DISEASE - POLICY LIMIT PAC3743424 1/9/2023 1/9/2024 Business Income/Extra Expense 12 MONTHS ALS A Employment Practices Liability PAC3743424 1/9/2023 1/9/2024 10,000 RE: CONTRACT# C23-05. RE: COOTRACE C23-05. BEAVER CONSPRUCTTON AND THE CITY OF WALTHAN ARE ENCEDED AS ADDITIONAL, INSURE WITH REGARD TO GENERAL LIABILITY ON A PRIMARY NONCONTRIBUTORY BASIS. UMBRELLA POLICY IS FOLLOW FORM. WAIVER OF SUBROGATION APPLIES. CERTIFICATE HOLDER CANCELLATION Ifrissore@seaverconstruction. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE SEAVER CONSTRUCTION 215 LEXINGTON STREET WOBURN, MA 01801 AUTHORIZED REPRESENTATIVE Sharon Ackerman/SAA Sharm Q Ackerman 1 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INSO25 (201401)