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HomeMy WebLinkAboutContractor Withdrawal Letter7/21/26 131 J —Z i,2—350 Pet 1-e-e_A1, Az/2_4, RECEIVED ' JUL 212026 BUILDING DEPARTMENT By f t- .t5 • , 3'11E JC. • • ; ••. t • • 21111, 7 7 (e).- Home Improvement Contractor Re . istration Card Registration valid for use type, only before the expiration date. Type: Corporation Number: 217231 Expiration: 10/27/2027 Issued to: PROLINE COVERING INC F . Nikon Guastix; . 24 CAYUGA AVE Mashpee, MA 02649 � � �. . . Office of Consumer Affairs & Business Regulation Lay>ra R. 1 Federal St., Suite 0720, Boston, MA 02110-2012 D 'Emilia �Y - Afftirldersecretar y 10/ Commonwealth of Massachusetts Construction Supervisor Division of Occupational Licensure Unrestricted - Buildings of any use group which contain less than Board of Building Reulations and Standards 35.000 cubic feet (991 cubic meters) of enclosed space. Cons MJW ,p rvisor 44'CS-122150 spires: 05/23/2029 RAISSA GUASTI ,� 24 CAYUGA AVE MASHPEE MX 02649 r ''3 Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Commissioner i�Us e / Contact OPSI: (617) 727-3200 or visit www.mass.gov/dpllopsi •�.�- DATE(MM/DDNYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 07/07/2026 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. 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). PRODUCER CONTACT Samuel Santos NAME: WORLD INSURANCE ASSOCIATES LLC (A/C.NNE Ext): (508)771-8381 (A/C,No): ADDRESS:A SamuelSantos@worldinsurance.com 34 Main MA-28 INSURER(S)AFFORDING COVERAGE NAIC# West Yarmouth MA 02673 INSURER A: HARTFORD UNDERWRITERS INS CO 30104 INSURED INSURER B MOBILE DRYWALL INC INSURER C: INSURER D: 40 POLARIS DR INSURER E: MASHPEE MA 02649 INSURER F: COVERAGES CERTIFICATE NUMBER: 1236702 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MM/DDNYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENE CLAIMS-MADE OCCUR PREMISES Ea occur ence) $ MED EXP(Any one person) $ N/A PERSONAL&ADVINJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- LOC PRODUCTS-COMP/OP AGG $ JECT OTHER. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS ONLY �_ AUTOS HIRED L NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION �//�I STATUTE AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 A OFFICER/MEMBEREXCLUDED7 N/A N/A N/A , 6S60UBOW87936626 02/20/2026 02/20/2027 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 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/Iwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Proline Covering ACCORDANCE WITH THE POLICY PROVISIONS. 24 Cayuga Ave AUTHORIZED REPRESENTATIVE Mashpee MA 02649 Daniel M.Crowley,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2016 ACORD CORPORATION. All rights reserved. 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