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PATRIOT ENVIRONMENTAL SERVICES
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Last modified
10/14/2019 4:11:36 PM
Creation date
10/10/2019 4:26:39 PM
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Contracts
Company Name
PATRIOT ENVIRONMENTAL SERVICES
Contract #
N-2019-194
Agency
PUBLIC WORKS
Expiration Date
9/24/2022
Insurance Exp Date
11/1/2019
Destruction Year
2027
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Starr Surplus Lines Insurance Company <br />AMENDMENT - NOTICE OF CANCELLATION FOR <br />SCHEDULED THIRD PARTIES <br />Policy Number: 1000065977181 Effective Date: 11/1/2018 at 12:01 AM <br />Named Insured: Patriot Environmental Services, Inc. <br />This endorsement modifies the insurance coverage form(s) listed below that have been purchased by you <br />and <br />evidenced as such on the Declarations page. Please read the endorsement and respective policy(ies) <br />carefully. <br />Auto Dealers Coverage Form, Business Auto Coverage Form, Business Auto Physical <br />Damage Coverage Form, Commercial General Liability Coverage Form, Contractor's <br />Pollution Liability Coverage Form, Electronic Data Liability Coverage Form, Excess <br />Liability Policy Form, Garage Coverage Form, Liquor Liability Coverage Form, Motor <br />Carrier Coverage Form, Owners And Contractors Protective Liability Coverage <br />Form -Coverage For Operations Of Designated Contractor, Pollution Liability Coverage <br />Form Designated Sites, Products/Completed Operations Liability Coverage Form, <br />Product Withdrawal Coverage Form, Professional Liability Coverage Form, Railroad <br />Protective Liability Coverage Form, Site Pollution Liability Coverage Form, Special <br />Protective And Highway Liability Policy -New York Department Of Transportation, <br />Truckers Coverage Form, Underground Storage Tank Policy Designated Tanks. <br />It is agreed that in the event the Insurer cancels the policy for any reason other than non-payment of premium, <br />the Insurer will give a 30 day notice of cancellation to the following certificate holder(s): <br />SCHEDULE <br />Blanket where required by a written contract. <br />The Insurer will endeavor to provide notice of cancellation to the certificate holder(s) listed in the Schedule by email. <br />The Insurer agrees to provide such notice of cancellation to scheduled certificate holders for this policy. <br />This notification of a pending cancellation of coverage is intended as a courtesy only. The Insurer's failure to provide <br />such notice will neither extend the policy cancellation nor negate cancellation of the policy; nor will this failure <br />result in obligation or liability of any kind upon the Insurer, its agents or representatives. <br />This endorsement does not affect, in any way, coverage provided under this policy, the cancellation of this policy or <br />the effective date of cancellation. <br />All other terms and conditions of this Policy remain unchanged. <br />MANUSCRIPT (06/10) <br />Page 1 of 1 <br />REVIEnD & APPROVED <br />By Ris ANAGEMENT DIViSiON <br />Attachment Code: D513904 I A A�Pp 0 2019 <br />Certificate ID: 16321114 <br />M. LAMBERT <br />
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