Governor and Executive Council Agenda item PDF - 2026-01-07 - agenda 49

Meeting Date

2026-01-07

Attachment Kind Label

Agenda item PDF

Attachment Relation

primary_meeting_attachment

Agenda Numbers

49

Agency Names

Department Of Environmental Services

Parent Meeting Title

Governor and Executive Council meeting - 2026-01-07

NHDES

The State of New Hampshire

Department of Environmental Services

JAN 0 7 2026

Robert R. Scott, Commissioner

December 3, 2025

Her Excellency, Governor Kelly A. Ayotte

and the Honorable Council

State House

Concord, New Hampshire 03301

REQUESTED ACTION

Authorize the Department of Environmental Services (NHDES) to award a grant to the Sanborn Regional School

District (VC# 154453-BOOl), Kingston, NH, in the amount not to exceed $75,000 for lead remediation in drinking

water at four district schools, under the provisions of RSA 485:F, effective upon Governor and Council approval

through December 31, 2026.100% Drinking Water and Groundwater Trust Fund (DWGTF).

FY 2026

$75,000

Funding is available in the following account:

03-44-44-444010-7428-073-500583

Dept. Environmental Services, Drinking Water and Groundwater Trust Fund, Grants Non-Federal

EXPLANATION

The Drinking Water and Groundwater Trust Fund (DWGTF) was created in 2016, using $276 million of MtBE trial

judgement funds, as authorized by RSA 485-F. The purpose of the DWGTF is to provide sustainable, long-term

funding for the protection, preservation, and enhancement of the drinking water and groundwater resources of

the state. The Drinking Water and Groundwater Advisory Commission (Advisory Commission) was established to

administer and provide guidance to the State on the use of the DWGTF. In 2023, the Advisory Commission

awarded $1,000,000 to the New Hampshire Department of Environmental Services (NHDES) to provide grants for

remediation of lead in drinking water in K-12 schools at any outlet testing at 5 parts per billion (ppb) or above.

The Advisory Commission approved this funding to be awarded to public and nonpublic schools in New Hampshire

for up to 100% of the total lead remediation costs as needed.

The Sanborn Regional School District will use the $75,000 grant for lead remediation at the Daniel J. Bakie School,

Memorial School, Sanborn Regional High School, and Sanborn Regional Middle School. Eligible work includes

installation of water bottle filling stations, point of use filters, removal and replacement of faucets, fixtures,

fountains, solder, piping, plumbing components, and water treatment at any drinking water outlet with lead

results at 5 ppb or above that are available for consumption by children

In the event these funds become unavailable, general funds will not be requested to support this project.

This agreement has been approved by the Attorney General's Office as to form, substance, and execution.

We respectfully request your approval.

Robert R. Scott, Commissioner

DES Website: www.des.nh.gov

P.O. Box 95, 29 Hazen Drive, Concord, New Hampshire 03302-0095

Telephone: (603) 271-2513 • Fax: (603) 271-5171 • TDD Access: Relay NH 1-800-735-2964

FORM NUMBER G-1 (version 11/2021)

GRANT AGREEMENT

The State of New Hampshire and the Grantee hereby

Mutually agree as follows:

GENERAL PROVISIONS

I. Identification and Definitions.

1.1. State Agency Name

Department of Environmental Services

1.2. State Agency Address

29 Hazen Drive, P.O. Box 95

Concord, NH 03302-0095

1.3. Grantee Name

Sanborn Regional School District (SAU 17)

1.4. Grantee Address

51 Church Street PC Box 429 Kingston NH 03848

1.5 Grantee Phone #

603-395-3796

1.6. Account Number

03-44-44-444010-7428-073

1.7. Completion Date

12/31/2026

1.8. Grant Limitation

$75,000

1.9. Grant Officer for State Agency

Cheryl Bondi, Drinking Water and Groundwater

Trust Fund Administrator

1.10. State Agency Telephone Number

603-271-8321

If Grantee is a municipality or village district: "By signing this form we certify that we have complied with any public

meeting requirement for acceptance of this grant, including if applicable RSA 31:95-b."

1.11. Grantee Signa

Grantee Signature 2

1.12. Name & Title of Grantee Signor 1

Dawn Dutton, Chair of School Board

Name 8i Title of Grantee Signor 2

Grantee Signature 3 Name & Title of Grantee Signor 3

1.13. State Agency Signatures) 1.14. Name & Title of State Agency Signor(s)

Robert R. Scott, Commissioner

Department of Environmentai Services

1.15. Approval by Attorney General (Form, Substance and Execution) (if G & C approval required)

By: u-cdo AftG Assistant Attorney General, On: /^z/^02S

1.16. Approval by Governor and Council (if applicable)

By: On: / /

2. SCOPE OF WORK: In exchange for grant funds provided by the State of New Hampshire, acting

through the Agency identified in block l.I (hereinafter referred to as "the State"), the Grantee

identified in block 1.3 (hereinafter referred to as "the Grantee"), shall perform that work identified and

more particularly described in the scope of work attached hereto as EXHIBIT B (the scope of work

being hereinafter referred to as "the Project").

4.

4.1.

4.2.

5.

5.1.

5.2.

5.3.

5.4.

5.5.

7.

7.1.

7.2.

8.1.

8.2.

8.3.

9.

9.1.

AREA COVERED. Except as otherwise specifically provided for herein, the

Grantee shall perform the Project in, and with respect to, the State of New

Hampshire. 9.2.

EFFECTIVE DATE: COMPLETION OF PROJECT.

This Agreement, and all obligations of the parties hereunder, shall become

effective on the date on the date of approval of this Agreement by the Governor

and Council of the State of New Hampshire if required (block 1.16), or upon 9.3.

signature by the State Agency as shown in block 1.14 ("the Effective Date").

Except as otherwise specifically provided herein, the Project, including all reports 9.4.

required by this Agreement, shall be completed in ITS entirety prior to the date in

block 1.7 (hereinafter referred to as "the Completion Date").

GRANT AMOUNT: LIMITATION ON AMOUNT: VOUCHERS: PAYMENT.

The Grant Amount is identified and more particularly described in EXHIBIT C,

attached hereto. 9.5.

The manner of, and schedule of payment shall be as set forth in EXHIBIT C.

In accordance with the provisions set forth in EXHIBIT C, and in consideration 10.

of the satisfactory performance of the Project, as determined by the State, and as

limited by subparagraph 5.5 of these general provisions, the State shall pay the

Grantee the Grant Amount. The State shall withhold from the amount otherwise

payable to the Grantee under this subparagraph 5.3 those sums required, or

permitted, to be withheld pursuant to N.H. RSA 80:7 through 7-c.

The payment by the State of the Grant amount shall be the only, and the complete

payment to the Grantee for all expenses, of whatever nature, incurred by the

Grantee in the performance hereof, and shall be the only, and the complete,

compensation to the Grantee for the Project. The State shall have no liabilities to 11.

the Grantee other than the Grant Amount. 11.1.

Notwithstanding anything in this Agreement to the contrary, and notwithstanding

unexpected circumstances, in no event shall the total of all payments authorized, 11.1.1

or actually made, hereunder exceed the Grant limitation set forth in block 1.8 of 11.1.2

these general provisions. 11.1.3

COMPLIANCE BY GRANTEE WITH LAWS AND REGULATIONS. In 11.1.4

connection with the performance of the Project, the Grantee shall comply with all 11.2.

statutes, laws regulations, and orders of federal, state, county, or municipal

authorities which shall impose any obligations or duty upon the Grantee, including 11.2.1

the acquisition of any and all necessary permits and RSA 31-95-b.

RECORDS and ACCOUNTS.

Between the Effective Date and the date seven (7) years after the Completion

Date, unless otherwise required by the grant terms or the Agency, the Grantee

shall keep detailed accounts of all expenses incurred in connection with the 11.2.2

Project, including, but not limited to, costs of administration, transportation,

insurance, telephone calls, and clerical materials and services. Such accounts

shall he supported by receipts, invoices, hills and other similar documents.

Between the Effective Date and the date seven (7) years after the Completion

Date, unless otherwise required by the grant terms or the Agency pursuant to 11.2.3

subparagraph 7.1, at any time during the Grantee's normal business hours, and as

often as the State shall demand, the Grantee shall make available to the State all 11.2.4

records pertaining to matters covered by this Agreement. The Grantee shall

permit the State to audit, examine, and reproduce such records, and to make audits 12.

of all contracts, invoices, materials, payrolls, records of personnel, data (as that 12.1.

term is hereinafter defined), and other information relating to all matters covered

by this Agreement. As used in this paragraph, "Grantee" includes all persons,

natural or fictional, affiliated with, controlled by, or under common ownership

with, the entity identified as the Grantee in block 1.3 of these provisions

PERSONNEL.

The Grantee shall, at its own expense, provide all personnel necessary to perform 12.2.

the Project. The Grantee warrants that all personnel engaged in the Project shall

be qualified to perform such Project, and shall be properly licensed and authorized

to perform such Project under all applicable laws.

The Grantee shall not hire, and it shall not permit any subcontractor, subgrantee, 12.3.

or other person, firm or corporation with whom it is engaged in a combined effort

to perform the Project, to hire any person who has a contractual relationship with

the State, or who is a State officer or employee, elected or appointed.

The Grant Officer shall be the representative of the State hereunder. In the event

of any dispute hereunder, the interpretation of this Agreement by the Grant 12.4.

Officer, and his/her decision on any dispute, shall be final.

DATA: RETENTION OF DATA: ACCESS.

As used in this Agreement, the word "data" shall mean all information and things 13.

developed or obtained during the performance of, or acquired or developed by

reason of, this Agreement, including, but not limited to, all studies, reports, files,

formulae, surveys, maps, charts, sound recordings, video recordings, pictorial

reproductions, drawings, analyses, graphic representations.

computer programs, computer printouts, notes, letters, memoranda, paper, and

documents, all whether finished or unfinished.

Between the Effective Date and the Completion Date the Grantee shall grant to

the State, or any person designated by it, unrestricted access to all data for

examination, duplication, publication, translation, sale, disposal, or for any other

purpose whatsoever.

No data shall he subject to copyright in the United States or any other country by

anyone other than the State.

On and after the Effective Date all data, and any property which has been received

from the State or purchased with funds provided for that purpose under this

Agreement, shall be the property of the State, and shall be returned to the State

upon demand or upon termination of this Agreement for any reason, whichever

shall first occur.

The State, and anyone it shall designate, shall have unrestricted authority to

publish, disclose, distribute and otherwise use, in whole or in part, all data.

CONDITIONAL NATURE OR AGREEMENT. Notwithstanding anything in

this Agreement to the contrary, all obligations of the State hereunder, including,

without limitation, the continuance of payments hereunder, are contingent upon

the availability or continued appropriation of funds, and in no event shall the State

be liable for any payments hereunder in excess of such available or appropriated

funds. In the event of a reduction or termination of those funds, the State shall

have the right to withhold payment until such funds become available, if ever, and

shall have the right to terminate this Agreement immediately upon giving the

Grantee notice of such termination.

EVENT OF DEFAULT: REMEDIES.

Any one or more of the following acts or omissions of the Grantee shall constitute

an event of default hereunder (hereinafter referred to as "Events of Default"):

Failure to perform the Project satisfactorily or on schedule; or

Failure to submit any report required hereunder; or

Failure to maintain, or permit access to, the records required hereunder; or

Failure to perform any of the other covenants and conditions of this Agreement.

Upon the occurrence of any Event of Default, the State may take any one, or more,

or all, of the following actions:

Give the Grantee a written notice specifying the Event of Default and requiring it

to be remedied within, in the absence of a greater or lesser specification of time,

thirty (30) days from the date of the notice; and if the Event of Default is not

timely remedied, terminate this Agreement, effective two (2) days after giving the

Grantee notice of termination; and

Give the Grantee a written notice specifying the Event of Default and suspending

all payments to he made under this Agreement and ordering that the portion of the

Grant Amount which would otherwise accrue to the Grantee during the period

from the date of such notice until such time as the State determines that the

Grantee has cured the Event of Default shall never be paid to the Grantee; and

Set off against any other obligation the State may owe to the Grantee any damages

the State suffers by reason of any Event of Default; and

Treat the agreement as breached and pursue any of its remedies at law or in equity,

or both.

TERMINATION.

In the event of any early termination of this Agreement for any reason other than

the completion of the Project, the Grantee shall deliver to the Grant Officer, not

later than fifteen (15) days after the date of termination, a report (hereinafter

referred to as the "Termination Report") describing in detail all Project Work

performed, and the Grant Amount earned, to and including the date of termination.

In the event of Termination under paragraphs 10 or 12.4 of these general

provisions, the approval of such a Temiination Report by the State shall entitle

the Grantee to receive that portion of the Grant amount earned to and including

the date of termination.

In the event of Termination under paragraphs 10 or 12.4 of these general

provisions, the approval of such a Termination Report by the State shall in no

event relieve the Grantee from any and all liability for damages sustained or

incurred by the State as a result of the Grantee's breach of its obligations

hereunder.

Notwithstanding anything in this Agreement to the contrary, either the State or,

except where notice default has been given to the Grantee hereunder, the Grantee,

may terminate this Agreement without cause upon thirty (30) days written notice.

CONFLICT OF INTEREST. No officer, member of employee of the Grantee,

and no representative, officer or employee of the State of New Hampshire or of

the goveming body of the locality or localities in which the Project is to be

performed, who exercises any functions or responsibilities in the review or

Grantee Initials

Date

14.

15.

16.

17.

17.1

17.1.1

17.1.2

approval of the undertaking or carrying out of such Project, shall participate in 17.2.

any decision relating to this Agreement which affects his or her personal interest

or the interest of any corporation, partnership, or association in which he or she

is directly or indirectly interested, nor shall he or she have any personal or

pecuniary interest, direct or indirect, in this Agreement or the proceeds thereof.

GRANTEE'S RELATION TO THE STATE. In the performance of this

Agreement the Grantee, its employees, and any subcontractor or subgrantee of 18.

the Grantee are in all respects independent contractors, and are neither agents

nor employees of the State. Neither the Grantee nor any of its officers,

employees, agents, members, subcontractors or subgrantees, shall have authority

to bind the State nor are they entitled to any of the benefits, workmen's

compensation or emoluments provided by the State to its employees.

ASSIGNMENT AND SUBCONTRACTS. The Grantee shall not assign, or 19.

otherwise transfer any interest in this Agreement without the prior written

consent of the State. None of the Project Work shall be subcontracted or

subgranted by the Grantee other than as set forth in Exhibit B without the prior

written consent of the State. 20.

INDEMNIFICATION. The Grantee shall defend, indemnify and hold harmless

the State, its officers and employees, from and against any and all losses suffered

by the State, its officers and employees, and any and all claims, liabilities or

penalties asserted against the State, its officers and employees, by or on behalf 21.

of any person, on account of, based on, resulting from, arising out of (or which

may be claimed to arise out of) the acts or omissions of the Grantee or

subcontractor, or subgrantee or other agent of the Grantee. Notwithstanding the

foregoing, nothing herein contained shall be deemed to constitute a waiver of the

sovereign immunity of the State, which immunity is hereby reserved to the State.

This covenant shall survive the termination of this agreement. 22.

INSURANCE.

The Grantee shall, at its own expense, obtain and maintain in force, or shall

require any subcontractor, subgrantee or assignee performing Project work to

obtain and maintain in force, both for the benefit of the State, the following

insurance:

Statutory workers' compensation and employees liability insurance for all

employees engaged in the performance of the Project, and

General liability insurance against all claims of bodily injuries, death or property

damage, in amounts not less than $1,000,000 per occurrenee and $2,000,000

aggregate for bodily injury or death any one incident, and $500,000 for property

damage in any one incident; and

23.

24.

The policies described in subparagraph 17.1 of this paragraph shall be the standard

form employed in the State of New Hampshire, issued by underwriters acceptable

to the State, and authorized to do business in the State of New Hampshire. Grantee

shall furnish to the State, certificates of insurance for all renewal(s) of insurance

required under this Agreement no later than ten (10) days prior to the expiration

date of each insurance policy.

WAIVER OF BREACH. No failure by the State to enforce any provisions hereof

after any Event of Default shall be deemed a waiver of its rights with regard to

that Event, or any subsequent Event. No express waiver of any Event of Default

shall he deemed a waiver of any provisions hereof. No such failure of waiver

shall be deemed a waiver of the right of the State to enforce each and all of the

provisions hereof upon any further or other default on the part of the Grantee.

NOTICE. Any notice by a party hereto to the other party shall be deemed to have

been duly delivered or given at the time of mailing by certified mail, postage

prepaid, in a United States Post Office addressed to the parties at the addresses

first above given.

AMENDMENT. This Agreement may be amended, waived or discharged only

by an instrument in writing signed by the parties hereto and only after approval of

such amendment, waiver or discharge by the Governor and Council of the State

of New Hampshire, if required or by the signing State Agency.

CONSTRUCTION OF AGREEMENT AND TERMS. This Agreement shall be

construed in accordance with the law of the State of New Hampshire, and is

binding upon and inures to tbe benefit of the parties and their respective successors

and assignees. The captions and contents of the "subject" blank are used only as

a matter of convenience, and are not to be considered a part of this Agreement or

to be used in determining the intend of the parties hereto.

THIRD PARTIES. The parties hereto do not intend to benefit any third parties

and this Agreement shall not be construed to confer any such benefit.

ENTIRE AGREEMENT. This Agreement, which may be executed in a number

of counterparts, each of which shall be deemed an original, constitutes the entire

agreement and understanding between the parties, and supersedes all prior

agreements and understandings relating hereto.

SPECIAL PROVISIONS. The additional or modifying provisions set forth in

Exhibit A hereto are incorporated as part of this agreement.

Grantee Initials'

Date /

Lead Remediation in Schools

Sanborn Regional School District- DWGT-PB34

Drinking Water and Groundwater Trust Fund - Grant

EXHIBIT A

SPECIAL TERMS & CONDITIONS

1. Project-related changes to the Scope of Services outlined in Exhibit B require New Hampshire Department of

Environmental Services (NHDES) approval in advance, and if applicable as determined by NHDES, may require

approval by the Drinking Water and Groundwater Advisory Commission and a grant amendment subject to

approval by the Governor and Executive Council.

2. PERIOD OF PERFORMANCE: Lead remediation costs incurred by the recipient during the period that begins

on May 17, 2016, and ends on the completion date listed on the grant agreement (section 1.7) are eligible for

reimbursement.

3. Work must be completed by the completion date listed on the grant agreement (section 1.7).

EXHIBIT B

SCOPE OF SERVICES

Sanborn Regional School District, New Hampshire

The Sanborn Regional School District (Grantee) will use the grant funds to perform lead remediation at

drinking water outlets testing at or above 5 parts per billion (ppb) at the Daniel J. Bakie School, Memorial

School, Sanborn Regional Middle School, and Sanborn Regional High School. Eligible costs under this grant

agreement include installation of water bottle filling stations, point of use filters, removal and replacement of

faucets, fixtures, fountains, solder, piping, plumbing components, and water treatment at any drinking water

outlet with lead levels at 5 ppb or above available for consumption by children, and activities required to

achieve the required lead remediation outcome.

EXHIBIT C

METHOD OF PAYMENT

The New Hampshire Department of Environmental Services (NHDES) shall pay to the Grantee the total

reimbursable project costs up to $75,000 for eligible lead remediation costs in accordance with the following

requirements:

Reimbursement requests for remediation costs shall be made no more than once per calendar month by the

Grantee using the Drinking Water and Groundwater Trust Fund Request for Disbursement Form as supplied by

the NHDES, which shall be completed and signed by the Grantee. The disbursement form shall be accompanied

by proper supporting documentation based upon direct costs. The Grantee will maintain adequate

Grantee Initials

Date /O-f

Lead Remediation in Schools

Sanborn Regional School District- DWGT-PB34

Drinking Water and Groundwater Trust Fund - Grant

documentation to substantiate all lead remediation-related costs. All work shall be performed to the satisfaction

of the NHDES before payment is made. Qualified project costs incurred are eligible for reimbursement from

May 17, 2016, through the end of the grant period as noted in section 1.7 of the standard grant agreement.

The total reimbursement shall not exceed the grant award of $75,000. Each disbursement request will be paid

100% grant funds up to $75,000.

Grantee Initials

Date/CP

NKWHAMl'SmRF

DEPARTMENT OF

''V-

P:

CERTIFICATE OF VOTE

AUTHORITY TO ACCEPT GRANTS

Environmental

Services

Drinking Water and Groundwater Trust Fund (DWGTF)

Lead Remediation in Drinking Water for NH K-12 Schools

A Certificate of Vote of Authorization (COV) is a certificate that states a Grantee is willing to enter into a grant

agreement with the State of New Hampshire Department of Environmental Services (NHDES) and designates an

Authorized Representative of the Grantee's governing body to execute the grant documents.

FORM GUIDANCE

• Please fill out areas highlighted in yellow DIGITALLY before printing for final wet signature.

• The Witness must have a titled position at the Grantee's address listed below.

• The Authorized Representative listed under item 3 does not sign this form.

Sanborn Regional School District (SAU 17)

51 Church Street PC Box 429 Kingston NH 03848

I, Rick Edelman of the Sanborn School District do hereby certify that:

1. I am the duly elected Vice Chair School Board of the Sanborn Regional School Board;

2. At a board meeting held on June 4, 2025, the Sanborn Regional School Board voted to accept a grant

from the Drinking Water and Groundwater Trust Fund and enter into grant agreement with the New

Hampshire Department Environmental Services to perform lead remediation of drinking water in K-12

schools.

3. The Sanborn Regional School Board further authorized Dawn Dutton, Chair of School Board, to

execute any documents which may be necessary to effectuate this grant agreement.

IN WITNESS WHEREOF, I have hereunto set my hand as the

Rick Eledman Vice Chair School Board of the Sanborn Regional School Board on September 17, 2025

Witness Signature Date:

Drinking Water and Ground Water Trust Fund

Primex®NH Public Risk Management Exchange CERTIFICATE OF COVERAGE

The New Hampshire Public Risk Management Exchange (Primex^) is organized under the New Hampshire Revised Statutes Annotated, Chapter 5-B,

Pooled Risk Management Programs, in accordance with those statutes, its Trust Agreement and bylaws, Primex' is authorized to provide pooled risk

management programs established for the benefit of poiitical subdivisions in the State of New Hampshire.

Each member of Primex^ is entitled to the categories of coverage set forth below. In addition, Primex^ may extend the same coverage to non-members.

However, any coverage extended to a non-member is subject to ail of the terms, conditions, exclusions, amendments, rules, policies and procedures

that are applicable to the members of Primex', including but not limited to the final and binding resolution of ail claims and coverage disputes before the

Primex' Board of Trustees. The Additional Covered Party's per occurrence limit shall be deemed included in the Member's per occurrence limit, and

therefore shall reduce the Member's limit of liability as set forth by the Coverage Documents and Declarations. The limit shown may have been reduced

by claims paid on behalf of the member. General Liability coverage is limited to Coverage A (Personal injury Liability) and Coverage B (Property

Damage Liability) only. Coverage's C (Public Officials Errors and Omissions), D (Unfair Employment Practices), E (Employee Benefit Liability) and F

(Educator's Legal Liability Claims-Made Coverage) are excluded from this provision of coverage.

The below named entity is a member in good standing of the New Hampshire Public Risk Management Exchange. The coverage provided may,

however, be revised at any time by the actions of Primex'. As of the date this certificate is issued, the information set out below accurately reflects the

categories of coverage established for the current coverage year.

This Certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend, or

alter the coverage afforded by the coverage categories listed below.

Participating Member: Member Number.

Sanborn Regional School District 934

SAU#17

PO Box 429

51 Church St.

Kingston, NH 03848

Company Affording Coverage:

NH Public Risk Management Exchange - Primex^

PO Box 23

Hooksett, NH 03106-9716

Type of Coverage Effective Date

(mm/dd/vywi

Expiration Date

(mm/dd/vwy) UmHs- NH Statutory Limits May Apply, if Not:

X General Liability (Occurrence Form)

Professional Liability (describe)

7/1/2025 7/1/2026 Each Occurrence $ 2,000,000

General Aggregate $ 10,000,000

n MadT n Occurrence Fire Damage (Any one

fire)

Med Exp (Any one person)

X Au

De

tomobile Liability

ductible Comp and Coll: $1,000

Any auto

7/1/2025 7/1/2026 Combined Single Limit

(Each Accident)

Aggregate

$2,000,000

$10,000,000

X Workers' Compensation & Employers' Liability 7/1/2025 7/1/2026 X 1 Statutory

Each Accident $2,000,000

Disease — Each Employee $2,000,000

Disease — Policy Limit

X Property (Special Risk includes Fire and Theft) 7/1/2025 7IM2026 Blanket Limit. Repiacement

Cost (uniess otherwise stated) Deductible:

$1,000

Description: Proof of Primex Member coverage only. Pollution and hazardous waste related liabilities, expenses and claims are

excluded from coverage in the coverage document.

CERTIFICATE HOLDER: Additional Covered Party Loss Payee Primex' - NH Public Risk Management Exchange

By: Beti "Pmtetl

Date: 9/8/2025 mpurcell@nhprimex.orgState of New Hampshire

Department of Environmentai Services

29 Hazen Drive, PO Box 95

Concord, NH 03302-0095

Please direct inquires to:

Primex' Claims/Coverage Services

603-225-2841 phone

603-228-3833 fax