|
ACo!t®` CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD Y)
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />-
<br />IMPORTANT: If tine certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder In lieu of such endorsee t(s).
<br />PRODUCER LOCKTON COMPANIES
<br />HOUSTACT
<br />3657 IARX77 DRIVE, SUITE 700
<br />HOUSTON TX 7704E
<br />BG6-260-3538
<br />A E:
<br />AC No, EMt: AI Na:
<br />E-M UM
<br />AOd't! SS:
<br />IN S AFFORDING OVE
<br />IC
<br />INSURERA: ACE ADnei'I= Insurange COi1r any
<br />22667
<br />INSURED WASTE MANAGEMENT HOLDINGS, INC.& ALL AFFILIATED,
<br />1306000 RELATED & WM CURBSIDE, LLCIARY COMPANIES INCLUDING:
<br />5101 E. LA PALMA AVENUE
<br />ANAHEIM CA 92870 ��/�✓�INSURER
<br />INSURERS: indennnitylosul'aocCCoofNorth America
<br />43575
<br />INSURERC: ACE Fire Underwriters Insurance Connrant
<br />20702
<br />INSURER o
<br />E:
<br />INSURER F:
<br />nn
<br />CERTIFY THAT THE POLICIES UI INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE HER DO NAMED ABOVE FOR THE POLICY PERIOD
<br />THIS IS INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH , LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />LNTR
<br />TYPE OF INSURANCE
<br />pPOLICIES
<br />gn5
<br />pp
<br />POLICY NUMBER
<br />POLICY FEE
<br />I/I /2018
<br />PO(MmLIIO
<br />I/I/2019
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS "MADE �OCCUR
<br />Y
<br />Y
<br />HDO G27873091
<br />CACH OCCURRENCE
<br />S 5.000,000
<br />ORE GET EaoccunD nco BE
<br />& 5,000,000
<br />X
<br />MED EXP (Any one pereanu
<br />$ XXXXXXX
<br />XCU INCLUDED
<br />X I
<br />ISO FORM C000010413
<br />PERSONAL &ADV INJURY
<br />$5000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY JECT ❑X LOC
<br />GENERAL AGGREGATE
<br />S 6,000,000
<br />PRODUCTS"COMP/OP AGO
<br />$ 6,000,000
<br />OTHER:
<br />$
<br />A
<br />AUTOMOBILE
<br />1xxx
<br />LIABILITY
<br />ANVAUTOBODILY
<br />owmeDs H RULED
<br />AluIppr��as oNLv ACJrGEs
<br />I ONLY X 3N6 ONED
<br />Y
<br />Y
<br />MM9. 1-125097890
<br />I/ /20 R
<br />1/1 /20 9
<br />1 Be BCNEaltdeDt61 iGLE IT
<br />_
<br />$ I OOO OOO
<br />INJURY (Par person)
<br />$ XXXXXXX
<br />eooanwunv (Par acaaent
<br />XXXXXXX
<br />$Al
<br />Pc,OPERg DAMAGE$XXXXXXX
<br />MCS -)0
<br />S XXXXXXX
<br />A
<br />X
<br />UMBRELLA UAB
<br />X
<br />OCCUR
<br />Y
<br />Y
<br />XOO G27929242 003
<br />I/I/2018
<br />I/I/7019
<br />EACH OCCURRENCE
<br />S 15000,000
<br />EXCESS LIAS
<br />CLAIMS "MADE
<br />AGGREGATE
<br />8 15,000,000
<br />DEB
<br />RETENTIONS
<br />S XXXXXXX
<br />AWORKERS
<br />C
<br />COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPaETORIPARTWCRIEXlOUTIYE
<br />ORFS ME.SF.cwDEoa FMIA
<br />if a.,, (Mandatory In NH)
<br />s ves.Res,lae OFe,
<br />UEYCRIFI'ION OF OpERATIOIJ54elow
<br />Y
<br />WLR WLR C646278A(A�JOS)
<br />778(A`-,C''A,&I,1A`
<br />SCF C64622791 (WI)
<br />I/i/2018
<br />If /_D1R
<br />I/i/2018
<br />I/1/C019
<br />1/1/2019
<br />I/1/2019
<br />PER OTH-
<br />X STATUTE ER
<br />ELEA[1H ACGIOENT
<br />$3,OKODO
<br />EL DISEASE - EA EMPLOYEE
<br />s 3AOU,000
<br />EL. 016U6E-PROSY LIMIT
<br />3,000000
<br />A
<br />EXCESS AUTO
<br />LIABILITY
<br />Y
<br />Y
<br />XSA H25097889
<br />1/1/2018
<br />1/1/2019
<br />COMBINED SINGLE LIMIT
<br />89,000,000
<br />(EACH ACCIDENT)
<br />DESCRIPTION OE OPERATIONS I LOCATIONS I VEHICLES RCORD 101, Additional Remarks Schedule, may no attached if mere apace Is required)
<br />BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CER'HFICA'I'B HOLDER ON ALL POLICIES WHERE AND TO THE EXTENT REQUIRED BY
<br />WRITTEN CONTRACT WHERE PERMISSIBLE BY LAW CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEFr FOR WORKERS' COMRIEL)
<br />WHERE AND TO "I'I IF. EXTENT REppCC UIRED BY O'S1LTEN CONTRACT. ADDITIONAL INSURED IN FAVOR OF CITY OF SANTA ANA. ITS OFFWHERE REICERS.
<br />EMPLOYE
<br />CONTRAC'TSWAIVERSOF SUBR00'AII'IORS N N FAVOR OP CITYAI LN SSAON N fA ANA, ITS OFFICERS, OLICIES EXCEPT EMPLOYEES � AGENTS, OLUNTEF.RS AND REPR SENTATUIRED BY IIVES N
<br />ON ALL POLICIES WHERE REQUIRED BY WRITTEN CONTRACT WHERE PERMISSIBLE BY LAW THE INSURANCE AFFORDED TO THE ADDITIONAL INSURED
<br />AS DESCRIBED IN THIS CERTIFICATE OF INSURANCE FOR WORK PERFORMED BY THE NAMED INSURED I PRIMARY AND NON-CONTRIBUTORY TO ANY
<br />SIMILAR COVERAGE MAINTAINED BY THE ADDITIONAL INSURGU INHERE AND 1'D THE EXTENT' REQU BY CONTRACT.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />11076601 AUTHORIZED REPRESENTATIVE
<br />CITY OF SANTA ANA
<br />DEPARTMENT OF PUBLIC WORKS
<br />ATTN: CHRISTY KENDIG
<br />20 CIVIC CENTER PLAZA, M-21
<br />SANTA ANA CA 92702
<br />2D 25 (2016/03) ©19HU-ZU15 ACORD CORPORATIOPM. All rights reserved
<br />, ue rn.ulcv Ildme anu logo are regiSuerea merite of ACUHU
<br />
|