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AC"Ro CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DD/YYYY)
<br />vl /2020
<br />12/4/2018
<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(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 endorsement(s).
<br />PRODUCER LOCKTON COMPANIES
<br />3657 BRIARPARK DRIVE, SUITE 700
<br />HOUSTON TX 77042
<br />866-260-3538
<br />NAME: T
<br />P E F
<br />"°, EXt : A/c, No
<br />E-MAIL
<br />-M
<br />ADDRESS:
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A : ACE AITlerlcan Insurance Company
<br />22667
<br />INSURED WASTE MANAGEMENT HOLDINGS, INC. & ALL AFFILIATED,
<br />1306000 RELATED & SUBSIDIARY COMPANIES INCLUDING:
<br />WM CURBSIDE, LLC q
<br />INSURER B : Indemnity Insurance Co of North America
<br />43575
<br />INSURER C : ACE Fire Underwriters Insurance Company
<br />20702
<br />INSURER D :
<br />5101 E. LA PALMA AVENUE 1t �oLC) % �—/ c'
<br />INSURER E :
<br />ANAHEIM CA 92870/ j3
<br />INSURER F :
<br />C1
<br />COVERAGES CERTIFICATE NUMBER: 11076601 REVISION NUMBER: XXXXXXX
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<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 POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYYY
<br />POLICY EXP
<br />MM/DD/YYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />Y
<br />Y
<br />HDO G71212993
<br />1/1/2019
<br />1/1/2020
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />CLAIMS -MADE OCCUR
<br />EK]PREMISES
<br />DAMAGE TO RENTED
<br />Ea occurrence
<br />$ 5,000,000
<br />X
<br />MED EXP (Any oneperson)
<br />$ XY_�
<br />XCU INCLUDED
<br />X
<br />ISO FORM C000010413
<br />PERSONAL & ADV INJURY
<br />$ 5,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY PECOT- LOC
<br />GENERAL AGGREGATE
<br />$ 6,000,000
<br />PRODUCTS - COMP/OP AGG
<br />$ 6,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />MMT H2527863A
<br />1/1/2019
<br />1/1/2020
<br />COMBINED SINGLE LIMIT
<br />Es accident
<br />$ 1000000
<br />BODILY INJURY (Per person)
<br />$ XXXXXXX
<br />ANY AUTO
<br />AUTOS ONLY AUTODULED
<br />1xx
<br />BODILY INJURY (Per accident
<br />$ XX )CX,CX
<br />AUTOS ONLY X AUUTOS ONLDY
<br />Perr accidentDAMAGE$XXXXXXX
<br />$ XXXXxxX
<br />MCS-90
<br />1
<br />•
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />Y
<br />Y
<br />XOO G27929242 004
<br />1/1/2019
<br />1/1/2020
<br />EACH OCCURRENCE
<br />$ 15000,000
<br />AGGREGATE
<br />$ 15,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED I I RETENTION $
<br />$ xxxxxxx
<br />B
<br />A
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N
<br />OFFICER/MEMBER EXCLUDED? N❑
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below I
<br />NIA
<br />Y
<br />I I
<br />WLR C65435846 (AOS)
<br />WLR C65435809 (CA & MA)
<br />SCF C65435883 (WI)
<br />I
<br />1/1/2019
<br />1/I/2019
<br />1/I/2019
<br />I
<br />1/1/2020
<br />1/1/2020
<br />1/1/2020
<br />PER OTH-
<br />X I STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 31000,000
<br />E.L. DISEASE- EA EMPLOYEE
<br />$ 3,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />3,000,000
<br />A
<br />EXCESS AU10
<br />LIABILITY
<br />Y
<br />Y
<br />XSAH25278598
<br />1/1/2019
<br />1/1/2020
<br />COMBINED SINGLE LIMIT
<br />$9,000,000
<br />(EACH ACCIDENT)
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE 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 (EXCEPT FOR WORKERS' COMPEL)
<br />WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT. ADDITIONAL INSURED IN FAVOR OF CITY OF SANTA ANA, ITS OFFICERS,
<br />EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES (ON ALL POLICIES EXCEPT WORKERS' COMPENSATION/EL) WHERE REQUIRED BY WRITTEN
<br />CONTRACT. WAIVER OF SUBROGATION IN FAVOR OF CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES
<br />ON ALL POLICIES WHERE REQUIRED BY WRITTEN CONTRACT WHERE PERMISSIBLE BY LAW. THE INSURAN E AFFORDED TO THE ADDITIONAL INSURED
<br />AS DESCRIBED IN THIS CERTIFICATE OF INSURANCE FOR WORK PERFORMED BY THE NAMED INSURED IS P MARY AND NON-CONTRIBUTORY TO ANY
<br />SIMILAR COVERAGE MAINTAINED BY THE ADDITIONAL INSURE WHERE AA'D TO EXTENT REQUIRE CONTRACT. _
<br />�� �� L
<br />a. L t\111 -1L IIVLVLI\ l,M1Yl,LLL/}rIV IY OUQ P1LLaU1U11G11LJ t P—AI Vd be /
<br />11076601
<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 />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED I
<br />THE EXPIRATION DATE THEREOF, .NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2016/03)
<br />©1988-2015 ACORD CORPORATICYM- All riahtw rpcprvpri
<br />The ACORD name and logo are registered marks of ACORD
<br />
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