Laserfiche WebLink
Digitally signed by Francine R. <br />Francine R. Villareal Villareal <br />ACOR" CERTIFICATE OF LIABILITY INSURANCE <br />l)AT/20DDIYYIY) <br />., .i. 1/1/2023 <br />2/9/2022 <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 />CONT <br />NAMEACT <br />3657 BRIARPARK DRIVE, SUITE 700 <br />PHONE FAX <br />Ext : A/C Na <br />HOUSTON TX 77042 <br />E-MAIL <br />866-260-3538 <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />A <br />INSURER A: ACE Alnerlean Insurance Conipany <br />22667 <br />INSURED WASTE MANAGEMENT HOLDINGS, INC. & ALL AFFILIATE <br />1306000 <br />INSURER B : Indemnity Insurance Co of North America <br />43575 <br />RELATED & SUBSIDIARY COMPANIES INCLUDING: <br />INSURER C: ACE Fire Underwriters Insurance Company <br />20702 <br />INSURER D : ACE Property & Casualty Insurance Co <br />20699 <br />WM CURBSIDE, LLC <br />5101 E. LA PALMA AVENUE <br />ANAHEIM CA 92870 <br />INSURER E : <br />INSURER F : <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 />MMIDDIYYYY <br />POLICY EXP <br />MMIDD/YYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />Y <br />HDO G72492365 <br />1/1/2022 <br />1/1/2023 <br />EACH OCCURRENCE <br />$ 5,000,000 <br />CLAIMS -MADE � OCCUR <br />DAMAGER( RENTED <br />PREMISES Ea occurrence <br />$ 5,000,000 <br />X <br />MED EXP (Any one person) <br />$ XXXXXXX <br />XCU INCLUDED <br />X <br />ISO FORM CG00010413 <br />PERSONAL & ADV INJURY <br />$ 5,000,000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 6,000,000 <br />JPRO- <br />POLICY XLOC <br />PRODUCTS - COMP/OP AGG <br />$ 6,000,000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />Y <br />Y <br />MMT H25550328 <br />1/1/2022 <br />1/1/2023 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 1,000,000 <br />X <br />BODILY INJURY (Per person) <br />$ XXXXXXX <br />ANY AUTO <br />X <br />BODILY INJURY (Per accident) <br />$ XXXXXXX <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />Xr <br />PROPERTY DAMAGE <br />Per accident <br />$ XrXrXXrXrXrXr <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />X <br />$ XXXXXXX <br />MCS-90 <br />D <br />X <br />UMBRELLA LAB <br />X <br />OCCUR <br />Y <br />Y <br />XEUG27929242 007 <br />1/1/2022 <br />1/1/2023 <br />EACH OCCURRENCE <br />$ 15,000,000 <br />AGGREGATE <br />$ 15,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION $ <br />$ XXXXXXX <br />B <br />`A <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE YIN <br />OFFICER/MEMBER EXCLUDED? N <br />(Mandatory in NH) <br />NIA <br />Y <br />WLR C68918595 (AOS) <br />WLR C68918558 (AZ, ,N & MA) <br />SCE C68918637 (WI) <br />1/1/2022 <br />1/1/2022 <br />1/1/2022 <br />1/1/2023 <br />1/1/2023 <br />1/1/2023 <br />X STER- <br />ATUTE OETH <br />E.L. EACH ACCIDENT <br />$ 3,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 3,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ 3,000,000 <br />A <br />EXCESS AUTO <br />Y <br />Y <br />XSA H25550286 <br />1/1/2022 <br />1/1/2023 <br />COMBINED SINGLE LIMIT <br />LIABILITY <br />$9,000,000 <br />(EACH ACCIDENT) <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />THIS CERTIFICATE SUPERSEDES ALL PRFN'TOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TF.RM(S) REFERENCED. <br />BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE AND TO THE EXTENT REQUIRED BY WRITTEN <br />CONTRACT WHERE PERMISSIBLE BYLAW. CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/EL) WHERE AND TO THE <br />EXTENT REQUIRED BY WRITTEN CONTRACT. ADDITIONAL INSURED IN FAVOR OF CITY OF SANTAANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND <br />REPRESENTATIVES (ON ALL POLICIES EXCEPT WORKERS' COMPENSATION/EL) WHERE REQUIRED BY WRITTEN CONTRACT. WAIVER OF SUBROGATION IN FAVOR OF CITY <br />OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES ON ALL POLICIES WHERE REQUIRED BY WRITTEN CONTRACT WHERE <br />PERMISSIBLE BY LAW. THE INSURANCE AFFORDED TO THE ADDITIONAL INSURED AS DESCRIBED IN THIS CERTIFICATE OF INSURANCE FOR WORK PERFORMED BY THE <br />NAMED INSURED IS PRIMARY AND NON-CONTRIBUTORY TO ANY SIMILAR COVERAGE MAINTAINED BY THE ADDITIONAL INSURED WHERE AND TO THE EXTENT <br />REQUIRED BY CONTRACT. <br />11076601 <br />CITY OF SANTA ANA <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE <br />CANCELLED BEFORE <br />RISK MANAGEMENT DIVISION, 4TH FLOOR <br />THE EXPIRATION DATE THEREOF, <br />NOTICE WILL <br />BE DELIVERED IN <br />20 CIVIC CENTER PLAZA <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />P. O. BOX 1988 <br />SANTA ANA CA 91701 <br />AUTHORIZED REPRESENTATIVE <br />e.a.. <br />RAM&flAg7P ere DR4si0R <br />REVIEWED & APPROVED BY. - <br />Cc, 1988-2015 ACORD C <br />.. <br />v <br />ACORD 25 (2016/03) The ACORD name and <br />logo are registered marks of ACORD <br />_ <br />Risk Management Analyst <br />