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Francine R. Digitally signed by Francine R.
<br />Villareal
<br />1 Villareal - Date: 2021.03.30 14:24:34 -07'00'
<br />A�CO�RO® CERTIFICATE LIABILITY I I DATE (MM/DD/YYYY)
<br />3/30/2021
<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 INSU(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 CONTACT
<br />NAME: Rocio Leon
<br />HUB International Insurance Services Inc. PHONE FAx
<br />3636 American River Drive, Suite 200 A/C No Ext: 916-480-4134 A/c No: 916-993-7234
<br />Sacramento CA 95864 ADDRESS: rocio.leon@hubinternational.com
<br />License#:0757776
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURERA: Greenwich Insurance Company
<br />22322
<br />INSURED WAREDIS-02
<br />Ware Disposal Inc.
<br />P.O. Box 1318
<br />Santa Ana CA 92702
<br />COVERAGES CERTIFICATE NUMBER: 1010612776
<br />INSURERB: Westchester Surplus Lines Insurance Co.
<br />10172
<br />INsuRERc: Alaska National Insurance Company
<br />38733
<br />INSURERD: Aspen Specialty Insurance
<br />10717
<br />INSURER E :
<br />INSURER F :
<br />REVISION NUMBER:
<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 />POLICYNUMBER
<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 />GEC3000730-06
<br />2/28/2021
<br />2/28/2022
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE OCCUR
<br />PREM SESOEa occurrence)
<br />$ 100,000
<br />X
<br />IVIED EXP (Any one person)
<br />$ 5,000
<br />$1,000 PD Ded.
<br />Per Occurrence
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />Fy] PRO -
<br />POLICY JECT LOC
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />AECO04538606
<br />2/28/2021
<br />2/28/2022
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1 000 000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />X
<br />BI/PD Deductible
<br />$ 10,000
<br />CA9948
<br />B
<br />UMBRELLA LAB
<br />X
<br />OCCUR
<br />G46863306004
<br />2/28/2021
<br />2/28/2022
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />X
<br />AGGREGATE
<br />$ 10,000,000
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />DED RETENTION $
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />20H WS 05450
<br />8/1/2020
<br />8/1/2021
<br />X PERUTE OTH-
<br />STATER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />OFFICER/MEMBER EXCLUDED?
<br />NIA
<br />E.L. DISEASE- EA EMPLOYEE
<br />$ 1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE- POLICY LIMIT
<br />$ 1,000,000
<br />D
<br />Transportation Pollution Liab
<br />EROOJP520
<br />10/26/2020
<br />10/26/2021
<br />Each Poll. Condition
<br />$4,000,000
<br />Excess of CA9948 Auto Liability
<br />Aggregate
<br />Retention
<br />$10,000,000
<br />$25,000
<br />DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />(General Liability Per Project Aggregate applies per written contract)
<br />RE: Work performed by the insured for certificate holder per written contract (Excess Liability Policy G46863306004 is excess over General Liability
<br />GEC3000730-06, Auto Liability AECO04538606 and Employers Liability 20HWS05450)
<br />Additional Insured: City of Santa Ana; its officers, employees, agents, and representatives are additional insured with respect to General Liability and Auto
<br />Liability as required by contract.
<br />Forms: CG2010 1219, CG2037 1219, IX1405 0910, XIL431 0605, XIC411 1013
<br />•
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF,
<br />NOTICE WILL
<br />BE DELIVERED IN
<br />City of Santa Ana
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Risk Management Division, 4th Floor
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92701
<br />Risie Management Diveaian
<br />REVIEWED & APPROVEDSY:
<br />O 1988-2015 ACORD C
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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<br />1415KmanagementAnalyst
<br />
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