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ACORO• CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MWDDIYYYL) <br />1 <br />lh.i 1,1202I <br />12/62019 <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 INSURERIS), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: N the certificate holder is an AODMDRAL 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 andomemerd(el. <br />PRODUCER LOCKTON COMPANIES <br />CT <br />3657 BRIARPARK DRIVE, SUITE 700 <br />HOUSTON TX 77042 <br />866-2M3538 <br />Ivc No Ext : FIX No): <br />E.MK <br />ADDRESS <br />INSURE DING COVERAGE <br />NAIC a <br />A: ACE meri'an Insurance C n1 ar <br />22667 <br />INSUREINSURER <br />13482D T IN IA D, <br />RELATED 8 SUBSIDIARY COMPANIES INCLUDING <br />1348279 WASTE MANAGEMENT ORANGE COUNTY <br />GREAT WESTERN <br />r <br />INSURERB: eAttached <br />INSURER C: <br />INSURER D <br />DAVERECLAIMATION <br />1800 SOUTH GRAND AVENUE <br />SANTA ANA CA 92705 <br />NS R <br />COVERAGES CERTIFICATE NUMBER• I I S37709 REVISION NUMB=-. V V V V V V V <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 />IN <br />TYPE OF INSURANCE <br />Mo. <br />MIND <br />S&I— <br />POLICYNUMBER <br />IO CYE F <br />I/1/2020 <br />POLICY P <br />1/12021 <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />Y <br />HDOG71237345 <br />EACH OCTOR <br />5000000 <br />CLAIMS -MADE T OCCUR <br />DR I TO RENTED ^ <br />5,000,000 <br />X <br />XXXXXXX <br />XCU INCLUDFD <br />MED EXP (My ors, non <br />X <br />ISO FORM ('CA K 10d l T <br />PERSONAL S ADV INJURY <br />5 5,000,000 <br />GEN'LAGGREGATEDMRAPPLIES PER <br />POLICY ff]PEaF aLOC <br />GENERAL AGGREGATE <br />S 6.000.000 <br />PRODUCTS- CONNOR AGG <br />56.000000 <br />OTHER <br />5 <br />,A <br />AUTOMOBILE <br />LIABILITY <br />Y <br />Y <br />MMTH2529000N <br />lil/2020 <br />112021 <br />NFDBIN UELIMO <br />S I000000 <br />X <br />ANYAUTO <br />BODILY INJURY (Per camm) <br />S XXXXXXX <br />X <br />CI�EpU <br />QUTOSONLY AlIT0��5WWLED <br />BODILY INJURYIPerso,narl <br />S XXXXXXX <br />X <br />ED <br />AUTOSONLY X A OBONLYD <br />Pq PERTY MAGE <br />Por e I <br />5 XXXXXXX <br />X <br />MCS 90 <br />SXXXXXXX <br />B <br />X <br />UMBRELLA L AS <br />X <br />JOCCUR <br />Y <br />Y <br />See AMched <br />111 /2020 <br />1112021 <br />EACH OCCURRENCE <br />5 100.000 000 <br />EXCESS DAB <br />CLAIM&MADE <br />AGGREGATE <br />5 100QOQ Q00 <br />DED RETEI NS <br />S XXXXXXX, <br />A <br />WORKERS COMPENSATK)N <br />AND EMPLOYERS LIABILITY YIN <br />Y <br />WLR C66043010 LAZ.CA&A <br />)111/2020 <br />1112021 <br />X STATUTE ER <br />ANY PRCPRIETORRPRiNEmEYECUTVE <br />WFICENMEWIME UDED] N I <br />NIA <br />EL EACM ACCIDENT <br />5 3 QQQ QQQ <br />(Myem4tlMory N NMI <br />IpEScm"ON <br />E L DISEASE EA EMPLOYEE <br />3.000 000 <br />i- E POUCYLIMa <br />3,000000 <br />OF OPEMTONS.— <br />A <br />EXCESSALTU <br />LIABILITY <br />Y <br />Y <br />XSA H23289961 <br />COMBINED SINGLE LIMIT <br />SMIO.00D <br />71,1/20201/12U21 <br />(EACH ACCIDENT( <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. AM11111N Piastres SCIMdule, may as alleched N Mrs apace Is required) <br />BLANKET' WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE AND TO THE EXTENT <br />REOURED BY WRFTTEN CONTRACT WHERE PERMISSIBLE BY LAW CERTIFICATE HOLDER IS NAMED AS AN ADDHONAL INSURED <br />( EXCEPT FOR WORKERS' COMP/EL) WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT <br />CERTIFICATE HOLDER See Attachments <br />MENT (VISION <br />SHOULD ANY OF THE ABOVE DESCIUSED POLICIES BE CANCELLED BEFORE <br />TH PIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />*SANTHA <br />ANCE WtIM THE POLICY PROVISIONS <br />11582709 <br />ENTATNE <br />CITY OF SANTAANA <br />. LAMBERT <br />RISK MANAGEMENT DIVISION, 4TH FLOOR. M-28 <br />20 CIVIC CENTER PLAZA <br />P.O. BOX 1988 <br />SANTA ANA CA 92701 <br />ACORD 28 I2016/03) @1988-2015 ACORD CORPORATIOW. All rights reserved <br />The ACORD name and logo are registered marks of ACORD <br />