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l Samantha M. olynannreaea bysa„wmm M. <br />mbM <br />Lambert oae:mn.m2srt22e4 07-00' DATE (MMI <br />A� 0® CERTIFICATE OF LIABILITY INSURANCE Page Iof9 DD/YYVY) <br />g(MMI021 <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. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endorsements . <br />PRODUCER I CONTACT NAME: <br />CANNON COCHRAN MANAGEMENT SERVICES, INC. PHONE (A/C No.Ext: FAX A/C No.Eat: <br />17015 N. SCOTTSDALE RD E-MAIL ADDRESS:certiticateteam ccrosi.com <br />SCOTTSDALE, AZ 85255 INSURER(S) AFFORDING COVERAGE NAIC At <br />REPUBLIC SERVICES, INC. <br />18500 N. ALLIED WAY <br />PHOENIX, AZ 85054 <br />COVERAGES CERTIFICATE NUMBER: 2023644 REVISION NUMBER: 1 <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 />INSR <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />(MM/DDNYYY) <br />POLICY EXP <br />(MWDD/YYYY) <br />LIMITS <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE M OCCUR <br />HDO G72482074 <br />06/30/2021 <br />06/30/2022 <br />EACH OCCURRENCE <br />$ 5,000,000 <br />DAMAGE TO RENTED <br />PREMISES (Ea occurrence) <br />$ 5,000,000 <br />MED EXP (Any one person) <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY PROJECT LOC <br />OTHER: <br />PERSONAL B ADV INJURY <br />$5,000,000 <br />GENERAL AGGREGATE <br />$5,000,000 <br />PRODUCTS -COMP/OP AGO <br />$ 5,000,000 <br />A <br />AUTOMOBILE LIABILITY <br />X ANYAUTO <br />X OWNED AUTOS 0 SCHEDULED <br />ONLY AUTOS <br />X HIREDAUTOS NON -OWNED <br />ONLY AUTOS ONLY <br />ISA H25549752 <br />06/30/2021 <br />06/30/2022 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$5,000,000 <br />BODILY INJURY(Per person) <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE <br />(Per accident) <br />E <br />LIAB X OCCUR <br />EXCESS LIAB CLAIMS -MADE <br />DIED F7 RETENTION $ <br />G46782148 005 <br />06/30/2021 <br />oww 2022 <br />EACH OCCURRENCE <br />$ 10,000000 <br />JUMBRELLA <br />AGGREGATE <br />$ 10,000,000 <br />B <br />A <br />C <br />A <br />D <br />NORKERS COMPENSATION YIN <br />ND EMPLOYERS' LIABILITY <br />NY PROPRIETOPoFARTNER/EXECUTIVE <br />FFICER/MEMBER EXCLUDED? <br />Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N/A <br />WLR C67824064 ADS <br />WLR C67824027 CA/MA/OR <br />SCF C67824106- WI <br />WCU C67824143- OH XS <br />TNS C68990592-TX NSXS <br />06/30/2021 <br />06/30/2021 <br />06/30/2021 <br />06/30/2021 <br />06/30/2021 <br />06/30/2022 <br />06/30/2022 <br />06/30/2022 <br />06/30/2022 <br />06/30/2022 <br />11 PER <br />STATUTE OTHER <br />E.L. EACH ACCIDENT <br />000 <br />E.L. DISEASE -EA EMPLOYEE <br />$ 3,000,000 <br />.L. DISEASE -POLICY LIMIT <br />$ 3,000,000 <br />Contractors Pollution Liability: <br />See page 2 for details <br />06/30/2021 <br />06/30/2022 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Division Number: 3876 - Named Insured Includes: Republic Waste Services of Southern California, LLC - Dba: Anaheim Disposal // Brea Disposal // Chino Hills Disposal <br />Garden Grove Disposal // Placentia Disposal // Yorba Linda Disposal //Villa Park Disposal // Republic Services of Southern California - Anaheim <br />CANCELLATION <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />CITY OF SANTA ANA <br />RISK MGMT DIVISION <br />20 CIVIC CENTER PLAZA, 4TH FLOOR <br />SANTA ANA, CA 92701 <br />United States <br />m 1988-2016 <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />lilrkMuuyvnadDbialon <br />Reviewm6APPROVEDBr. <br />lIIS}1 Id )� � b,.W <br />® Risk Management Supervisor <br />