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AGENCY CUSTOMER ID: <br />LOC #: <br />A Rom® ADDITIONAL REMARKS SCHEDULE <br />Page 2 Of 2 <br />AGENCY <br />NAMED INSURED <br />Willis (Bermuda) Ltd. <br />Republic Services, Inc <br />18500 N Allied Way <br />Phoenix, AS B5054 <br />POLICY NUMBER <br />See Page 1 <br />CARRIER <br />NAIL CODE <br />See Page 1 <br />See Page 1 <br />EFFECTIVE DATE: See Page 1 <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance <br />INSURER AFFORDING COVERAGE: Group Ark Insurance Limited NAIC#: D9965 <br />POLICY NUMBER: YLD21-00292 EFF DATE: 06/30/2021 EXP DATE: 06/30/2022 <br />TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: <br />Excess Liability Per Occurrence $5,000,000 <br />Aggregate $5,000,000 <br />INSURER AFFORDING COVERAGE: Allied World Assurance Company Ltd NAIC#: C0892 <br />POLICY NUMBER: C001390/020 EFF DATE: 06/30/2021 EXP DATE: 06/30/2022 <br />TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: <br />Excess Liability Per Occurrence $15M p/o $25M <br />Aggregate $15M p/o $25M <br />INSURER AFFORDING COVERAGE: Endurance Specialty Insurance Limited NAIC#: C0948 <br />POLICY NUMBER: EXCl0004073708 EFF DATE: 06/30/2021 EXP DATE: 06/30/2022 <br />TYPE OF INSURANCE: <br />Excess Liability <br />ACORD 101 <br />LIMIT DESCRIPTION: LIMIT AMOUNT: <br />Per Occurrence $10M p/o $25M <br />Aggregate $IOM p/o $25M <br />(i7 20OR ACORD COI <br />The ACORD name and logo are registered marks of ACORD <br />SR ID: 21613305 BATCH: 2245022 CERT: W22213409 <br />R <br />`W��mMw����ggnvJ�DlW99flan <br />S.M1W.1pd 4�1�4�vt <br />;® <br />® <br />Risk Managementsupervisw <br />