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<br />. , <br /> <br />PRODUCER <br />Lockian Companies of Houston, Inc. <br />5847 San Felipe, Suile 320 <br />Houston, TX 77057 <br />888-280-3538 (Phone) <br />888-492-1055 (Fax) <br />INSURED: WASTE MANAGEMENT and <br /> <br />Waste Management of Orange County <br />1800 S. Grand Avenue <br />Santa Ana, CA 92705 <br /> <br />CERTIFICATE OF INSURANCE Da~e;)~1~~~~) <br /> <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATiON <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE <br />,ACE American Insurance Company <br />Indemnity Insurance Company of North America <br /> <br />Insurer A: <br />Insurer B: <br />Insurer C: <br />Insurer D: <br />Insurer E: <br /> <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, <br />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. AGGREGATE LIMITS SHOWN MAY BE EXHAUSTED BY PAID CLAIMS. <br />,~~ TYPE OF INSURANCE <br />GENERAL LIABILITY <br /> <br />ALL OWNED AUTOS <br />X HIREDAUTas <br /> <br />POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS <br />DATE <br /> EACH OCCURRENCE $ 5,000,000 <br /> FIRE DAMAGE IA" ONE "REi $ 5,000,000 <br />HOO G21693054 1/1/2004 1/1/2005 MED EXP PER "RSONI <br /> PERSONAL & ADV INJURY $ 5,000,000 <br /> GENERAL AGGREGATE $ 6,000,000 <br /> PRODUCTS/COMp, op, AGG $ 6,000,000 <br /> COMBINED SINGLE LIMIT $ 10,000,000 <br /> (EACH ACCIDENT) <br />ISA H08010948 1/1/2004 1/112005 <br /> <br /> <br />A <br /> <br />X COMMERCIAL GENERAL LIABILITY <br />X OCCURRENCE <br />X xcu INCLUDED <br />X ISOFORMCGOO011001 <br />GEN'L AGGREGATE LIMIT APPLIES PER' <br /> <br />X PROJECT <br /> <br />X LOCATION <br /> <br />AUTOMOBILE LIABILITY <br />X ANY AUTO <br /> <br />A <br /> <br />X NON-OWNED AUTOS <br />X MCS-'O <br /> <br />EXCESS LlABILlTY/UMBRELLA <br /> <br />A <br /> <br />X OCCURRENCE <br /> <br />XOOG21808234 <br /> <br />1/1/2004 <br /> <br />EACH OCCURRENCE <br />1/1/2005 AGGREGATE <br /> <br />$ <br />$ <br /> <br />15,000,000 <br />15,000.000 <br /> <br />CLAIMS MAaE <br /> <br />WORKERS' COMPENSATION <br />B and EMPLOYERS LIABILITY <br /> <br />A <br /> <br />WLR C43972765 <br />SCF C43972728 (WI) <br /> <br /> WORKERS' COMPENSATION STATUTORY <br />1/1/2004 1/112005 EL EACH ACCIDENT $ 3,000,000 <br /> EL DISEASE-EA EMPLOYEE $ 3,000,000 <br /> EL DISEASE-POLICY LIMIT $ 3,000,000 <br /> <br />REMARKS, DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS, <br />C~6~K BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE AND TO THE EXTENT REQUIREO BYWR'TIEN CONTRACT. <br />¡g¡ CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/EL) WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT. <br />CIIy of Sanla Ana, Ita officers, employees, agents and yolunlee.. are nemed as Addltlonallnsurads with respect to all operations by the Named <br />Insured on all IIcles exce Wor1<ers' Com naationlEL where and to tha extent as ulred b written contract <br /> <br />CERTIFICATE HOLDER: <br /> <br />CANCELLATION: <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION OATE THEREOF. THE ISSUING INSURER WILL MAIL '30 DAYS WRITTEN NOTICE <br />TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, "EXCEPT 10 DAYS NOTICE FOR NON- <br />PAYMENT. <br /> <br />City of Santa Ana <br />20 Civic Cenler Plaza <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br /> <br />AUTHORIZED REPRESENTATIVE <br /> <br />~-.,..~ <br /> <br />frl-år <br /> <br />