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175487 , k---- CERTIFICATE OF LIABILITY INSURANCE 08/01/ 011 YYYI7 OS/Ol/201 1 THIS CERTIFICATE IS ISSUED AS A MATTER OF M CSRMATfOFsQ NLY, AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGAT)VELY AMENDI,-EXTENC) ;OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIIPICATE HOLDER. - IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, thepolicy(-Ras)-.must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain polici"rnay require an-endorserRent. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER John O. Bronson Co. / #0425149 3636 American River Drive Suite 200 Sacramento, CA 95864 916-974-7800 CON ACT NAME- ROCiO Leon - 916-480-4134 916-480-4134 p,' c No : E-MAa ADDRESS: Aeon@'ohnobronson.com INSUMERISI AFFORDING COVERAGE NAIC 4 INSURER A: Alaska National Insurance Company (San Fmncisco,C, 38733 INSURED Ware Disposal Inc./Madison Materials P.O. BOX 8089 Newport Beach, CA 92658 G O - / INSURER B : INSURER C : INSURER D : INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL SUBRPOLICY POLICY NUMBER MMIDDDY EFF MM/DD EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY MAGE TO RENTED DAPREMI E Ea occurrence $ MED EXP An one p arson $ CLAIMS -MADE = OCCUR PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN-L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY "' LOG $ AUTOMOBILE LIABILITY Ea accitlent BODILY INJURY (Per parson) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accltlent) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAR H OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABIUTY Y / N I I WS 05450 08/01/2011 08/01/2012 X. WC STATU- OTH- I E.L. EACH ACCIDENT $ 1,000,000 A ANY PROPRIETOR/PARTNER/EXEGUTIVE OFFICER/MEMBER EXCLUDED? N / A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes. descri ba —de, E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Ramarha Schedule, If more space Is required) RE: Work performed by the insured for certificate holder per written contract Add- Laura Stitt yh- -dy------- In[eresfs: Assistant City AtlUrn C4 Forms: �.cK I Irra..ra 1 c AVLUCK CANGCLLA I ION a30 "aV Notice of Cancellation/10 Day for Non-Pay/Non-Rptg+ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana Public Works Agency THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y g y ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA, M-21 SANTA ANA, CA 92701 AUTHORIZED REPRESENTATIVE © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD