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A�?Dm CERTIFICATE OF LIABILITY INSURANCE
<br />E (MMIDDIY
<br />ATEMMM2018YYY)
<br />r
<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 be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />HUB Int'I - CAL Bronson - License #0757776
<br />3636 American River Drive, Suite 200
<br />Sacramento CA 95864
<br />CONTACT
<br />NAME: ROCIO Leon
<br />PHONE FAX
<br />A/C No E t : 916-480-4134 A/c No): 916-993-7234
<br />ADDRESS: Rocio.Leon@hubintemational.com
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A: Greenwich Insurance Company22322
<br />INSURED WAREDIS-02
<br />Ware Disposal Inc.
<br />P.O. Box 1318
<br />INSURER B : Evanston Insurance Company35378
<br />INSURERC: GuideOne National Insurance Company
<br />14167
<br />INSURER D : Alaska National Insurance Company
<br />38733
<br />Santa Ana CA 92702
<br />INSURER E :
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 445521118 REVISION NUMBER -
<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 LTR
<br />TYPE OF INSURANCE
<br />ANDDL
<br />SWVD UER
<br />POLICY NUMBER
<br />MM/DDY/YYYY
<br />MMIDD/YYXP
<br />I LIMITS
<br />A
<br />X i COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE � OCCUR
<br />Y
<br />GEC3000730-02
<br />2/28/2017
<br />2/28/2018
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE(RENTED
<br />PREMISESSEa occurence
<br />$ 100,000
<br />MED EXP (Any one person)
<br />$ 5,000
<br />X ! $1,000 PD Ded. _
<br />Per Occurrence
<br />PERSONAL 8 ADV INJURY
<br />$ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY JE LOC
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE LIABILITY
<br />AECO04538602
<br />2/28/2017
<br />2128/2018
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1 000 000
<br />BODILY INJURY (Per person)
<br />$
<br />X 1 ANY AUTO
<br />ALL OWNED SCHEDULED
<br />'AUTOS AUTOS
<br />NON -OWNED
<br />HIRED AUTOS AUTOS
<br />I
<br />BODILY INJURY (Per accident)
<br />I PROPERTY DAMAGE
<br />Per accident
<br />$
<br />I $
<br />BI/PD Deductible
<br />I $ 5,000
<br />C
<br />! UMBRELLA LIAR
<br />X OCCUR
<br />560000069 00
<br />11/14l2017
<br />2/28/2018
<br />EACH OCCURRENCE
<br />j $ 5,000,000
<br />X EXCESS uA8
<br />I CLAIMS -MADE
<br />I
<br />j AGGREGATE
<br />$ 5,000,000
<br />DED RETENTION $
<br />$
<br />I
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETORIPARTNER/EXECUTIVE YIN
<br />OFFICERIMEMBER EXCLUDED? ❑N
<br />N / A
<br />17H WS 05450
<br />8/1/2017
<br />8/l/2018 I
<br />X SPER TATUTE ERH
<br />E.L. EACH ACCIDENT I
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYE
<br />$ 1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$1,000,000
<br />B
<br />Environmental Impairment
<br />Liability/CPL
<br />17CPLOWE00598
<br />2/28/2017
<br />I
<br />2128/2020
<br />�
<br />Each Loss 1,000,000
<br />Aggregate 1,000,000
<br />Deductible 10,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />(General Liability Per Project Aggregate applies per written contract)
<br />RE: Work performed by the insured for certificate holder per written contract
<br />Additional Insured: City of Santa Ana; its officers, employees, agents, volunteers and representative
<br />Forms: CG2010 0413, CG2037 0413, IX1405 0910, XIL431 0605
<br />REVIEWED BY: EUNICE HEREDIA (PG I OF )
<br />i,r-m I Irta.r>, i c riuLur-m
<br />CITY OF SANTA ANA PUBLIC WORKS AGENCY
<br />PO BOX 1988 M-21
<br />SANTA ANA CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED RE
<br />P
<br />RESE
<br />NTATIVE
<br />O 1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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