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CE .'IFICATE OF INSURANCE Date:(MM/DD/YY) <br /> 3/14/2003 <br /> PRODUCER - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Lockton anselipe, Agencyofof Houston,Inc. ONLY AND CONFERS. NO RIGHTS UPON THE CERTIFICATE <br /> 5847 San Felipe,Suite 320 <br /> Houston,TX 77057 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 866-260-3538(Phone) ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> 866-492-1055(Fax) <br /> This Certificate Voids and Supercedes any previously issued certificate. INSURERS AFFORDING COVERAGE <br /> INSURED: WASTE MANAGEMENT, INC. and Insurer A: ACE American Insurance Company <br /> Waste Management of Orange County Insurer B: Indemnity Insurance Company of North America <br /> 1800 South Grand Avenue <br /> Santa Ana, CA 92705 Insurer C: National Union Are Insurance Company of Pittsburgh,PA <br /> Insurer D: Gerling Konzern Allgemeine <br /> Insurer E: <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 /> INSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS _. <br /> LTR DATE <br /> GENERAL LIABILITY EACH OCCURRENCE $ 5,000,000 <br /> A x COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(ANY ONE FIRE) $ 5,000,000 <br /> X OCCURRENCE HDO G2058693A 1/1/2003 1/1/2004 MED EXP(PER PERSON) <br /> X XCU INCLUDED PERSONAL&ADV INJURY $ 5,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 6,000,000 <br /> X PROJECT PRODUCTS/COMP.OP.AGG $ 6,000,000 <br /> X LOCATION <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 10,000,000 <br /> A x ANY AUTO ISA H07840263 1/1/2003 1/1/2004 (EACH ACCIDENT) <br /> X HIRED AUTOS <br /> X NON-OWNED AUTOS <br /> X MCS-90 <br /> EXCESS LIABILITY/UMBRELLA EACH OCCURRENCE $ 100,000,000 <br /> A x OCCURRENCE X00021740019 1/1/2003 1/1/2004 AGGREGATE $ 100,000,000 <br /> C CLAIMS MADE 2859983 <br /> D I 839/CX3591203 <br /> WORKERS'COMPENSATION WORKERS'COMPENSATION STATUTORY <br /> B and EMPLOYERS LIABILITY WLR C43510885 1/1/2003 1/1/2004 EL EACH ACCIDENT - $ 1,000,000 <br /> A SCF C43510927 (W I) EL DISEASE-EA EMPLOYEE $ 1,000,000 <br /> EL DISEASE-POLICY LIMIT $ 1,000,000 <br /> REMARKS: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT PROVISIONS: <br /> CHECK ® BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT. <br /> BOX <br /> ® CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED(EXCEPT FOR WORKERS'COMP/EL)WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT. <br /> Re: Self insured for auto physical damage. <br /> Additional Insured In favor of City of Santa Ana,Its officers agents and employees(on all policies except Workers' <br /> Compensation/EL)where and to the extent as required by written contract.The Above Auto Liability policy provides liability <br /> coverage to the trucks owned by the City of Santa Ana that are operated and maintained by Waste Management of Orange County. <br /> CERTIFICATE HOLDER: CANCELLATION: <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL MAIL 30 DAYS WRITTEN NOTICE <br /> TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. <br /> City of Santa Ana APPROVED ` g p FORM • <br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE: <br /> P.O. Box 1988 / <br /> Santa Ana, CA 92701 A -.1 . — <br /> Michael Vigliotta / <br /> fPT„ty city Attorney <br />