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HomeMy WebLinkAboutWARE DISPOSALA-2017-367-01 INSURANCE NOT ON FILE WORK MAY NOI PROCEED MAYOR CLERK OF COUNCIL Miguel A. Pulldo MAYOR PRO TEM DATE: JUL 0 2 2019 Juan Villages COUNCILMEMSERS Cecilia Iglesias David Penaloza Vlcentettarmlento O Vf� Sannie Jose Solodo CI,1goiii A \` / t--, Ware Disposal, Inc. Attn: Jay B. Ware 1035 E. 4"' Street Santa Ana, CA 92702 CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza Santa Ana, California 92701 mvry sante-ana ore June 4,2019 CITY MANAGER Kristine Ridge CITY ATTORNEY Sonia R. Carvalho ACTING CLERK OF THE COUNCIL Norma Mitre Re: Further extension of Agreement #A-2005-242 for collection and handling of construction and demolition debris generated, produced and/or accumulated at temporary construction sites Dear Mr. Ware, Pursuant to the terms detailed in the Extension of Agreement No. A-2017-367 ("Extension") entered into by Ware Disposal, Inc. and the City of Santa Ana, dated December 19, 2017, the time period for the original Agreement #A-2005-242 ("Agreement"), as amended, was extended until June 30, 2020, with an option to extend for one year. By operation of this letter, the parties hereby agree to extend the Agreement for an additional one (1) year period until June 30, 2021. The insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of said Agreement, as amended, r7ml unchanged and in full force and effect. Fuad eiss, PE, PI'S Executi e Director, Public Works Agency CITY O t SANTA ANA: Kristine Ridge City Manager APPROVED AS TO FORM: Sonia R. Carvalho City Attonine�y� Q a � /VV-.o.�v�� J M.Funk Assistant City Attorney 7,,f)DISPO AV Title: �� R / /%� ` ✓ �7� ATTEST: (` Norma Mitre r Acting Clerk of the Council SANTA ANA CITY COUNCIL Miguel A. Pulido Juan villegas Vicente aarmlento David Penaioaa Jose action vacant Cecilia Iglesias Mayor Mayor Pro Tom, Word 5 Wood Word Ward Wood Word movildoftane mi Ivllleoea(ateenta ana.ora vermiento6searda-ana ore tloaneloxaralsanleana ore Ieolmie(aserge-am oro rJ91a (d= I kCCiRt3 CERTIFICATE OF LIABILITY INSURANCE DATE27/2010019 Y, 2/7/9 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IN8URER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the Certificate holder in lieu of such endorsement(s), PRODUCER HUB International Insurance Services Inc. Liconse#0767776 3636 American River Drive, Suite 200 Sacramento CA 95664 CONTNAMEACT ROCIO Leon PHON o ESP. 916-480-4134 FAXa rc no:916-993-7234 Amt. Rocio.Leon@hublnternational.com INSURERS) AFFORDING COVERAGE NAIC d INOURERA: Greenwich Insurance Company 22322 _ INSURED Ware Disposal Inc, WAREDIB-02 War P.O. Box 1318 INSURER e : Westchester Surplus Lines Insurance Co. 10172 INSURERC: Alaska National Insurance Company 38733 INSURERD: Evanston Insurance Company 35378 Santa Ana CA 92702 / 1�1 INSURERS: INSURER Fi COVERAGES GCK I ]PICA It NUMBIEK: tiNHR1nr.96 GPIRCInhi MIIn.10Eo. 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, ILTD TYPE OF INSURANCE ADDL U POLICY NUMBER MOIDD EPF YYYI MMIOOYEXP LIMITS_ A X COMMERGIAL GENERAL LIABILITY CLAIMS -MADE II OCCUR STOOD PD Bed, Y GEC3000730-04 228/2019 2/26/2020 EACH OCCURRENCE If1,000000 TED A PREMISES RE urre $100,000 $5EDD X e c. MED ENE (Any one person) Per Owunence PERSONAL B ADV INJURY _ $1,000,000 AGGREGATE UMITAPPLIES PER: POLICYI jE� El LOG GENERAL AGGREGATE $2,000,000 GEN'L PRODUCTS - COMPIOP AGO $2,000,000 $ OTHER: A AUTOMOBILE X` LIABILITY ANYAUTO AE00046386M 212812019 2128/2020 COMBINED SINGLE LIMIT E cider $ 0000 BODILY INJURY (Per person) — 3 _ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY( Per arddenQ $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE ereccid_enI), $ BUPD Dedustlble $10,400 B X UMBRELLA LIAD EXCESS DAG X OCCUR CLAIMS -MADE G46863306002 2)28/2019 2/28/2020 EACH OCCURRENCE a 10,000,000 AGGREGATE $10,OOo 000 DFD RETENTIONS $ C WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN OFFICERMEMBER IPAEXOIUDEDp ECUTIVF. NIA 1BH WS 05450 81112018 8/1I2010 X I PER OTH- STATUTE ER _ E.L. EACH ACCIDENT $$1,000,000 E.L. DISEASE - EA EMPLOYE $$1000,000 (Mandatory In NH) If yea, downbe under E.L.DISEASE'- POLICY LIterr _ 8$1,0OQo00 - DESOUPTICALOF OPERATIONS Le"v D Envlmnmonlai lmpalment LIa0111ty/LPL FT17CPLOWE00598 2281201] 2I282020 Eech Loee 1000,000 A88ra9zto IDU0,000 Deduodam 10,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACOaD 101, Addlpenal Remarks Srhedule, maybe acaCbed it more space Is required) (General Liability Per Project Aggregate applles perwfhten contract) , RE: Work performed by the insured for certificate holder per written contract Additional Insured: City of Santa Ana: its officers, employees, agents, Volunteers and representative Forms: CG201 D 0413, OG2037 0413, IXI405 0910, XIL431 0605 L ur 1 a &F� l�S -t`i� f it V t✓ V 4 CITY OF SANTA ANA PUBLIC WORKS AGENCY PO BOX 1988 M-21 SANTA ANA CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1 All rinhic rasansbd ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GEC3000730-04 COMMERCIAL GENERAL LIABILITY CG 2010 0413 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART �1119F#1111� Name Of Additional Insured Person(s) Or Oraanizationi I Location(s) Of Covered Operations City of Santa Ana, its officers, employees, agents, Any Location volunteers and representatives. 20 Civic Center Plaza, Santa Ana CA 92701 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. S. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work' out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C1 1? 011�) CG 20 10 04 13 O Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional Insured is required by a contract or agreement, the most we will pay on behalf of the additional insureds the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations, y� ar�d l? ��21 nor cu�i�nl 3 / G Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 2010 0413 POLICY NUMBER:GEC300730-04 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or anization s Location And Description Of Completed Operations City of Santa Ana, its officers, employees, agents, volunteers and representatives. 20 Civic Center Plaza, Santa Ana CA 92701 Any Location Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11 — Who Is An Insured is amended to Include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and Included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 0413 O Insurance Services Office, Inc., 2012 `e A Page 1 of 1 ENDORSEMENT# This endorsement, effective 12:01 a.m„ 02/23/2019 forms a part of Policy No: GEC3000730-04 issued to Ware Disposal, Inc by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT In the event coverage is cancelled for anystatutorily permitted reason, other than nonpayment of premium, advanced written notice will be mailed or delivered to person(s) or entity(ies) according to the notification schedule shown below: Name of Person(s) or Entity(ies) I Mailing Address: I Advanced Notice of City of Santa Ana 20 Civic Center Plaza, Santa Ana CA 92701 All other terms and conditions of the Policy remain unchanged. fo IXI 405 0910 02010 X.L. America, Inc. All Rights Reserved. May not be copied without permission. ENDORSEMENT# This endorsement, effective 12:01 a.m., 02/28/2019, forms a part of Policy No: GEO3000730-04 issued to Ware Disposal, Inc by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE CLAUSE ENDORSEMENT - SCHEDULED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM RAILROAD PROTECTIVE LIABILITY COVERAGE FORM It is agreed that to the extent that insurance is afforded to the following Additional Insured under this policy, this insurance shall apply as primary and not contributing with any insurance carried by such Additional Insured, as required by written contract. Name of Person or Organization: City of Santa Ana, its officers, employees, agents, volunteers and representatives. 20 Civic Center Plaza, Santa Ana CA 92701 All other terms and conditions of this policy remain unchanged. OA N, ce 1a'CP1A XIL 431 0605 O, 2005, XL America, Inc. C,'�X 4�qO Francine R. r'9'm'""gned byantlne Villareal °9e1030 80° 12""' ACORO® CERTIFICATE OF LIABILITY INSURANCE �i. DATE(MMIDDIYYYY) 7/27/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND 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 CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER HUB International Insurance SerVICES Inc. 3636 American River Drive, Suite 200 Sacramento CA 95864 CONTACT NAME: ROCIo Leon AIONNo Exl: 916-4BO-4134 FAX No:916-993-7234 E-MAIL ADDRESS: Rocio.Leon@hubinternational.com INSURER(S) AFFORDING COVERAGE NAIL# INSURERA: Greenwich Insurance Company 22322 License#: 0757776 INSURED WAREDIS-02 Ware Disposal Inc. P.O. Box 1318 INSURER B: Westchester Surplus Lines Insurance Co. 10172 INSURER C: Alaska National Insurance Company 38733 INSURER D: Indian Harbor Insurance Company 36940 Santa Ana CA 92702 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 278481332 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. INSR R TYPE OF IN SURANCE ADDL MD POLICYNUMBER YEFF MMIDDYYYY POLICY EXP MMIDDYYYy LIMITS A X COMMERCIAL GENERAL LIABILITY V GEC3000730-05 2/28/2020 2/28/2021 EACH OCCURRENCE $1,000,000 CLAIMS -MADE 1XI OCCUR PREMSREIFID ES Eeoccomence $100,000 X MED EXP(Any one person) $5,000 $1, 000 PD Ded. Per Occurrence PERSONAL&ADVINJURY $1,000,000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 Fyl POLICY PEO LOC PRODUCTS - COMP/OP AGO $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY y AECO04538605 2/28/2020 2/28/2021 COMBINED SINGLE LIMIT Ea accident) $1,000,000 X BODI LV I NJURV(Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accitlent) $ Per accitlent $ HIRED NONOWNEDPROPERTVDAMAGE AUTOS ONLY AUTOS ONLY BI/PD Deductible $10,000 B UMBRELLA LIAB X OCCUR G46863306003 2/28/2020 2/28/2021 EACH OCCURRENCE $10,000,000 X AGGREGATE $10,000,000 EXCESS LIAB CLAIMS -MADE DIED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERSLIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE 20H WS 05450 8/1/2020 8/1/2021 X PER OTH- STATUTE ER EL EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCWDED9 N N/A EL DISEASE - EA EMPLOYEE $1,000,000 (Mlnfail in NH) If yes, describe under DESCRIPTION OF OPERATIONS brow EL DISEASE -POLICY LIMIT $1,000,000 D Pollution &Remediation Legal PECO056139 2/28/2020 2/28/2023 Each Poll. Condition $5,000,000 Liability/CPL Aggregate $10,000,000 Retention $10,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, A#tliti onal Remarks Schindel e, may be atta chef if more space is required) (General Liability Per Project Aggregate applies per written contract) RE: Work performed by the insured for certificate holder per written contract Additional Insured: City of Santa Ana; its officers, employees, agents, and representatives are additional insured with respect to General Liability and Auto Liability as required by contract. Forms: CG2010 0413, CG2037 0413, IX1405 0910, XIL431 0605, XIC411 1013 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division, 4th Floor 20 Civic Center Plaza AUTHORIZED REPRESENTATFIE Santa Ana CA 92701 „/j �— ,SdPMlJ"< Risk ManagementDiuiaian +�REVIEWED&APPROVED BY: ©1988-2015 ACORD `�9�IiLllJC1` ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD '®' Nick Management Analyst POLICY NUMBER: GEC3000730-05 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations City of Santa Ana, its officers, employees, agents, Any Location volunteers and representatives. 20 Civic Center Plaza, Santa Ana CA 92701 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury', "property damage" or "personal and advertising injury' caused, in whole or in part, by: 1. Your acts or omissions, or 2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: The insurance afforded to such additional insured only applies to the extent permitted by law: and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed, or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 �• Rime Mrmagemerd DMsian BY.' rrREVIEWED&{APPRIOV�ED r�✓vNG�MZ R. V�fZ�.f ® Risk Management Analyst C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 Risk Mrmagemerd DMsisn REVIEWED &{APPRIOV�ED BY.' ® Risk Management Analyst POLICY NUMBER: GEC300730-05 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations City of Santa Ana, its officers, employees, agents, volunteers and representatives. 20 Civic Center Plaza, Santa Ana CA 92701 Any Location Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury' or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law, and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement, or 2. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 04 13 0 Insurance Services Office, Inc., 2012 Rime Mrmagemerd DMsian &{APPRIOV�ED BY.' �rrREvEWED r�lHY�h2 R. V�fZ�.f ® Risk Management Analyst ENDORSEMENT# This endorsement, effective 12:01 a.m., 02/28/2020 forms a part of Policy No: GEC3000730-05 issued to Ware Disposal, Inc by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. In the event coverage is cancelled for any statutorily permitted reason, other than nonpayment of premium, advanced written notice will be mailed or delivered to person(s) or entity(ies) according to the notification schedule shown below: Name of Person(s) or Entity(ies) Mailing Address: Number of Days Advanced Notice of Cancellation: City of Santa Ana 20 Civic Center Plaza, Santa Ana CA 92701 30 All other terms and conditions of the Policy remain unchanged. IXI 405 0910 © 2010 X.L. America, Inc. All Rights Reserved. May not be copied without permission. Rime Mrmagemerd DMsian &{APPRIOV�ED BY.' �REVIEWED r�✓vNG�MZ R. V�fZ�.f ® Risk Management Analyst ENDORSEMENT# This endorsement, effective 12:01 a.m., 02/28/2020, forms a part of Policy No: GEC3000730-05 issued to Ware Disposal, Inc by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. :7hyJ_1:Ya121111:7_12[d=IrdA_111,61 =1 =1IBig] :11=1l41=11Y11111113d:I=1bill 4=1ll: This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM RAILROAD PROTECTIVE LIABILITY COVERAGE FORM It is agreed that to the extent that insurance is afforded to the following Additional Insured under this policy, this insurance shall apply as primary and not contributing with any insurance carried by such Additional Insured, as required by written contract. Name of Person or Organization: City of Santa Ana, its officers, employees, agents, volunteers and representatives. 20 Civic Center Plaza, Santa Ana CA 92701 All other terms and conditions of this policy remain unchanged. XIL 431 0605 ©, 2005, XL America, Inc. 5s' Rime Mrmagemerd DMsian BY. rrREVIEWED&{APPRIOV�ED r�✓vNG�MZ R. V�fZ�.f ® Risk Management Analyst ENDORSEMENT #044 This endorsement, effective 12:01 a.m., July 20, 2020 forms a part of Policy No. AECO04538605 issued to WARE DISPOSAL, INC. by Greenwich Insurance Company. 110.16E:10II I.R]:I�ilq►lril:I_ 0lei *91aago] I[N'M,I7_F901111:77_1111101111Ill :7g11111]1119 CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT In the event coverage is cancelled for any statutorily permitted reason, other than nonpayment of premium, advanced written notice will be mailed or delivered to person(s) or entity(ies) according to the notification schedule shown below: Number of Days Name of Person(s) or Entity(ies) Mailing Address: Advanced Notice of Cancellation: City of Santa Ana Risk Management Division, 4th Floor, 20 Civic Center Plaza 30 Santa Ana, CA 92702 All other terms and conditions of the Policy remain unchanged. IXI 405 0910 JABR 07/20/2020 © 2010 X.L. America, Inc. All Rights Reserved. May not be copied without permission. oti Risk MuagnnentDMsian REVIEWED&APPROVED BY: V:r ldd RBk Management Analyst POLICY NUMBER: AECO04538605 XIC 411 1013 ENDORSEMENT #011 This endorsement, effective 12:01 a.m., February 28, 2020 forms a part of Policy No. AECO04538605 issued to WARE DISPOSAL, INC. by Greenwich Insurance Company. 10:1R2=12UZ67:11=141=12Ydrd:l_VN*bd:1=l4Pl'A»=F_F-4=1;1=FM97Ydrd_ I=11114WM I_1111 Cal IT, 1_V 0 191-11 a] a] 1110 [a] � I_101 � &111 N =1 I] This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM A. COVERED AUTOS LIABILITY COVERAGE, Who Is An Insured, is amended to include as an "insured" any person or organization you are required in a written contract to name as an additional insured, but only for "bodily injury" or "property damage" otherwise covered under this policy caused, in whole or in part, by the negligent acts or omissions of: You, while using a covered "auto", or 2. Any other person, except the additional insured or any employee or agent of the additional insured, operating a covered "auto" with your permission, Provided that: a. The written contract is in effect during the policy period of this policy, b. The written contract was signed by you and executed prior to the "accident" causing "bodily injury" or "property damage" for which liability coverage is sought, and C. Such person or organization is an "insured" solely to the extent required by the contract, but in no event if such person or organization is solely negligent. B. The Limits of Insurance provided for the Additional Insured shall not be greater than those required by contract and, in no event shall the Limits of Insurance set forth in this policy be increased by the contract. C. General Conditions, Other Insurance is amended as follows: Any coverage provided hereunder shall be excess over any other valid and collectible insurance available to the additional insured whether such insurance is primary, excess, contingent or on any other basis unless the contract specifically requires that this policy be primary. All terms, conditions, exclusions and limitations of this policy shall apply to the liability coverage provided to any additional insured, and in no event shall such coverage be enlarged or expanded by reason of the contract. All other terms and conditions of this policy remain unchanged. XIC 411 1013 © 2013 X.L. America, Inc. All Rights Reserved. May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permi I[/XXYIxIPA1 111 'IIS[y Page 1 of 1 Rime Mrmagemerd DMsian &{APPRIOV�ED BY.' �REVIEWED r�✓vNG�MZ R. V�fZ�.f ®6 Risk Management Analyst Westchester A Chubb Company Declarations ACE Catastrophe Liability Plussm Policy Policy Number: G46863306 003 1 Previous Policy Number: G46863306 002 COVERAGE IS PROVIDED IN THE COMPANY DESIGNATED BELOW Westchester Surplus Lines Insurance Company NAMED INSURED AND ADDRESS PRODUCER NAME AND ADDRESS Ware Disposal, Inc. CRC Insurance Services Inc. (As Per Underlying Insurance) 1 Metroplex Drive P.O. Box 1318 Suite 400 Santa Ana, California 92702 Birmingham, AL 35209 PRODUCER CODE 101571 Policy Period: From 02/28/2020 To 02/28/2021 12:01 A.M Local Time at the Address of the Named Insured as stated herein Limits of Insurance $ 10,000,000 Each Occurrence $ 10,000,000 Aggregate Premium $ Advance Premium © Flat Except For Acquisitions ❑ Adjustable Surplus Lines Tax $ Total Amount Due Stamping Office Fee $ Annual Premium Policy Fee: - Schedule of Underlying Insurance First Policy of Underlying Insurance Company: See Schedule A Limits of Insurance Policy Period: See Schedule A $ See Schedule A Each Occurrence $ See Schedule A Aggregate, Where Applicable $ Not Applicable Forms attached to and forming a part of this policy at inception: Policy Form: ACE Catastrophe Liability Plus Policy XSC-27266 Schedule of Underlying Insurance: ❑ XSWO02 ❑X XSWO04 Endorsements as Listed on the Schedule of Endorsements CPfs2 Authorization Information: 9ZJOHN J. LUPiCA. President XSWO01 (07/10) OChubb. 2016. A rghts reserved. Rime Mrmagemerd Division r(R�EVIEWED&pAPPP1RL,OVVrED BY.' ® Risk Management Analyst SCHEDULE A - SCHEDULE OF UNDERLYING INSURANCE Named Insured Endorsement Number Ware Disposal, Inc. Policy Symbol Policy Number Policy Period Effective Date of Endorsement MLW G48883308 003 02/2 8/2020 To 02/28/2021 02/28/2020 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: ACE CATASTROPHE LIABILITY PLUS POLICY TYPE OF POLICY APPLICABLE LIMITS INSURER - POLICY PERIOD (A) Automobile "Bodily Injury" and "Property Damage" Liability Combined Single Limit $ 1,000,000 Each "Occurrence" Uninsured / Underinsured Motorist $ Not Applicable Each "Occurrence" (B) General $ 1,000,000 Each "Occurrence" Limit Liability $ 2,000,000 General Aggregate Limit (X) Per Project/Location $ 2,000,000 Products/Completed Operations Aggregate Limit $ 1,000,000 Personal & Advertising Injury Limit (C) Employers Coverage B- Employers Liability Liability 'Bodily Injury" by Accident $ 1,000,000 Each Accident "Bodily Injury" by Disease $ 1,000,000 Each Employee Bodily Injury" by Disease $ 1,000,000 Policy Limit (D) Employee $ 1,000,000 Each "Claim" Benefits $ 1,000,000 Aggregate Liability (E) Automobile "Bodily Injury" and "Property Damage" Liability Combined Single Limit $ 1,000,000 Each "Occurrence" (Excess of Item (A) above) Greenwich Insurance Company 02/28/2020 - 02/28/2021 Greenwich Insurance Company 02/28/2020 - 02/28/2021 Western World Insurance Company 02/28/2020 - 02/28/2021 Alaska National Insurance Company 08/01/2019 - 08/01/2020 Greenwich Insurance Company 02/28/2020 - 02/28/2021 Crum & Forster Specialty Insurance Company 02/28/2020 - 02/28/2021 XSWO04 (07/10) ©Chubb. 2016. All rights reserved. Risk Management Division /R' EvEWED &{AP'PIRIOeVeEDBY.' 3'llllLtll[-� r�lVf.lN4�e Tom. V�RK ®' ® Risk Management Analyst Francine R. Digitally signed by Francine R. Villareal 1 Villareal - Date: 2021.03.30 14:24:34 -07'00' A�CO�RO® CERTIFICATE LIABILITY I I DATE (MM/DD/YYYY) 3/30/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSU(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Rocio Leon HUB International Insurance Services Inc. PHONE FAx 3636 American River Drive, Suite 200 A/C No Ext: 916-480-4134 A/c No: 916-993-7234 Sacramento CA 95864 ADDRESS: rocio.leon@hubinternational.com License#:0757776 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Greenwich Insurance Company 22322 INSURED WAREDIS-02 Ware Disposal Inc. P.O. Box 1318 Santa Ana CA 92702 COVERAGES CERTIFICATE NUMBER: 1010612776 INSURERB: Westchester Surplus Lines Insurance Co. 10172 INsuRERc: Alaska National Insurance Company 38733 INSURERD: Aspen Specialty Insurance 10717 INSURER E : INSURER F : 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICYNUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y GEC3000730-06 2/28/2021 2/28/2022 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR PREM SESOEa occurrence) $ 100,000 X IVIED EXP (Any one person) $ 5,000 $1,000 PD Ded. Per Occurrence PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 Fy] PRO - POLICY JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y AECO04538606 2/28/2021 2/28/2022 COMBINED SINGLE LIMIT Ea accident $ 1 000 000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY X BI/PD Deductible $ 10,000 CA9948 B UMBRELLA LAB X OCCUR G46863306004 2/28/2021 2/28/2022 EACH OCCURRENCE $ 10,000,000 X AGGREGATE $ 10,000,000 EXCESS LAB CLAIMS -MADE DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE 20H WS 05450 8/1/2020 8/1/2021 X PERUTE OTH- STATER E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE- EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ 1,000,000 D Transportation Pollution Liab EROOJP520 10/26/2020 10/26/2021 Each Poll. Condition $4,000,000 Excess of CA9948 Auto Liability Aggregate Retention $10,000,000 $25,000 DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) (General Liability Per Project Aggregate applies per written contract) RE: Work performed by the insured for certificate holder per written contract (Excess Liability Policy G46863306004 is excess over General Liability GEC3000730-06, Auto Liability AECO04538606 and Employers Liability 20HWS05450) Additional Insured: City of Santa Ana; its officers, employees, agents, and representatives are additional insured with respect to General Liability and Auto Liability as required by contract. Forms: CG2010 1219, CG2037 1219, IX1405 0910, XIL431 0605, XIC411 1013 • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division, 4th Floor 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 Risie Management Diveaian REVIEWED & APPROVEDSY: O 1988-2015 ACORD C ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ��,_— 1415KmanagementAnalyst POLICY NUMBER: AECO04538606 X|C4111O13 END0RSEK8ENT#U11 This endorsement, effective 12:01 a.m., February 28, 2021 forms a part of Policy No. AECO04538606 any person or organization you are required in a written contract to name as an additional insured, but only for "bodily injury" or "property damage" otherwise covered under this policy caused, in whole or in part, by the negligent acts or omissions of: 2. Any other person, except the additional insured or any employee or agent of the additional insured, operating acovered ^au(n^with your permission; Provided that: a. The written contract isineffect during the policy period nfthis policy; b. The written onn(nyot was signed by you and emsouhsd prior to the "accident" causing "bodily injury" nr"property damage" for which liability coverage is sought; and C. Such person or organization is an ''insunad" solely to the extent required by the onn(nyct, but in no event ifsuch person nrorganization is solely negligent. B. The Limits of Insurance provided for the Additional Insured shall not be greater than those required by contract and, in no event shall the Limits of Insurance set forth in this policy be increased by the contract. the additional insured whether such insurance is primary, excess, contingent or on any other basis unless the contract specifically requires that this policy be primary. X|C411 1013 KD2O13Xl.America, Inc. All Rights Reserved. Page of May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its ponnis KESS 03/21/2016 r #044 Phis eindoirseirineint, effedive 12:01 asin , [ek)iruairy 28, 2021 foinrins a Ipairk. of ['Iolhicy tJo, A6 )45386()6 issued to WAFUIDl&[C)SN , IltRl Iby ire einwichi Ilinsuraince (".oirinpainy, IC I IIIIS F(I'll IIIkJGES IC IV IHE[3(14 I(lo',(, IV ILE�A&EFZE�AD II IF 'y' CIII MCEI I A rIIIaI III ruFIII CA riam ro o nhcEFZS r lira thie eveint coverage lis caincelled for ainy statutoirily peirrinitted irr asoin, othieir thiain noiripayinneint of Ipreirir7iliurir7i, advainced wirittein notice will Ibe rinailed or delivered to peirsoin(s) oir einfity(ie) accoirdiing to thie notificatioin schiedule shiowin Ibelow: t,hvriridbeir of IDays t,Jairine of IV eirsoirii(s) or IV iriifity(ies) Mailking Addiress: Advainced t,Jofice of C.aincellatioin: iity of Sainta Aina Risk IMainageirineint IDivislioiru, 4thi IV Moor, 20 ('.ivic (".einteir [�Iaza 30 Sainta Aina, (,'.A 92792 All othieir teirinns aind coindifloins of thie If olhicy reirinaiin unchiainged , 1XI 405 0910 JA[3FR ()7/2()/2()2() @2010X] Airineirica, linc, A11FRighitsFReseirved May not Ibe copied withiout Ipeirinnissioin, RAMwagmedDMsiun z5K a REVIEWED & APPROVED BY.- P e., Risk Management Analyst . .............................. I 9014 r4rd 09 to] Lh 140 -1kael IV-*] Lh I Lh IQ 11MG] V-11 WCJQ 09 IQ 0 4 V-11 1.114 1 WKV-01TVA lIM-IT-0:11111 9-11 11MI SCHEDULE Name Of Additional Insured Person(s) Or OLganization(s) Location(s) Of Covered Operations City of Santa Ana, its officers, employees, agents, Any Location volunteers and representatives. Risk Management Division 20 Civic Center Plaza, M-28 P.O. Box 1988 Santa Ana, CA 92702 Information required to comelete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. 1. The insurance aAorded to such additionM insured only applies to the extent permitted by law; and coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 11ith respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 12 19 C Insurance Services Office, Inc., 2018 RAMwagmedDMsiun z5K a REVIEWED & APPROVED BY. - Is Wld Risk Management Analyst ................................................. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the 9-turujit of i-tsurp-tce: iMIMMONSM i 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. age 2 of 2 C Insurance Services Office, Inc., 2018 . ..............F..".O..-R.A..�.M..w.. a..g.medDMiun 5a REVIEWED & APPROVEBY- PRi5k Management Analyst Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations City of Santa Ana, its officers, employees, agents, All Locations as required per written contract. volunteers and representatives. Risk Management Division 20 Civic Center Plaza, M-28 P.O. Box 1988 Santa Ana, CA 92702 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section U — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds. the following is added to organization(s) shown in the Sohedu|e, but only SentionU|—Limnks Of Insurance: with respect to liability for "bodily injury" or If onmsnyge provided to the additional insured is "property damage" oaused, in vvhn|e or in pad, by required by a onn(nyct or agreement, the most we "your work" a( (h� |noa(inn designated and will pay on behalf of the additional insured is the described in (h� �oh�du|� of this endorsement amount nfinsurance: performed for that additional insured and included in the "prnducts-onmp|e(ed operations hazard" 1. Required by the contract nragreement; or However: 2. Available under the applicable limits of 1. The insurance afforded to such additional insurance; insured only applies to the extent permitted by whichever is less. law; and This endorsement shall not increase the 2. |fcoverage provided (nthe additional insured is applicable limits nfinsurance. required by a onn(nyct or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the onn(nyct or agreement to provide for such additional insured. RAMwagmedDMsiun CG 20 37 12 19 C Insurance Services Office, Inc., 2018 Named Insured Endorsement Number Ware Disposal, Inc. Policy Symbol Policy Number Policy Period Effective Date of Endorsement MLW G46863306 004 02/28/2021 To / /2022 02/28/2021 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company I IN ►r•: LX4► . K,110lill THIS ENDORSEMENT MODIFIESINSURANCE VIDED UNDER THE FOLLOWING: ACE CATASTROPHE LIABILITY LPOLICY TYPE OF POLICY APPLICABLE LIMITS IPOLICY PERIOD Liability(A) Automobile "Bodily Injury" and "Property Damage" • « « Single 111 !R1 i • 0, 1 • • • 0 • 50• «, r (B) General $ 1,000,000 Each "Occurrence" Limit Liability $2,000,000 General Aggregate Limit ( ) PerProject/Location $2,000,000 Products/Completed Operations Aggregate Limit $1,000,000 Personal & Advertising Injury Limit O Employers Coverage B — Employers Liability Liability "Bodily Injury" by Accident $1,000,000 Each Accident "Bodily Injury" by Disease $1,000,000 Each Employee Bodily Injury" by Disease $1,000,000 Policy Limit II • • .......... . :•• n rJ JJJ�I• ••• «- Elm 1 1 1 ! 1 1 • 1! r • -• • • r 1 02/28/2022 - ! c 02/28/2022 b; 1 02/28/2022 c 1. • • • ! « ! r 181 r LSBEZLAZE• • TIMITMITTTRITIWIM �F IZAManagzmedDiviaian a REVIEWED & APPROVED SY: --� Risk Management Analyst