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Insurance-Waste Management Holdings Inc - 2016-04-29,AlI co�KO' CERTIFICATE OF LIABILITY INSURANCE DATE lMhVDDmnI I 1/v2017 1 4/29/2016 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(les) 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 Ilau stanch endorsement(s). PRODUCER LOCKTON COMPANIES 5847 SAN FELIPE, SUITE 320 HOUSTON TX 77057 866-260-3538 NUNFACTMEI ac. Na Ext): ac No),- E- 1 R R F ' V R X COMMERCIAL GENERALLIABILITY CLAIMSNADEQ OCC OR Y INSURER A: ACE AinCrican lrtsuni ia COm a0V 22667 INSURED WASTE MANAGEMENT HOLDINGS, INC. &ALL AFFILIATED, 1306000 RELATED & SUBSIDIARY COMPANIES INCLUDING: WM CURBSIDE, LLC 500 S. JEFFERSON INSURER B: Indemnity Insurance Cc ot'Nonh America 7 43575 INSURERC a ACE Propert& Casualt Insurance Cc / v0699 INSU ERD: ACI: Fire Undenwiterslnsurance Company 20702 PLACENTIA CA 92870F _ RE :0N'1UUB: %� XCl11NCL11DPD COVERAGES CERTIFICATF.NIIMRFP- 11076611 ocDiclnM uuaaoco, vvvvvvv .....................,. .......�� 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. MS�1 TYPE OF INSURANCE DDL AINSD SUER VAT) POLICY NUMBER Map YEFF POLI P LIMBS A X COMMERCIAL GENERALLIABILITY CLAIMSNADEQ OCC OR Y Y HDOG27403311 1/1/2016 1/112017 EACHOCCURRENCE 5.000000 PDR FADET oc mn SOOO OQQ MED EXP (Anyoneperson) XXXXXXX %� XCl11NCL11DPD X ISO P012M COOOOI041? PERSONAL & ADV INJURY S 5,000,000 GEN'L AGGREGATE LIMIT APPLIES.PER: POLICY PED El LOC GENERAL AGGREGATE s6 000,000 PRODUCTS - COMPIOPAGG $ 6.000 000 S OTHER A AUTOMOBILE LIABILITY ALL WNED Sr;HEDULEO AUTSS AU8, SS NxANY AUTO Y Y MMTHOSS66326 I/1i2016 1/1/2017 OMBIIMa=tlEDSIIJGLELIMIT emi s 1000,000 BODILY INJURY (Per "man) S XXXXXXX BODILYINJURY (Per aceadenl3XXXXXXX HIREOAUTOS X �pON�OWNEO MCS -90 PPROP(ERttDcanANtAGE 5 XXXXXXX S XXXXXXX C X UMSRELLALBB I X OCCUR Y Y XOOG27929242001 1/1/2016 1/1/2017 EACHOCCURRENCE 5 15.000000 EXCESS LIAR CLAIMS -MADE AGGREGATE $ 15,000,000 DED I I RETENTIONS S..t'XXXXXX A A D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANVPPOpflIETOWPAatNEWEkC11rNE YIN OFFlCENAIEMBERE%CLUOEa+ IMmtl"=e uNI DESCRIVtION OF OPEATT10NSb01pw NIA Y WLR C48596769 ((AOS) WLR 04 8 5 965 00 fAL,(eA,&MA SCP C4$J96$4$(W�II) UI/2016 I/112016 1/1/2016 1/1/2017 1/1/2017 IIIPO17 PER X siATUTE Tlfi EL. EACHncc10Em 33000000 E.6DSEA£E-EAEAIPLOYEE .3000000 ELOISEASE-POUCYLIMIT J000000 A EXCESSAUTOY LIABILITY Y XSA 1108866314 111/2016 1/1/2017 COMBINED SINGLE LIMIT $9,000,000 (EACH ACCIDEN. r) DESCRIPTION OF OPERATIONS ILOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarle Schedule, may be ahached if more space is requlretll THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS. HOLDER. APPLICABLE TO THE CARRIERS LISTED AND THE POL CY TERM(S) REFERENCED. BLANKET WAIVER OF SLIBROG Al ION IS GRANTED IN FAVOR OF CER11FIC ATE HOLDER ON ALL POLICIES RIE RL LISTED TO THI EXTENT SRU(S) RE BY WLLITTEN CO\IR \Cr WLIERE. PFR\IISS1131F BYLAW CERTIFICATE HOLDER IS NAMED AS A\ AIDDITIO\Al HERE AN (TO 1H EXT NTR REQUIRED QUI EDAIYELI WHEREAND 10 Till EXTENT RFQL RULO BY WRITTEN CONTRACT. ADDITIONAL INSURCU IN f_\V'OR-0F COSTO MESA SANITARY DISTRICT, S' C IR ELECTED AND .APPOINTED OFFICIALS, AGENTS.OFFICI=RS VOLUNTEERS :AND EMPLOY ECS ((J\ ALL. P01_IC IIS MESA' WORKERS' COMPLNSAIIONiEI.) WHERE RI:QUII2F0 BY \\'RI rT['X COV I'RACI Tf{F INSURANCEAPFORDID l0 TI2 ADDITION AI INSURED AS DESCRIBED IN I HIS CERTIFICATE OF INSURANCE FOR WORK PERFORMED BY I HE NAMED INSURED IS PRIMARY AND NON-CONTRIBU10Rl' TO ANY SIMILAR COVERAGE MAINTAINED BY THE ADDH ZONAL INSURED WHERE. AND TO THE FXT ENT REQUIRED BY CONTRACT. 30 DAYS NOTICE OF CANCELLATION IS INCLUDED ON THE POLICIES. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN .ACCORDANCE WITH THE POLICY PROVISIONS. 11076631 AUTHORIZED REPRESENTATIVE -- COSTA MESA SANITARY DISTRICT 628 WEST 19TH STREET COSTA MESA CA 92627 ACORD 25 (2014101) ©1988-2014 ACORD CORPORATE . All rights reserved 1 ne AuuKu name and logo are registered marks of ACORD POLICY NUMBER: HDO G27403311 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: ANY OWNER; LESSEE OR CONTRACTOR WHOM YOU HAVE AGREED TO INCLUDE AS AN ADDITIONAL INSURED UNDER A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TO THE DATE OF LOSS. (If no entry appears above, information required to complete this endorsement would be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you. CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984 Attachment Code: D446557 Master ID: 1306000, Certificate ID: 14055377