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Insurance - CR&R Haulaway Storage Containers, Inc. 2019-01-07-� CR&RINC-01 MG91408E CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)01/07/2019 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 License # OE77964 CONTACT NAME: Solid Waste Insurance Marketing P.O. Box 7072 (AtCNNo, Ext): (626) 795-9000 (A//c, No):(626) 577-8940 Pasadena, CA 91109 AD AIL INSURED CR&R, Inc. Haulaway Storage Containers, Inc. 11292 Western Avenue Stanton, CA 90680 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: XL Insurance America _ 24554 INSURER B: INSURER C : INSURER D: INSURER E INSURER F: nr%1kI=MA9±G@ /%CE21r1C11%ATC K11IRAQC0- 0=11ICIr%Kl Ail11UR1:R- 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. Costa Mesa Sanitary District �Y INSR TYPE OF INSURANCE ADDL;SUBR POLICY NUMBER POLICY EFF POLICY EXP LTR INSD WVD MM/DD/YYYY MM/DD/YWY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence)_ $ AUTHORIZED REPRESENTATIVE MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JECT LOC PRODUCTS -COMP/OP AGG $ OTHER: $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) . $ HIRED NON -AWNED PROPERTY DAMAGE (Per accident) $ AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION PER X STATUTE EERH AND EMPLOYERS' LIABILITY YIN N RWD943620911 04/01/2018 04/01/2019 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A E.L. EACH ACCIDENT $ 9,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Earlier Notice of Cancellation Provided by Us WC990110 (Ed. 1/08) A Tr 111 r%r-M !-A k1f%M1 1 ATIAAI ACORD 25 (2016/03) W 19ss-ZU15 AL;UKU c:UKrUKA I IUN. Ali rlgnis reserves. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Costa Mesa Sanitary District �Y ACCORDANCE WITH THE POLICY PROVISIONS. 290 Paularino Ave. Costa Mesa, CA 92626 t AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) W 19ss-ZU15 AL;UKU c:UKrUKA I IUN. Ali rlgnis reserves. The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EARLIER NOTICE OF CANCELLATION PROVIDED BY US ENDORSEMENT This endorsement modifies insurance provided under the following: WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY Number of Days Notice: 60 WC.99 01 10 (Ed. 1/08) (If no entry appears above, information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement.) For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation, as provided in PART SIX — CONDITIONS, D. Cancelation of the Workers' Compensation and Employers' Liability Insurance Policy or as amended by an applicable state cancellation endorsement, is increased to the number of days shown in the Schedule above. All other terms and conditions remain the same. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 04-01-2018 to 04-01-2019 Insured CR&R Incorporated Insurance Company XL Insurance America, Inc. WC 99 01 10 Ed. 1/08 Policy No. RWD9435209-11 Countersigned by 0 2007 XL America, Inc. Endorsement No.