Loading...
Insurance - Waste Management Holdings - 1-31-2020A� EY CERTIFICATE OF LIABILITY INSURANCE 1/1/2021 DATE(MMIDDNYYY) 1/31/2020 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(les) 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 LOCKTON COMPANIES CONTACT NAME: PHONE FAX A/c Ext): A No 3657 BRIARPARK DRIVE, SUITE 700 HOUSTON TX 77042 866-260-3538 E-MAIL ADDRESS: INSURERIS) AFFORDING COVERAGE NAIC # y INSURER A: ACE American Insurance Company 22667 1/1/2020 INSURED WASTE MANAGEMENT HOLDINGS, INC. & ALL AFFILIATED, INSURER B: Indemnity Insurance Co of North America 43575 1306000 RELATED & SUBSIDIARY COMPANIES INCLUDING: WM CURBSIDE, LLC 10633 RUCHTI ROAD INSURER C: ACE Fire Underwriters Insurance Company 20702 INSURER D: ACE Property & Casualty Insurance Co 20699 INSURER E: SOUTH GATE CA 90280 INSURER F cnVFRAnFA CFRTIFICOTF NUMRFR- 157X6929 REVISION NUMBER: XXXXXXX 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 TYPE OF INSURANCE DL SUBR WVDPOLICY NUMBER POLICDY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR y y HDO G71237345 1/1/2020 1/1/2021 EACH OCCURRENCE 5000,000 DAMA5 000 000 PRE MISES Ea occurrence MED EXP (Any oneperson) XXXXXXX X XCU INCLUDED PERSONAL & ADV INJURY $ 5,000 OOO X ISO FORM CG00010413 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 6 000 000 POLICY JECOT-FXJ LOC PRODUCTS - COMP/OP AGG $ 6,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y Y MMT H25290008 1/1/2020 1/1/2021 Eaa�dntSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ XXXXXXX X ANY AUTO X AUTOS SCHEDULED AUTOS X AUTOS ONLY X NON-OWNED ONLY BODILY INJURY (Per accident $ XXXXXXX Per a�� DAMAGE $ XXXXXXX $ XXXXXXX X MCS -90 D X UMBRELLA LIAB X OCCUR Y Y XOO G27929242 005 1/1/2020 1/1/2021 EACH OCCURRENCE $ 15,000,000 AGGREGATE $ 15000,000 EXCESS LIAR CLAIMS -MADE DED I I RETENTION $ $ XXXXXXX B A C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY FICERIMEM EPROPRIETOR�EXCLUDE�ECUTIVE (Mandatory in NH) NIA Y WLR C66043058 (AOS) WLR C66043010 (AZ,CA & M SCF C66043095(WI) 1/1/2020 1/1/2020 1/1/2020 1/1/2021 1/1/2021 1/1/2021 X STATUTE ER E.L. EACH ACCIDENT $ 3,000000 E.L. DISEASE - EA EMPLOYEE 3,000,000 If yes, be unr SCOPERATIONS below DESCRIPTION OF� E.L. DISEASE - POLICY LIMIT s3,000,000 A EXCESS AUTO LIABILITY y y XSA H25289961 1/1/2020 1/1/2021 COMBINED SINGLE LIMIT $9,000,000 (EACH ACCIDENT) DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S) REFERENCED. BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT WHERE PERMISSIBLE BY LAW. CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMPEL) WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT. ADDITIONAL INSURED IN FAVOR OF COSTA MESA SANITARY DISTRICT, THEIR ELECTED AND APPOINTED OFFICIALS, AGENTS, OFFICERS, VOLUNTEERS, AND EMPLOYEES ON ALL POLICIES (EXCEPT WORKERS' COMPENSATION/EL) WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT. THE INSURANCE AFFORDED TO THE ADDITIONAL INSURED AS DESCRIBED IN THIS CERTIFICATE OF INSURANCE FOR WORK PERFORMED BY THE NAMED INSURED IS PRIMARY AND NON-CONTRIBUTORY TO ANY SIMILAR COVERAGE MAINTAINED BY THE ADDITIONAL INSURED WHERE AND TO THE EXTENT REQUIRED BY CONTRACT. 30 DAY NOTICE OF CANCELLATION IS INCLUDED ON THE POLICIES. CERTIFICATE HOLDER CANCELLATION See Attachments ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved 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 ACCORDANCE WITH THE POLICY PROVISIONS. 15786929 AUTHORIZED REPRESENTATIVE COSTA MESA SANITARY DISTRICT W10 0� 290 PAULARINO AVE. VV COSTA MESA CA 92626 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD Attachment Code : D446557 Master ID: 1306000, Certificate ID: 15786929 POLICY NUMBER: HDO G71237345 Endorsement Number: 39 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONALOWNERS LESSEES • '1 CONTRACTORS — ( 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 will 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 1185 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 Attachment Code : D540767 Certificate ID : 15786929 POLICY NUMBER: HDO G71237345 Endorsement Number: 41 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 Location And Description Of Completed Operations Organization(s) Any person or organization whom you have agreed All locations where you perform work for such to include as an additional insured under a written additional insured pursuant to any such written contract, provided such contract was executed prior contract. to the date of loss. 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 © Insurance Services Office, Inc., 2012 Page 1 of 1 Attachment Code : D540810 Certificate ID : 15786929 ADDITIONAL INSURED ENDORSEMENT Named Insured Waste Management, Inc. Endorsement Number 17 Policy Symbol Policy Number Policy Period Effective Date of Endorsement MMT MMT H25290008 1/1/2020 To 1/1/2021 Issued By (Name of Insurance Company) CE American Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: MOTOR CARRIER COVERAGE FORM Schedule Name of Person or Organization: any person or organization whom you have been required to include as an additional insured under contract or agreement, executed prior to the date of loss WHO IS AN INSURED (Section II) is amended to include as an additional insured the person or organization shown in the Schedule, but only with respect to their liability arising out of the ownership, maintenance or use of a covered "auto" being operated by or on behalf of the Named Insured. MS -11111 (01/17) ©Chubb. 2016. All rights reserved. Page 1 of 1 Attachment Code : D540793 Certificate ID : 15786929 POLICY NUMBER: HDO G71237345 Endorsement Number: 41 COMMERCIAL GENERAL LIABILITY CG 20 12 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART R -*91:1 111 State Or Governmental Agency Or Subdivision Or Political Subdivision: Any state, governmental agency or political subdivision that has issued a permit or authorization to you in connection with your operations. 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 any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. 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. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". 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 12 04 13 © Insurance Services Office, Inc., 2012 Page 1 of i