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Insurance - CR&R - 2009-03-13CR&RINC -03 SUOS ACORD� CERTIFICATE OF LIA ALITYINSURANCE DATE (MM/ 009 DDNYYY) PRODUCER Solid Waste Insurance Managers RE c ®/ 115 N. El Molino Ave THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HOLDER. DTH CONFERS NO S CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 7072 ;r Pasadena, CA 91101 R 2 Zo(� INSURERS AFFORDING COVERAGE NAIC # INSURED CR &R Incorporated `I r1';' APiak;t Jo ff�l INSURER A: XL SPECIALTY INSURANCE COMPANY POLICY EXPIRATION DATE (MM/DDIYYI Haulaway Storage Containers, Inc. 11292 Western Avenue Stanton, CA 90680- INSURER B: INSURER c: INSURER D: INSURER E. $ PREMISES Ea occurence COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR DD' INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE M /DD/YY) POLICY EXPIRATION DATE (MM/DDIYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ PREMISES Ea occurence $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE FI OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ POLICY JE0 LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR 71 CLAIMS MADE AGGREGATE $ $ ' DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND X WC STATU- OTH- TORY LIMITS ER A EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? RWD943520902 4/1/2009 4/1/2010 E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,00( OTHER :1 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS 10 day notice of cancellation in the event of non payment of premium. Re: Refuse Hauling I1a SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Costa Mesa Sanitation District DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Public Services Department P.O. Box 1200 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Costa Mesa, CA 92628 -1200 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 26 (2001/08) © ACORD CORPORATION 1988 CR &RINC -03 SUOS IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. M%..vrtu to ttvviiva)