Insurance - CR&R - 2002-04-10 1 ACORD CERTIFICATE 0 F.'LtABILI Y 'INSURANCE
DATE IMM/POIYYI
3/28/02
PRODUCER 626/795-9000 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Solid Waste Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Managers, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
R F, f F I V E D ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
1 1 5 N. El Molino Ave. COMPANIES AFFORDING COVERAGE
Pasadena, CA 91101 COMPANY q Discover Prop & Cas.lns. Co.
INSURED
Costa Mesa Disposal, Inc. ��TQ ` JARY DISK( COMPANY
I COMPANY
I 2051 Placentia Ave. C
I Costa Mesa CA 92627 COMPANY
D
iCOVERAGES "- .. - -- . .
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.
COI TYPE OF INSURANCE Po POLICY EFFECTIVE POLICY EXPIRATION
LTR UCY NUMBER DATE IMM/DD/YY7 DATE(MM/DD/YY) UMITS
A I GENERAL LIABILITY D150P00045 3/11/02 3/11/03 GENERAL AGGREGATE S 2000000
I COMMERCIAL GENERALABILITY
I' I CLAIMS MADE I h , OCCUR $PRODUCTS COMP'OP AGG 1000000
I PFRSONAL&ADV INJURY S 1000000
I X 1 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE S
S 1000000
FIRE DAMAGE Any o Ii el I S 1000000
MED EXP(Any o e per on) I $
JGCO
A AUTOMOBILE UABILITY D150P00045 3/11/02 3/11/03
COMBINED 9HGL-LIMIT $
I X I ANY AUTO
) i ALL OWNED AUTOS 1000000
SCHEDULED AUTOS BODILY INJURY
���� + I IPe Per nl $
I X 1 HIRED AUTOS
BODILY INJURY
X ; NON-OV NED AUTOS IPe uae II
1
PROPCRTY DAMAGE $
I GARAGE LIABIUTY 1
AU-0 ONLY EA ACCIDENT S
I ANY AUTO I
IIOTHER THAN AUTO DNLY-
EACH LCIDENT i
AGGREGATE I $
EXCESS UABILITY
,; EACH OCCURRENCE $
L UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND I 'NC STATU- I
EMPLOYERS'UABILITY
TORY LIMITS I ER
THE PROPRIETOR/ I EL EACH ACCIDENT ( $
IPARTNERS/EXECUTIVE I INCL 1 EL DISEASE POLICY LIMIT 13
OFFICERS ARE: , EXCL
OTHER
EL DISEASE EA EMPLOYEE I $
1
I
I
JESCRIPTiON Of OPERATIONSILOCATi0NSIVEHICLES/SPECIAL ITEMS
Re: Rubbish Hauling
Endorsement CG2010 attached 10 DAY NOTICE OF CANCELLATION!N
THE EVENT I OF NON PAY. 1 T PREMIUM
=ERTIRCATE HOLDER" CRN£EiLATION: .
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Costa Mesa Sanitary Dist.
EXPIRATION DATE THEREOF THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Attn. Robin B. Hamers, Mgr 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
P O Box 1200 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
Costa Mesa, CA 92628 OF ANY KIN UPON THE MPANy, ITS AGENTS OR REPRESENTATIVES.
AUTHONttp REP
/Arl ,
kCORD 25-$41/951. .. .... . .
2-39
sAeoRi!i CORPORATION:1988
THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY
CG 20 10 03 97
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -
SCHEDULED PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Endorsement effective Policy No.
3/11/02 12:01 A.M. standard time D15QP00045
Named Insured Counters' n By
COSTA MESA DISPOSAL, INC. arr
(Authorized Representative)
SCHEDULE
Name of Person or Organization:
AS PER ATTACHED CERTIFICATE OF
INSURANCE
(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 ongoing operations performed for that insured.
:G 20 10 03 97 Copyright,Insurance Services Office, Inc. 1996