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Insurance - CR&R 09-27-2019---�""1 CR&RINC-01 MG914088 ,�CORa►. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) ` 9/27/2019 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 # OB29370 1 CONTACT NAME: Solid Waste Insurance Marketing I PHONE FAX P.O. Box 7072 (AIC, No, Ext): (626) 795-9000 (A/C, No):(626) 577-8940 Pasadena, CA 91109 ADDRESS: __ _________________ _____________ _ INSURER A: Greenwich Insurance Company X22322 -- INSURED 1 ENSURER B: XL Specia* Insurance Company 137885 CR&R, Inc. Haulaway Storage Containers, Inc. I INSURER C: 11292 Western Avenue INSURER D : { Stanton, CA 90680 - - INSURER E: i INSURER F : 91nVGDAr=-Q f_FRTI(:If_ATF NII IIIARGD- RF\/ICIr1Ni NII IMRGD- 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. AUTHORIZED REPRESENTATIVE -SHOWN T-T---'---- __-_--------..._ _..___--._..... /NSR ;ADDL:SUBR ..---_.-- --- POLICY EFF T POLICY EXP j TYPE OF INSURANCE POLICY NUMBER LTR IN D' WVD M/DD M IDD LIMITS A 1 X 1 COMMERCIAL GENERAL' LIABILITY ! EACH OCCURRENCE__ $ 2'000'000 - --- ' I l CLAIMS -MADE X OCCUR X ! �GEC300046805 ! 9/3/2019 9/3/2020 PREM SES (Ea occu E TO encu M- 100'000 -- ? MED EXP (Any one person) $ 5,000 PERSONAL &_ADV INJURY $ - 2,000,000 - - -- GE_N'L AGGREGATE LIMIT APPLIES PER: j GENERAL AGGREGATE $ 2,000,000 _ X j POLICY JECT LOC E_PRODUCTS ,-_COMP/OP AGG r_$ 2000'000 OTHER: $ B AUTOMOBILE LIABILITY C __— COMBINED SINGLE LIMIT i (Ea accidentt_$ 2,000,000 X I ANY AUTO I X AECO04447705 j i I 9/3/2019 9/3/2020 --BODILY INJURY �Perperson) _$ - - OWNED SCHEDULED F__- AUTOS ONLY AUTOS BODILY INJURY (Per accident)_' HIREp NON- WNED i 0, O AUT S ONLY AUTO ONLY _$ PROPERTY DAMAGE $a i $ UMBRELLA LICCUR OLAIMS-MADE! !, � EACH OCCURRENCE__ i_$ EXCESS LIABAB AGGREGATE $ I DED ;E RETENTION $ $ WORKERS COMPENSATION PER 1 OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE_ ! _ER ANY PROPRIETOR/PARTNER/EXECUTIVE f- !I OFFICER/MEMBER EXCLUDED? I N / A E L EACH ACCIDENT --- — } i ( andatory in NH) - -' If yes, describe under j E.L. _DISEASE - EAEMPLOYEE $ - --- - - DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ i I j DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Common Policy Conditions (Cancellation)- IL00171198 Insurer B - Upset & Overturn Included PPT/Light - Comp / Coll - $1,000 / $1,000 Med - Comp / Coll - $2,000 / $2,000 Hvy / Extra Hvy / Tractors - Comp Only - $3,000 SEE ATTACHED ACORD 101 r_GRTIFIr_ATF Wnl nl=P I ANII'_FI 1 ATWIKI 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 Costa Mesa Sanitary District ry THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 290 Paularino Ave. Costa Mesa, CA 92626 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CR&RINC-01 MG914088 LOC #: AC"REP' ADDITIONAL REMARKS SCHEDULE Page I of 1 kGENCY License# OB293701 NAMED INSURED olid Waste Insurance Marketing 11292 Western Avenue CR&R, Inc. Haulaway Storage Containers, Inc. IOLICY NUMBER Stanton, CA 90680 EE PAGE I 'ARRIER NAIC CODE EE PAGE 1 ISEE P I EFFECTIVE DATE: I S_ - E EPAGE kDDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 26 FORM TITLE: Certificate of Liability Insurance — ------ - ------------ -- Description of Operations/Locations/Vehicles: Trailers - Comp Only - $1,000 Re: All Operations Business Auto -Additional Insured when Required by Contract or Agreement XIC4111013 Additional Insured -Owners, Lessees or Contractors -Scheduled Person or Organization CG20100413 ACORD 101 (2008/01) @ 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1'ILmn++t• s;aanr%,z f.RRRINC: ACORD,, CERTIFICATE OF LIABILITY INSURANCE DATE 1 ) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 10/15/2019 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT i NAME: Terri Gits Marsh & McLennan Agency LLC PHONE (A/C, (A/C, No A/C, No, Ext Marsh &McLennan Ins. Agency LLC E-MAIL Terri.Gits@MarshMMA.com 1 Polaris Way #300 ! INSURER(S) AFFORDING COVERAGE NAIC # Aliso Viejo, CA 92656 INSURER A: Markel American Insurance Company 28932 INSURED INSURER B: j CR&R Incorporated INSURER C: 11292 Western Avenue INSURER D: Stanton, CA 90680 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 CONTRACTOR 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 LTR TYPE OF INSURANCE ADDL SUBR INSR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP LIMITS MM/DD/YY COMMERCIAL GENERAL LIABILITYI EACH OCCURRENCE I $ DAMAGE TO RENTED CLAIMS -MADE U OCCUR i PREMISES (Ea occurrence) 1$ i MED EXP (Any one person) is PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ EI I PRODUCTS COMP/OP AGG $ POLICY ECOT I LOC i - !OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY (Per person) J$ OWNED SCHEDULED 'AUTOS BODILY INJURY (Per accident) I $ AUTOS ONLY HIRED NON -OWNED PROPERTYDAMAGE is Per AUTOS ONLY AUTOS ONLY a j $ A UMBRELLA LIAR X OCCUR ! MKLM3EUL100346 9/03/2019 09/03/2020. EACH OCCURRENCE s2,000,000 X EXCESS LIAB CLAIMS -MADE AGGREGATE 1$2,000,000 DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y i N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT 1$ OFFICER/MEMBER EXCLUDED? NIAJEl I (Mandatory in NH) -- -- --- E.L. DISEASE - EA EMPLOYEEI $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ i i I� ! I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) *See Attached for Additional Layer* Re: All Operations CERTIFICATE HOLDER GANGELLATIUN Costa Mesa Sanitary District 290 Paularino Ave. Costa Mesa, CA 92627 ACORD 25 (2016/03) 1 of 1 #S4423022/M4351715 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ,. !►' -ill ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD INSURED: CR&R Incorporated POLICY#: MKLM3EUL100346 POLICY PERIOD: 09/03/2019 TO: 09/03/2020 $2,000,000 Excess of $4,000,000 - Navigators Insurance Company #CHI9EXCZ030FPIV - NAIC #42307 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or b. 30 days before the effective date of cancellation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured's last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 6. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. if the first Named Insured cancels, the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed, proof of mailing will be sufficient proof of notice. B. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement Issued by us and made a part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three years afterward. D. Inspections And Surveys 1. We have the right to: a. Make inspections and surveys at any time; IL 001711 98 b. Give you reports on the conditions we find; and c. Recommend changes. 2. We are not obligated to make any inspections, surveys, reports or recommendations and any such actions we do undertake relate only to insurability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions: a. Are safe or healthful; or b. Comply with laws, regulations, codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us, but also to any rating, advisory, rate service or similar organization which makes insurance inspections. surveys, reports or recommendations. 4. Paragraph 2, of this condition does not apply to any inspections, surveys, reports or recommendations we may make relative to certification, under state or municipal statutes, ordinances or regulations, of boilers, pressure vessels or elevators. E. Premiums The first Named Insured shown in the Declarations: I. Is responsible for the payment of all premiums; and 2. Will be the payee for any return premiums we pay. F. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except In the case of death of an individual named insured. If you die, your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative is appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. IL 00 17 11 98 Copyright, Insurance Services Office, Inc,, 1998 Page 11 of 1 POLICY NUMBER: AECO04447705 / AECO04448605 XIC 411 1013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTOMATIC ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM A. COVERED AUTOS LIABILITY COVERAGE, Who Is An Insured, is amended to include as an "insured" any person or organization you are required in a written contract to name as an additional insured, but only for "bodily injury" or "property damage" otherwise covered under this policy caused, in whole or in part, by the negligent acts or omissions of: You, while using a covered "auto"; or 2. Any other person, except the additional insured or any employee or agent of the additional insured, operating a covered "auto" with your permission; Provided that: a. The written contract is in effect during the policy period of this policy; b. The written contract was signed by you and executed prior to the "accident" causing "bodily injury" or "property damage" for which liability coverage is sought; and C. Such person or organization is an "insured" solely to the extent required by the contract, but in no event if such person or organization is solely negligent. B. The Limits of Insurance provided for the Additional Insured shall not be greater than those required by contract and, in no event shall the Limits of Insurance set forth in this policy be increased by the contract. C. General Conditions, Other Insurance is amended as follows: Any coverage provided hereunder shall be excess over any other valid and collectible insurance available to the additional insured whether such insurance is primary, excess, contingent or on any other basis unless the contract specifically requires that this policy be primary. All terms, conditions, exclusions and limitations of this policy shall apply to the liability coverage provided to any additional insured, and in no event shall such coverage be enlarged or expanded by reason of the contract. All other terms and conditions of this policy remain unchanged. XIC 411 1013 © 2013 X.L. America, Inc. All Rights Reserved. Page 1 of 1 May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission. POLICY NUMBER: GEC300046805 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations Costa Mesa Sanitary District, its elected and Re: All Operations appointed officials, agents, officers, volunteers and employees 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", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. 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 additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 0413 C Insurance Services Office, Inc., 2012 Page 1 of 2 C. 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. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 0413