Insurance - CR&R - 2008-03-25CR &RINC -03 SUOS
AcohD CERTIFICATE OF LIABILITY INSURANCE
DATE (MM /DD/YYYY)
312512008
PRODUCER
Solid Waste Insurance Managers
115 N. EI Molino Ave v E p
P.O. Box 7072 AA
Pasadena, CA 91101 PR 022008
THIS CERTIFICATE IS ISSUED AS A MATTER OF, INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. EXTEND OR
AL ER THE OVERAGE A FORDED BOYTTHE POLICIES ES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED CR &R Incorporated SA SANITARYDQR��j
Haulaway Storage Containers, Inc.
11292 Western Avenue
Stanton, CA 90680 -
INSURER A: XL SPECIALTY INSURANCE COMPANY
INSURER B:
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 1-1 OCCUR
INSURER C:
INSURER D:
EACH OCCURRENCE
INSURER E:
PREMISES Ea occurence .
(_(IVERAG;=S
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'
NS
POLICY NUMBER
POLICY EFFECTIVE
TE MM/ D
POLICY EXPIRATION
DA M / D
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 1-1 OCCUR
EACH OCCURRENCE
$
PREMISES Ea occurence .
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY JE� LOG
PRODUCTS - COMP /OP AGG
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESS /UMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION . $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
RWD943520901
4/1/2008
-
4/112009
X TOR Y L MITS ER
E.L. EACH ACCIDENT
$ 1,000,00
E.L. DISEASE - EA EMPLOYEE
1 OOO,OO
$ i
E.L. DISEASE - POLICY LIMIT
1,000,000
$ s
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS r
10 day notice of cancellation in the event of non payment of premium.
Re: Refuse Hauling
GERTIFIGA
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) 9 ACURU GURPURATIUN 11JUd
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.
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