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2018/01/01 Waste Management Holdings, Inc. and all affiliated Related and Subsidary Companies Certificate of Liability Insurance
ACORtV CERTIFICATE OF LIABILITY INSURANCE F DATE(MM/DD/YYYY) III 1 / 1 /2019 1 12/ 11 /2017 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 LOCKTON COMPANIES 3657 BRIARPARK DRIVE, SUITE 700 HOUSTON TX 77042 866-260-3538 NCONTACT AME: PHONE EXt : (FAXAICNo E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: ACE American Insurance COm anV 22667 INSURED WASTE MANAGEMENT HOLDINGS, INC. & ALL AFFILIATED, 1306000 RELATED & SUBSIDIARY COMPANIES INCLUDING: WASTE MANAGEMENT MORENO VALLEY TRANSFER STATION INSURER B : Indemnity Insurance Co of North America 43575 INSURER C : ACE Fire Underwriters Insurance Company 20702 INSURER D : 17700 INDIAN STREET INSURER E : MORENO VALLEY CA 92551 INSURER F : COVERAGES CERTIFICATE NUMBER: 13848309 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DD/YYYY LIMITS A Xr COMMERCIAL GENERAL LIABILITY Y Y HDO G27873091 1/l/2018 I/1/2019 EACH OCCURRENCE S 5,000,000 CLAIMS-MADEFX7 OCCUR PREMISES Ea occur ence S 5,000,000 X MED EXP (Any oneperson) $ XXXXXXX XCU INCLUDED X ISO FORM C000010413 PERSONAL & ADV INJURY s 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PEC LOC GENERAL AGGREGATE s 6,000,000 PRODUCTS - COMP/OP AGG S 6,000,000 S OTHER: A AUTOMOBILE LIABILITY Y Y MMT H25097890 1/1/2018 I/1/2019 (COaBINEDISINGLE LIMIT S 1,000,000 ANY AUTO BODILY INJURY (Per person) S XXXXXXX AAUTOS ONLY AUTOSULEDBODILY 1xxx INJURY (Per accident S XXXXXXX HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY PROPERTY DAMAGES Per accidentMCS-90 XXXXXXX XXXXXXX 1 1$ A X UMBRELLA LIAB [IXOCCUR Y Y XOO G27929242 003 1/l/2018 1/l/2019 EACH OCCURRENCE S 15 000,000 AGGREGATE s 15,000,000 EXCESS LIAB CLAIMS -MADE DED I I RETENTIONS S X'}(j{xxxx B A C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N PROPRIETOR/PARTNER/EX/I/2019 OFFICER/MEMBER EXCLUDED?ECUTIVE (Mandatory in NH) If yes, describe under CESCRIPTION OF OPERATIONS below' N/A Y WLR C6462278A (AOS) WLRC64622778(AZ,CA,&MA SCF C64622791 (WI) 1/I/2018 1/l/2018 I/l/2018 l/i/2019 1ANY 1/I/2019 PER OTH- X STATUTE ER E.L. EACH ACCIDENT s 3,000,000 E.L. DISEASE - EA EMPLOYEE s 3,000,000 E.L. DISEASE - POLICYLIMIT 3,000 000 A EXCESS AUTO LIABILITY Y Y XSA H25097889 I/l/2018 1/112119 COMBINED SINGLE LIMIT S9,000,000 (EACH ACCIDENT) DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 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' COMP/EL) WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT. Lv LL1VLVLI\ I IVI11 OCC PILLaL:1111IC111- 13848309 QUAIL VALLEY VOLUNTEER FIRE DEPARTMENT 29714 HAUN ROAD MENIFEE CA 92586 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 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORAT10K. All rights reserved The ACORD name and logo are registered marks of ACORD Attachment Code : D446557 Master ID: 1306000, Certificate ID: 13848309 POLICY NUMBER: HDO G27873091 Endorsement Number: 37 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS LESSEES OR CONTRACTORS - (Form B) 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