2019/01/01 Waste Management Holdings, Inc. and all affiliated Related and Subsidary Companies Certificate of Liability Insurance (4)ACOR"° CERTIFICATE OF LIABILITY INSURANCE
166� 1/1/2020
DATE(MMIDD/YYYY)
1 12/4/2018
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
CONTACT
NAM
A/C, No, Ext : AIC, N❑
EMAIL
AOORESS:
SAFFORDING COVERAGE
NAIC#
INSURER A: ACE American Insurance Company
22667
INSURED WASTE MANAGEMENT HOLDINGS, INC. & ALL AFFILIATED,
1306000 RELATED & SUBSIDIARY COMPANIES INCLUDING:
WASTE MANAGEMENT MORENO VALLEY TRANSFER STATION
17700 INDIAN STREET
MORENO VALLEY CA 92551
INSURER B : Indemnity Insurance Co of North America
43575
INSURER C : ACE Fire Underwriters Insurance Company
20702
INSURER D
INSURER E :
INSURER F:
COVERAGES CERTIFICATE NUMBER: 11118309 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.
NSR
TYPE OF INSURANCE
ADDL
INSD
SUER
V1 VD
POLICY NUMBER
POLICY EFF
MMIDDIYYYY
POLICY EXP
IMMIDOM=1
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
XCU INCLUDED
Y
Y
HDO G71212993
1/1/2019
1/1/2020
EACH OCCURRENCE
5,000,000
pREMI , EeEoccurrrence
5,000,000
MED EXP (Any one person)
S X�XX
ISO FORM CG00010413
PERSONAL & ADV INJURY
$ 5,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY JECT — LOC
OTHER:
GENERAL AGGREGATE
$ 6,000,000
PRODUCTS - COMP/OP AGG
$ 6,000,000
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
AUTOS ONLY ASS
AUTOS ONLY ?� NON
S ONLY
MCS-90
Y
Y
MMT H2527863A
1/1/2019
1/1/2020
Ea=SINGLE LIMIT
$ 1,000,000
(BODILY INJURY (Per person)
$ XXXXX'VX
(BODILY INJURY (Per accidenl
$ )CXy,)C=
X
PPBaPER a DAMAGE
$ �
$ XXxy—xXX
A
X
UMBRELLA LIAB
EXCESS LIAB
I -V
OCCUR
CLAWS -MADE
Y
Y
XOO G27929242 004
1/1/2019
1/1/2020
EACH OCCURRENCE
$ 15,000,000
AGGREGATE
$ 15,000,000
DED RETENTION $
$ XxxxxxX
B
AANY
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
OFFICER/MEMBER EXCLUDED?PROPRIETORIPARTNERIEECUTIVE
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
Y
WLR C65435846 AOS)
WLR C65435809 (CA & MA)
SCF C65435883 (WI)
1/1/2019
1/1/2019
1/1/2019
1/1/2020
1/1/2020
1/1/2020
PER OTH-
X STATUTE ER
EL EACH ACCIDENT
$ 3000.000
L= L DISEASE- EA EMPLOYEE
s 3 000 000
E.LAISEASE-POLICYLIMI7
s 3000000
A
EXCESS AUTO
LIABILITY
Y
Y
XSA H25278598
1/1/2019
1/1/2020
COMBINED SINGLE LIMIT
$9,000,000
(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.
CERTIFICATE HOLDER MY 01 Menifee CANCELLATION See Atlacinnent
11118309
CITY OF MENIFEE
AND ITS OFFICERS
29714 HAUN ROAD
MENIFEE CA 92586
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
JAN 0 7 2019 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Received
AUTHORIZED REPRESENTATIVE
ACORD 25 f2015/031
0)1988-2015 ACORD CORPORATION- All riahts reserved
The ACORD name and logo are registered marks of ACORD
Attachment Code : D446557 Master ID: 1306000, Certificate ID: 11118309
POLICY NUMBER: HDO G71212993
Endorsement Number: 39
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