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2020/04/01 CR&R, Inc. Certificate of Liability InsuranceCR&RINC-01 12i DATE (MMIDDNYYY) CERTIFICATE OF LIABILITY INSURANCE srsl/2o20 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 endorsements . PRODUCER LICenSe #r 0829370 CONTACT Solid Waste Insurance Marketing AICC, No, Ext : (626) 795-9000 'C No :(626) 577-8940 P.O. Box 7072 Pasadena, CA 91109 E- IL INSURE S AFFORDING COVERAGE NAIC # INSURERA:XL Insurance America 24554 INSURED JNSURER B CR&R, Inc. Haulaway Storage Containers, Inc. INSURERC: 11292 Western Avenue INSURERD: Stanton, CA 90680 INSURER E INSURER F : 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. _ INS TYPE OF INSURANCE ADDS Bn POLICY NUMBER POLICY Err POLICY EXP LIMITS rAminnryvvyi rmm/nnnyyn COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS -MADE ❑OCCUR DAMAGESTO ) RENTED GERL AGGREGATE LIMIT APPLIES PER: POLICY ❑ JECT LOC OTHER: GENERAL AGGREGATE PRODUCTS - COMP/OP AGG AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS NON -OWNED AUTOS ONLY AUTOS ONLY HIRED r COMBINED SINGLE LIMIT (Ea BODILY INJURY Per erson BODILY INJURY Per accident PROPERTY AMAGf Peraccdant UMBRELLA LIAB EXCESSLIAB OCCUR CLAIMS -MADE _ RWD943520913 EACH OCCURRENCE AGGREGATE DX ED RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N AA�NYPROP RIETOR/PARTNERIEXECUTIVE ❑ %FILER/M in BE EXCLUDED? If yes, describe under DESCRIPTION OF OPERATIONS below N / A X 4/1/2020 4/1/2021 X PER OTH- STA E.L. EACH ACCIDENT E.L DISEASE - EA EMPLOYEE E.L DJSEASE -POLICY LIMIT 9EscRIPTioN of OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ?ARLIER NOTICE OF CANCELLATION PROVIDED BY US ENDORSEMENT WC 99 01 10 (Ed. 1/08) Valver of Our Right to Recover From Others Endorsement —California WC040306 (Ed. 04-84) CANCELLATION _ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Menifee 29844 Haun Rd. r (r Menifee, CA 92586 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED M ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WORKER! COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 01 10 (Ed. 1 /08) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EARLIER NOTICE OF CANCELLATION PROVIDED BY US ENDORSEMENT This endorsement modifies insurance provided under the following: WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY Number of Days Notice: 60 (If no entry appears above, information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement.) For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation, as provided in PART SIX — CONDITIONS, D. Cancellation of the Workers' Compensation and Employers' Liability Insurance Policy or as amended by an applicable state cancellation endorsement, is increased to the number of days shown in the Schedule above. All other terms and conditions remain the same. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Insured CR&R Incorporated Insurance Company XL Insurance America, Inc. WC 99 01 10 Ed. 1 /08 Policy No. RWD9435209-13 Countersigned by Endorsement No. © 2007 XL America, Inc. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA (Ed. 04-84) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Where required by written agreement signed prior to loss. All California Operations. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Endorsement No. Insured RWD9435209-13 CR&R Incorporated Insurance Company XL Insurance America,lnc. Countersigned By WC 04 03 06 Page 1 of 1 (Ed. 04-84) Copyright 1984 Workers' Compensation Insurance Rating Bureau of California. All Rights Reserved