2022/01/01 Waste Management Holdings, Inc. and all affiliated Related and Subsidary Companies.^c()Rif CERTIFICATE OF LIABILITY INSURANCE DATE (I/IIII/DO/YYYY)
12t09t2021
IMPORTAIIT: lf the certificate holder is an AODITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. lf
SUBROGATIOiI lS WAIVED, subject to the lerm3 and condition3 of the policy, certain policie3 may r6quiro an endoBement. A stalement on this
certific.te doo3 not conrer righls to rhe ce(ificare holder in lieu ot such ondorsement(s).
PRODUCER LOCKTON COMPANIES
3657 BRIARPARK DRIVE SUITE 7OO
HOUSTON TX 77042
866-260-3538
INSU RE R(S) AFFOROING COVERAGE
ACE American lnsurance Company 22667
lrisuREo wAsrE MANAGEMENT HoLDlNGs, tNC & ALL AFF|L|AT
1306000 RELATED & SUBSIDIARY COMPANIES INCLUDING:
WM CURBSIOE, LLC
10633 RUCHTI ROAD
SOUTH GATE CA 90280
TNSIJRER E: lndemnity lnsurance Co of North America 4357 5
rNsuRER c , ACE Fire Underwriters lnsurance Comoanv 20702
rt{suRER o: ACE Prooerlv & Casualtv lnsurance Co 20699
11112023
COVERAGES CERTIFICATE NUMBER REVISION NUMBER
CANCELLATION men
O 1988-2015 ACORD CORPORATION. All rig
The ACORD name and logo are registered marks of ACORD
CERTIFICATE HOLDER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREO NAMED ABOVE FOR THE POLICY
PERIOO INDICATED NOTWTHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OIHER DOCUMENT WTH RESPECT TO
WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO
AI I THF TFRl\,llS FXCI t]SIONS AND CONDITIONS OF SI]CH POI ICIES T IMITS SHOWN MAY HAVF BFFN RFDTICED 8Y PAID CL,lIMS
INSD
EACH OCCURRENCE $ 5,000,000
PRFMISFS rEa 6..!n6...1 $ 5,000.000
L/lED EXP lAnv one Eetso.)$ XXXXXXX
PERSONAL & ADV INJURY $ 5.000.000
GENERAL AGGREGATE $ 6.000 000
PROOUCTS COMPTOP AGG s 6 000 000
Y Y
HDO G724S2365 01t01t2022 o t to1t2023COIIIISERCIAL GENERAL LIABILITY
XCU INCLUDED
tso FoRM cG00010413
GFNl AGCRFCATF IIM TAPPIIFS PFR
X
X X
x
x
x
.]ECT
CLAIMS lrrADE
LOC
OTHER s
$ 1,000,000
BODTLY INJURY lPer pecon)S XXXXXXX
BOOILY TNJIJRY (Pe. aedent)S XXXXXXX
S XXXXXXX
SCHEOIJLED
NON-OtM!EDAUTOS ONLYr.irREo
X
X
X
X
X
Y Y
MMT H25550328 41t01t2022 01t41t2023
$ XXXXXXX
X EACH OCCURRENCE $ 15,000,000X
LAIMS.[]IADE AGGREGATE s'15,000,000
D
DEO RETENTION S
Y Y XEUG27929242 007 0110112422 0110112023
a
X qTAT TF I I FE
$ 3,000,000
EL OISE^SE EA EMPLOYEE $ 3,000,000
B
C
WORKERS COIPENSATION
AND EIIIPIOYERS' LIABIIITY
Y
R C6891E595 {AOS)R C68918558 (AZ,CA & lili
F C68918637 (Wt)SC
01141t2022\01101t2022
01101t2022
41101t2023
0110112023
4114112023
$ 3.000.000
01101t2022 41t01t2023EXCESS AUTO
LIABILITY Y Y
xsA H25550286 COMBINED SINGLE LIMIT
$9,000,000(EACH ACCIDENT)
DESCR|PnO OT OPERAITONS / LOCAT|OI{S / VEHTCLES (ACORD t01 , AddtUon.t R.m.rt. Sch..tut.. m.y b. .irch.d I moE rp.c. a. nqut,.d)
ALANKET WAIVER OF SUEROGATION IS GRANTEO IN FAVOR OF CERTIFICATE HOLOER ON ALL POLICIES WHERE ANO TO THE EXTENT REOUIREO 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 REOUIRED BY WRITTEN CONTRACT
SHOULD ANY OF THE ABOVE DESCRIBEO POLICIES BE CANCELLEO BEFORE
THE EXPIRATION DATE THEREOF, NOTICE IIVILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
111r8309
CITY OF MENIFEE
29844 HAUN ROAD
MENIFEE CA 92586
AUTHORIZEO REPRESENTATIVE
ACORO 25120r6/03)reserved
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORiiATION ONLY AI{D CONFERS I{O RIGI.ITS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE OOES t{OT AFFIRMATIVELY OR }{EGATIVELY AMEI'ID, EXTENO OR ALTER THE COVERAGE AFFORDED BY THE POLICIES AELOW.
THIS CERTIFICATE OF INSURANCE DOES tIOT CONSTITUTE A COT{TRACT BETWEEI{ THE ISSUING II{SURER{S), AUTHORIZED REPRESENTATIVE
OR PRODUCER. ANDTHE CERTIFICATE HOLDER-
AUTOII|OBILE LAAILITY
N
>&tc )-
Attachment Code : 0446557 Master lO: 1306000, Cedficate lD: 11118309
POLICY NUMBER: HOO G72492365 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 Contraclor 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.
(lf no entry appears above, information required to complete this endorsement will be shown in the Declarations as
applicable to this endorsement.)
WHO lS AN INSURED (Section ll) is amended to include as an insured the person or organizalion shown in the
Schedule, but only with respect lo liability arising out of "your work" for that insured by or for you.
cG 20 10 11 85 Copyright, Insurance Services Offlce, Inc., 1984 Page 1 of 1