2023/01/01 Waste Management Holdings, Inc. and all affiliated Related and Subsidary Companies (3)1 ol4
447E
.ciAD'CERTIFICATE OF LIABILITY INSURANCE 12t07 t2022
THIS CERTIFICATE IS ISSUEO AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
CERTIFICATE OOES NOT AFFIRMATIVELY OR NEGATIVELY AMET{D, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
THIS CERTIFICATE OF lt.iSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE
OR PRODUCER, AI{O THE CERTIFICATE HOLOER.
IMPORTANT: lf the certific.te holde. i! an ADDITIONAL INSURED, the policy(ies) mu3t have AOOITIONAL INSURED provisions or be endoraed. lf
SUBROGATIOX lS WAMD,3ubject to the terms and conditioru of the pollcy, cortaln policie! m.y requirs an endorsement. A statement on this
certifac.te does not confer righb to the certific.te holder in li.u of such endorsement(!).
PRooucER LOCKTON COMPANTES
3657 BRIARPARK DRIVE. SUITE 7OO
HOUSTON TX 77042
866-260-3538
PHONE
INSIJRER(S) AFFORDING COVERAGE
rr,rsunea n, ACE American lnsurance Company 22667
rnsiJREo wAsrE I\TANAGEMENT HoLDjNGS. tNc & ALL AFF|LiAT
1306000 RELATED & SUBSIDIARY COMPANIES INCLUDING:
WASTE MANAGEMENT MORENO VALLEY TRANSFER STATIO
17700 INDIAN STREET
MORENO VALLEY CA 92551
rNsuRER B: lndemnity l6surance Co of Norlh America 4357 5
rNsuRER c : ACE Fire lJnderwrilers lnsurance Comoanv 20702
rNsuRER D: ACE Propertv & Casualtv lnsu rance Co 20699
1t1t2024
RA CERTIFICATE NUMBER
CANCELLATION ee
REVISION NUMBER: XXXXXXX
13848309
OUAIL VALLEY
VOLUNTEER FIRE DEPARTIIIENT
29714 HAUN ROAD
MENIFEE CA 92586
T18 P1
SHOULO ANY OF I}IE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION OATE IHEREOF, NOTICE WILL BE DELIVERED IN
ACCOROANCE WITH THE POLICY PROVISIONS,
AUTHORIZEO REPRESENTATIVE
CERTIFICATE H DER men
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEO ABOVE FOR THE POLICY
PERIOO INDICATEO, NOTWTHSTANDING ANY REOUIREMENT, TERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT WTII RESPECT TO
WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBEO HEREIN IS SUBJECT TO
AI I THF TFRI\rlS FXCl IISIONS AND CONI]ITIONS OF SI]CH POI ICIES t IMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
rNso
EACH OCCURRENCE r 5.000,000
$ 5.000.000
MED EXP iAnv one oerson)$ XXXXXXX
PFRSONAL & ADV ]NJURY $ 5.000.000
s 6 000 000GENERAL A6GREGATE
PROOUCTS COMP/OPAGG t 6,000,000
o1/01t2023 41t01t2024
5
COMMERCIAL GENERAL LIABILIIY
XCU INCLUDED
tso FoRM cG00010413
NL AGGREGATE LIMITAPPLIES PER
X
X X
x
x
x
CLAIMS MAOE
Loc
OTHER
JECT
Y Y
HDO G72955924
COMBINEO SINGLE LIMIT s 1,000,000
BCD LY NJLTRY (Per personl S XXXXXXX
$ XXXXXXXBOOLLY INJURY (Peraccdenl)
$ XXXXXXX
$ XXXXXXX
Y
MMT H25575398 01to1t2023 01t01t2024AUTOMOBILE LIABILITY
OVVNEO
HIRED
AUTOS ONLY
SCHEOULEOAUTOS
NON.O\ANEO
X
X
lt
X
x
X
X I 15,000,000
AGGREGAIE s 15,000,000
UMBREILA LIAB
EXCESS LIAB LAIMS MAOE
X 01101/2023 01t01t2024
5
D
DED RETENTION $
Y Y
XEUG27 929242 008
X
$ 3,000,000
$ 3,000,000EL DISEASE EA EMPLOYEE
Y
{AOS)
(Az cA(wl)&[.4?
wLR C70311094wLR C70311057scF c703'1'1136
woRl(ERs coitPEr{sarroNANO EMPLOYERS' LIABILITY
OFFICER]II]IEMBER O(CLUDEOT N
01t01t2424
41141t2024
01/01t202401t01t2424
.. o,".r.. ...g!Err.!rj lt 3.Qollooo
COMBINED SINGLE LII\4IT
$9,000,000(EACH ACCTDENT)
EXCESS AUTO
LIABILITY Y Y
xsA H25575350
0p
0
a1t4112023
1t01t2023
110112a231t41t2023
oEscRtPioNoF oPERATTONS / LOCATTONS / VEHTCLES (ACORO 1Ol, Addruon.rRm.ri. Sch.dur., m.y b. att 6ned f DoE.pac. r. raqulEd)
BLANKET WAIVER OF SUBROGATION IS GRANTEO IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE AND TO THE EXTENT REOUIRED BY
WRITTEN CONTRACT WTIERE PERMISSIBLE BY LAW CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSUREO (EXCEPT FOR WORKERS' COMP/EL)
WHERE AND TO THE EXTENT REQUIREO BY WRITTEN CONTRACT,
ACORD 25 (2016i03)The ACORD name and logo are registered marks ot ACORD
rig
"l
B
C
Attachment Code: D446557 Master lD: 1306000, Certificate lD: 13848309
2
POLICY NUIiIBER: HDO G72955924 Endorsement Number: 49
COMMERCIAL GENERAL LIABILIry
cG 20 10 12 19
THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY,
ADDITIONAL INSURED _ OWNERS, LESSEES OR
CONTRACTORS _ SCHEDULED PERSON OR
ORGANIZATION
Name Of Additional lnsured PerSon(s)
Any Owner, Lessee or Contractor whom you ha\e
agreed to include as an additional insured under a
prior to the date of loss.
All locations where you are performing ongoing
operations for such additional insured pursuant to any
4478
A. Section ll - Who ls An lnsured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
wjth respect to liability for "bodily injury", "property
damage" or "personal and ad\ertising injury"
caused, in \ /hole or in part, by:
1. Your acts or omissions: or
2. The acts or omissions of those acting on your
behalt
in the perbrmance of vour onqoinq operations forthe additional insured(s) at the location(s)
designated abo\e.
Howe\€r:
1. The insurance afiorded to such additional
insured only applies to the extent permitted by
lawt and
2. lf co\erage pro\ided to the additional insured is
required by a contErct or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
B. With respect to the insurance afforded to these
additional insureds, the following additional
exclusions apply:
This insurance does not apply to "bodily injury" or
"property damage" occuning after:
1. All work, including materials, parts or
equipment fumished in connection with such
work, on the project (other than senice,
mainlenance or repairs) to be performed by or
on behalf of the additional insured(s) at the
location of the co\ered operations has b€en
completed; or
2. That portion of "your work" out of which the
injury or damage arises has been put to its
intended use by any person or organization
other than another contractor or subcontractor
engaged in performing operations for a
principal as a part of the same project.
C. With respect to the insurance afforded to these
additional insureds, the following is added to
Section lll - Limits Of lnsurance:
lf corerage pro\,ided to the additional insured is
cG 20 10 12 19 @ lnsurance Seftices Offce, lnc., 2018 Page 1 of 2
This endorsement modifes insurance pro\,ided under the bllowing:
COMMERCIAL GENERAL LIABILIry COVERAGE PART
SCHEDULE
Attachment Code : D446557 Master lD: 1306000, Certiflcate lD: 13848309
will pay on behalf of lhe additional insured is the
amount of insurance:
1. Required by the contract or agreement; or
2. A\ailable under the applicable limits of
insurancei
whiche\€r is less.
This endorsement shall not increase the
applicable limits of insurance.
4478
Page 2 ot 2 O lnsurance Services Offce, lnc., 2018 cG 20 10 12 19
Attachment Code: D446557 Master lD: '1306000, Certificate lD: 13848309 4478