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Waste Solutions Group of San Benito - Insurance CertificateCERTIFICATE OF LIABILITY INSURANCE DATE »018 "' 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 pollcy(iss) 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 endomament(s). PRODUCER ADO Risk Insurance Services Nest, Inc. Portland Oregon Office CONTACT eUME _159MI! FAX (A/D. Na. Eae: (866) 283 -7122 (AdC Mo.): (800) 363 -0105 Ei L ADDRESS: 851 Sw 6th Avenue Suite 385 COMMERCIALGENERALUMILITY Portland OR 97204 -1309 USA HDOG INSURER(S) AFFORDING COVERAGE NAICa INSURED INSURER A: ACE American Insurance company 22667 waste Connections. Inc. INSURER B: Indemnity Insurance Co of North America 43575 3 waterway Square Place Suite 110 INSURERC ACE Property & Casualty Insurance Co. 20699 INSURER D: PREMISES so=wer. The woodlands Tx 77360 USA INSURER E: EXCluded INSURER F: COVERAGES CERTIFICATE NUMBER::570063106087 REVISION NUMBER: 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. Limits shown are as requested TR TYPE OFWSURIINCE INBD VIVID _ _POLICY NUMBER MMIDD MIND LIMITS X COMMERCIALGENERALUMILITY HDOG EACH OCCURRENCE 51,000,000 CLAIMS- 09 ❑X OCCUR PREMISES so=wer. $5'000 MED E%P(Anyone parson) EXCluded PERSONAL S ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER', GENERAL AGGREGATE $5,000,000 X. POLICY ❑PRO JECT ❑LOC PRODUCTS -COMPIOP AGO 52,000,000 OTHER: A AUTOMOBILE LIABILITY ISA H08872016 08/01/201608/01 /2017 COMBINED SINGLE LIMIT e em 55,000,000 BODILY INJURY (Per pereon) % ANY AUTO BODILY INJURY (Per amident) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per ersident C X UMSRELLALUS % OCCUR 08 01/2016 08/01/2017 EACH OCCURRENCE $5,000,000 EXCESS LUB CLAIMS -MADE r policy ter s & conditions AGGREGATE $510001000 DED X RETENRON B A WORNERSCOMPENSATIONAND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR I PMTNER I EXECUTIVE OFFICEILMEMBER EXCLUDED? � (Manda"M NMI If OrSdRaaoWa under DESCRIPTION OF OPCRAT;ONC belo„ NIA FAOS 081011201 08/01/2016 08/01/2017 08/01/2017 PER OTH- % STATUTE E L. E ACH ACCIDENT $1,500,000 EL. DISEASE -EA EMPLOYEE 51,500,000 E1_DISEASE- POLICY LIMIT $1,500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Mdmenal Remark. Bohedele, may Im M0.d Nmore apace la required) Named Insured Includes: waste Connections, Inc. and all wholly owned subsidiaries. City of Gilroy is included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. A Waiver Of Subrogation is granted in favor of City of Gilroy in accordance with the policy provisions of the General Liability, Automobile Liability and Workers Compensation policies. Umbrella Liability follows frm. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE .THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Gilroy AUTHORIZED REPRESENTATIVE 7351ROsanna Street Gilroy CA 95029 USA t�A �� '�� 871988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD `m c a V V O S O Z m U L a m Q �1 ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) I 07 10812015 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 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 Aon Risk insurance Services West, Inc. Portland Oregon Office CONTACT NAME. (A/C No.Ezt): (866) 283 -7122 aC No : (800) 363 -0105 E-MAIL ADDRESS: 851 SW 6th Avenue Suite 385 COMMERCIAL GENERAL LIABILITY Portland OR 97204 -1309 USA HDOG INSURER(S) AFFORDING COVERAGE NAIC 0 INSURED INSURER A: ACE American Insurance company 22667 Waste Connections, Inc. 3 waterway Square Place suite 110 INSURER B: indemnity Insurance CO Of North America 43575 INSURER C: ACE Property & Casualty Insurance Co. 20699 The woodlands Tx 77380 USA INSURER D: PREMISES Ea occurrence) INSURER'E: MED EXP (Any one person) INSURER F: COVERAGES CERTIFICATE NUMBER: 570058638656 REVISION NUMBER: 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 WITHRESPECT 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. Limits -shown areas requested INSR LTR TYPE 60 INSURANCE INSD WVD POLICY NUMBER POLICY MM/DD MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY HDOG EACH OCCURRENCE S1,000,000 CLAIMS -MADE ❑X OCCUR PREMISES Ea occurrence) $5,0 00 MED EXP (Any one person) EXCI uded PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT .APPLIES PER: GENERAL AGGREGATE .$2,000,000 X POLICY PEC LOC PRODUCTS - COMP /OP AGG $1,000,000 OTHER: A I AUTOMOBILE LIABILITY ISA H08870019 ;08/01/2015 08/01/2016 COMBINED SINGLE'. LIMIT Ea accident $5,000,000 BODILY INJURY ( Per person) X ANY AUTO BODILY INJURY (Per accident) - ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident C X UMBRELLA LUI6 X OCCUR XOOG27614620001 08/01/2015 08/01/2016 EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE SIR applies per policy terns & conditions AGGREGATE $5,000,000 DED I X1 RETENTION B A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/ PARTNER / EXECUTIVE Y/ N OFFICER/MEMBER EXCLUDED? � (Mandatory .InNH) If yes,. describe under DESCRIPTION OF OPERATIONS below N/A I WLRC48129614 AOS WLRC48129626 AZ, CA, 'MA 08 01/2015 I 08/01/2015 I 08 01/2016 08/01/2016 X STATUTE 'iOTH- E.L. ACCIDENT - - - $1, 500, 000 -- - - - E.L. DISEASE -EA EMPLOYEE $1,500,000 E.L. DISEASE - POLICY LIMIT S1,500,000 DESCRIPTION OF OPERATIONS F LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Named insured ,Includes: waste Connections, Inc. and all wholly owned subsidiaries. City of Gilroy is included as Additional Insured in accordance with the policy ,provisions of the General Liability and Automobile Liability policies. A waiver of subrogation is granted in favor of City of Gilroy in accordance with the policy provisions of the General Liability, Automobile Liability and workers Compensation policies. umbrella Liability follows forme. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Gilroy AUTHORIZED REPRESENTATIVE 7351 ,Rosanna Street Gilroy CA 95029 USA �f (�� p �i �i e.)aaa Jl�ee1fX aaXM YOU4iY,O //fray JL 01988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD `m w �c C) m '>3 O x Fi 1z m 0 0 I` O Z 10 V CD CD V