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HomeMy WebLinkAboutCOI - Republic Services, Inc. - Expires 2024-06-30Page 1 of 3 A� a' CERTIFICATE OF LIABILITY INSURANCE DATEJMWDD O6/29/2023Y) 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(les) 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 Willis Towers Watson Insurance Services Nast, Inc. c/o 26 Century Blvd P.O. Box 305191 CONTACT Willis Towers Watson Certificate Center HAMS:FAX PHONE 1-877-945-7378 A/0 N 1-888-467-2378 W certificates@willis.com eADD INSURERS AFFORDING COVERAGE NAICS Naenvilie, TN 372305191 USA INSURERA: ACE American Insurance Company 22667 INSURED Republic Services, Inc. NBC Bnvironmental Srvices Inc. INSURERS: ACE Property 6 Casualty Insurance Company 20699' INSUFIERC: Indemnity InsvralN Company of North Amsri 43575 tNSURERD: Illinois Onion Insurance Company 27960 1605 Ferry Point Alameda, CA 94501 INSURER E ; ACE Fire Underwriters Insurance Company 20702 INSURER F: COVERAGES— CERTIFICATE NUMBER: W29462682 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. INTSRR TYPE OFINSUHANCE 6D WhAli POLICYEFF POLICY P Sn POLICY NUMBER MM,DDrfY MMIDDI LIMITS X COMMERCIALGENERAL LIABILITY EACH OCCURRENCE $ 5,000,000DAMAGE � CLAIMS -MADE x OCCUP ioHmlhu PREMISES Ea coarrorool S 51000, 000 MED EXP (My one Parton) $ A Y Y RDO G47334433 06/30/2023 06/30/2024 PERSONAL B ADV INJURY S 510001000 GENT. AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 30,000,000 POLICY L X PRO L� JECT X !LOC PRODUCTS -COMP/OP AGO IS 20, 000, 000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT accident) $ 101000, 000 �( BODILY INJURY (Per Person) S ANY AUTO li A OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY PAUTOS ONLY Y Y ISA H10735786 06/30/2023 06/30/2024 _ BODILY INJURY (Per accident) S PROPERTY DAMAGE Para $ $ e X UMBRELLAUAB X OCCUR EACHOCCURRENCE S 10,000,000 $ 10,000,000 EXCESS LIAB CLAIMS.MAD_E Y Y MU G46782148 007 06/30/2023 06/30/2024, AGGREGATE_ DED__FX RETENTIONS 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANWROPRIETOMPARTNERIEXECLMVE YIN OFFICER/MEMBERE%CLUDED? No (Mandatory In NN) NIA Y WI C50710397 06/30/2023 X PER O H _ STATUTE ER !EL.EACH ACCIDENT 06/30/2024 E.LDISEASE EAEMPLOYEE $ 3,000,000 S 3,000,000 II yes. descebe order DESCRIPTION OF OPERATIONS below -, E.L. DISEASE - POLICY LIMIT $ 3,000,000 A on xs workers' Compensation Y NCO C50710555 06/30/2023 06/30/2024 .Each Accident 04,000,000 .,Each Evp for Disease $4,000,000 (Annual Aggregate 1$4,000,000 DESCRIPTION OFOPERATIONSI LOCATIONS I VEHICLES (ACORD 101, AddlNonai Remarks Schedule, may be attached 11 more space Is required) The following provisions apply when required by written contract. As used below, the term certificate holder also includes any person or organization that the insured has become obligated to include as a result of an executed contract or agreement, GENERAL LIABILITY: Certificate holder is Additional Insured including on -going and completed operations when required by Written SEE ATTACHED y SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE JULTHE EXPIRATDATE EREOF, 7 �!...i tl ACCORDANCE WITHT EPOLCYP OVISIONSE WILL BE DELIVERED IN 1 City of Gilroy GILROY CITY CLERK'S OFFlCE 0 AUTHORIZED REPRESENTATIVE !/11 7351 Rosanna Street Gilroy, CA 95020 0 1988-2016 ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD sa xo: 24332696 "Tts: 3032953 16928: 2 ' of 3 AGENCY CUSTOMER ID: LOC #: AC40R ® ADDITIONAL REMARKS SCHEDULE L 1 Page 2 of 3 AGENCY NAMED INSURED Willis Towers Watson Insurance Services West, Inc. Republic services, Inc. NRC Environmental Services Inc. 1605 Ferry Point POLICY NUMBER See Page 1 Alameda, CA 94501 CARRIER NAIC CODE See Page 1 See Page 1 EFFECTIVE DATE: See Page 1 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance contract. Coverage is primary and non-contributory when required by written contract. Waiver of Subrogation in favor of the certificate holder is included when required by written contract. AUTO LIABILITY: Certificate holder is Additional Insured when required by written contract. Coverage is primary and non-contributory when required by written contract. Waiver of Subrogation in favor of the certificate holder is included when required by written contract. UMBRELLA: Certificate holder is Additional Insured when required by written contract. Coverage is primary and non-contributory when required by written contract. Waiver of Subrogation in favor of the certificate holder is included when required by written contract. WORKERS COMPENSATION AND EMPLOYERS LIABILITY: Waiver of Subrogation in favor of the certificate holder is included when required by written contract where allowed by state law. Stop gap coverage for ND and WA is covered under policy no. WLR C50710397 and stop gap coverage for OH is covered under policy no. WCU C50710555. TEXAS EMPLOYERS EXCESS INDEMNITY INSURANCE: Insured is a registered non -subscriber to the Texas Workers Compensation Act. Insured has filed an approved Indemnity Plan with the Texas Department of Insurance which offers an alternative in benefits to employees rather than the traditional Workers Compensation Insurance in Texas. The excess policy (#TNS C66934172) shown on this certificate provides excess Indemnity and Employers Liability coverage for the approved Indemnity Plan. Contractual Liability is included in the General Liability and Automobile Liability coverage forms. The General Liability and Automobile Liability policies do not contain endorsements excluding Contractual Liability. Separation of Insured (Cross Liability) coverage is provided to the Additional Insured, when required by written contract, per the Conditions of the Commercial General Liability Coverage form and the Automobile Liability Coverage form. Please note Pollution and Professional Liability requests should be directed to and expected separately from Republic@alliant.com. Additional Insureds: City of Gilroy, officers and employees INSURER AFFORDING COVERAGE: Illinois Union Insurance Company NAIC#: 27960 POLICY NUMBER: TNS C66934172 EFF DATE: 06/30/2023 EXP DATE: 06/30/2024 SUBROGATION WAIVED: Y TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Texas Excess Indemnity 6 Each Accident $5,000,000 Employer's Liability Each EE for Disease $5,000,000 Policy Aggregate $5,000,000 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR ID:24332696 BATCH:3032953 CERT: W29462682 16928: 2 of 3 AGENCY CUSTOMER ID: LOC #: Ac V ADDITIONAL H L, REMARKS SCHEDULE Page 3 of 3 AGENCY NAMEDINSURED Willis Towers Watson Insurance Services West, Inc. Republic Services, Inc. NRC Environmental Services Inc. 1605 Ferry Point POLICY NUMBER See Paqe 1 Alameda, CA 94501 CARRIER NAIC CODE See Page 1 See Page 1 EFFECTIVE DATE: See Page 1 REMA THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, I FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance INSURER AFFORDING COVERAGE: ACE Fire Underwriters Insurance Company POLICY NUMBER: SCF C5071049A EFF DATE: 06/30/2023 EXP DATE: 06/30/2024 SUBROGATION WAIVED: Y TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Workers Compensation b EL Each Accident $3,000,000 Employers Liability EL Disease - EA Empl. $3,000,000 Per Statute EL Disease - Pol Lmt. $3,000,000 INSURER AFFORDING COVERAGE: ACE American Insurance Company POLICY NUMBER: WLR C50710324 EFF DATE: 06/30/2023 EXP DATE: 06/30/2024 SUBROGATION WAIVED: Y TYPE OF INSURANCE: Workers Compensation 6 Employers Liability Per Statute LIMIT DESCRIPTION: EL Each Accident EL Disease - EA Empl. EL Disease - Pol Lmt. LIMIT AMOUNT: $3,000,000 $3,000,000 $3,000,000 NAIC#: 20702 HAICO: 22667 ACORD 101 (2008/01) m 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR ID:24332696 BATCH:3032953 CERT: W29462682 16928: 3 ' of 2023 Named Insureds: REPUBLIC SERVICES, INC. Southern Waste Services, Inc. US ECOLOGY, INC. Specialized Response Solutions, L.P. Eagle Construction and Environmental Services, LLC (formerly named: SWS Environmental, LLC) TMC Services, Inc. ENVIRITE OF ILLINOIS, INC. US Ecology Alaska, LLC (formerly named: NRC Alaska, LLC) ENVIRITE OF OHIO, INC. US Ecology Burlington, Inc. (formerly named: Enpro Services of Vermont, Inc.) ENVIRITE OF PENNSYLVANIA, INC. US Ecology Energy Waste Disposal Services, LLC ENVIRITE TRANSPORTATION LLC US Ecology Group Holdings Corp. (formerly named: NRC Group Holdings Corp.) EQ DETROIT, INC. US Ecology Group Holdings, LLC (formerly named: NRC Group Holdings, LLC) EQ DETROIT, INC. US Ecology Holdings Group, Inc. (formerly named: ENPRO Holdings Group, Inc.) EQ HOLDINGS, INC. US ECOLOGY HOLDINGS, INC. EQ INDUSTRIAL SERVICES, INC. US Ecology Holdings, LLC (formerly named: JFL-NRC Holdings, LLC) EQ INDUSTRIAL SERVICES, INC. US ECOLOGY HOUSTON, INC. EQ INDUSTRIAL SERVICES, INC. US ECOLOGY IDAHO, INC. EQ INDUSTRIAL SERVICES, INC. US ECOLOGY ILLINOIS, INC. EQ INDUSTRIAL SERVICES, INC. US Ecology Karnes County Disposal, LLC EQ METALS RECOVERY LLC US ECOLOGY LIVONIA, INC. (formerly named: EQThe Environmental Quality Company) EQ NORTHEAST, INC. US ECOLOGY MICHIGAN, INC. (formerly named: Dynecol, Inc.) EQ PARENT COMPANY, INC. US ECOLOGY NEVADA, INC. MICHIGAN DISPOSAL, INC. US ECOLOGY ROMULUS, INC. (formerly named: EQ Resource Recovery, Inc.) National Response Corporation US ECOLOGY SULLIGENT, INC. (formerly named: EQ Alabama, Inc.) National Response Corporation US ECOLOGY TAMPA, INC. (formerly named: EQ Florida, Inc.) Natl Response Corporation of Puerto Rico US ECOLOGY TAYLOR, INC. (formerly named: Vac -Ail Service, Inc.) NRC East Environmental Services, Inc. US ECOLOGY TEXAS, INC. NRC Environmental of Maine, Inc. US Ecology Thermal Services, Inc. NRC Environmental Services Inc. US ECOLOGY TRANSPORTATION SOLUTIONS, INC. NRC Gulf Environmental Services, Inc. (formerly named: Progressive Environmental Services, Inc) US ECOLOGY TULSA, INC. (formerly named: EQ Oklahoma, Inc.) NRC Intermediate Int. Holding Company, LLC US Ecology US Holding Company, LLC (formerly named: NRC US Holding Company, LLC) NRC NY Environmental Services, Inc. (formerly named: OP -TECH Environmental Services, Inc.) US ECOLOGY VERNON, INC. NRC Payroll Management LLC US ECOLOGY WASHINGTON, INC. OSRV Holdings, Inc. US ECOLOGY WINNIE, LLC Quail Run Services, LLC WAYNE DISPOSAL, INC. RTF Romulus, LLC CANADA: USE Canada Holdings, Inc. CANADA: US Ecology Stablex Holdings, Inc. CANADA: US Ecology Canada Inc. /Les Solutions Environnementales US Ecology Canada Inc. [MEXICO: National Response Corporation Mexico NRC, S. de R.L. de C.V. 16928: 3 of 3