Loading...
PROOF OF INSURANCE (2020 - 2020) CLOSEDA" = L> CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) �^ ""� 1 10/15/2019 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 AD'DITIO'NAL 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 CONTACT 701 B Street, 6th floor: W (760) 304-7120 ........................... _ Alliant Insurance Services, Inc.PHONE NA ilhem Morelos F' 04-7360 San Diego CA 92101 , AoDRpkq: N m ant.Com ry.......oreVos alll.�......m_.w..r........ ................................. tNSUR#F!@JAFFORDING COVERAGE ............... NAM # A: Tokio Marine„ p clal insur Oc Co trar23850 INSURED EDCODIS-01 INSURER GU deOne National InsuraNorth American CaDacity nce Company 25038 EDCG Disposal CorporationINSURER mm.. 6670 Federal Blvd _s ..,.ITITITc Company _ 14167 Lemon Grove CA 91945-1392 1 INSURER E: Great American Insm„mm nc ompany” 22667 INSURER 0: ACE a eC American nsuurance Company 16691 INSURER F :.m... COVERAGES CERTIFICATE NUMBER: 1877019705 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 POLICIE- DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES„ LIMITS SHOWN MAY HAVE BEEN REDUCED BY 'AID CLAIMS. ......................................... 1ti$iL$.i1sYD ..w.. POLIGYNUMBER.................. �._._........_ LTR TYPE OF INSURANCE k�00. p5 N AFF POLICY E%F' INSR ADri'% I D X XSLG71232669 PMfWVDDYYYYI rMM1DDJYYYYi LIMITS COMMERCIAL GENERAL LIABILITY Y 10/15/2019 10/15/2020 EACH OCCURRENCE $1,.000,000 I CLAIMS -MAGE R X-11 OCCUR X $250,000 SIR GEN'L AGGREGATE LIMIT APPLIES PER: )CI POLICY PRO. LOC JECT OTHER D AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY B X UMBRELLA LIAR X OCCUR X E X E%CESS LIAR CLAIMS -MADE _............. y..._.................... . DED Y RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y' I N ANYPROPRIE TORIPARTNIE'RIEXEOU TI VE OFFICERIM'EMBEREXCLUOED7 N/A (Mandatory In NH) Wes, describe under DES'CRIP'TION OF OP'ERA'TIONS befoow A Premises Pollution ..NMXGE TO REN I'EDW...... PRE_M IS FSEq occa naroe MED EXP (Any one person) ......._ .. §ONAL &ADVINJURY ............. ......... GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $ 300,000 ............._ .,....w $10,000 $1,000,000 .......... $ 2,000,000 $ 2,000.000 _. m ISAH2529175A 10/15/2019 10/15/2020$1,000,000 COMBINED SINGLE, LIMB"r BODILY INJURY (Per person) $ BODILY ^INJURY (Per accident) $ PROan;DtAMAGE $................................. $ 10/15/2019 10/15/2020 EACH OCCURRENCE $15,000,000 56000002302 TUOE5096456106 10/15/2019 10/15/2019 10/15/2020 10/15/2020 AGGREGATE I $15,0 00.,000... STATUTE CR J PER. L.. ER_ E.L. EACH ACCIDENT $ $ E.L. DISEASE - POLICY LY T MIT $ PPK1858484 7/31/2018 7/31/2020 PoltcYAggregate $5,0001000 Offsite Cleanup $5,000,000 Onsite Cleanup $51,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of EI Segundo is named as Additional Insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo ACCORDANCE WITH THE POLICY PROVISIONS. Public Works Dept. 350 Main Street AUTHORIZEDREP ESENTATIVE EI Segundo CA 90245 I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Named Insured EDCO Disposal Corporation Policy SymbolPolicy Number Policy Period XSL I G71232669 1 10/15/2019 to 10/15/2020 Issued By (Name of Insurance Company) ACE American Insurance Company am Endorsement Number 1 Effective Date of Endorsement insert the policy number. The remainder of the Information is to be completed only when this endorsement is tissued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: EXCESS COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Name of Person or Organization: Any Person or Organization 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. A. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract 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 provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance And Retained Limit: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Authorized Representative XS-6W25b (04/13) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS — SCHEDULED PERSON OR ORGANIZATION Named Insured EDCO Disposal Corporation Policy Symbol Policy Number Policy Period XSL G71232669 1 10/15/2019 to 10/15/2020 Issued By (Name of Insurance Company) ACE American Insurance Company Endorsement Number 2 Effective Date of Endorsement nserl the policy number. The remainder of the Inforntalion is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This Endorsement modifies insurance provided under the following: EXCESS COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations ,Any Owner, Lessee or Contractor Whom you have agreed All locations where you are performing operations to include as an additional insured under a written contract, for such Additional Insured pursuant to any such provided such contract was executed prior to the date of written contract loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organiza- tion(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract 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 provide for such additional insured. 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" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or XS -21168a (04/13) Copyright, Insurance Services Office, Inc., 2012 Page 1 of 2 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 III — Limits Of Insurance And Retained Limit: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Authorized Representative XS -21168a (04/13) Copyright, Insurance Services Office, Inc., 2012 Page 2 of 2 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Named Insured EDCO Disposal Corporation Endorsement Number 10 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71232669 10/15/2019 to 10/15/2020 Issued By (Name of Insurance Company) ACE American Insurance Company insert the policy number, The remainder of the information Is tc be completed only when this endorsement is issued subsequent to the preparation of lbe policy, THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: EXCESS COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Name of Person or Organization: Any Person or Organization against whom you have agreed to waive your right of recovery in a written contract, provided such contract was executed prior to the date of loss. We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. Authorized Agent XS -6W34 (09/95) Ptd. in U.S.A. Page 1 of 1 EDCODIS-01 MSCHWAR'TZ U RA N C E DATE/1712 D/YYY1) CERTIFICATE OF LIABILITY INSURANCE ..............._.......... ..................m �._arz 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 PRODUCER ........... ......................... ........... ........� 1fAC,'{ment(S). Is certificate does not confer Irl is to the certificate holder in lieu of such endorse License # 1C36861 N rE: Melissa D Schwartz Inland Empire-Alliant Insurance Services, Inc. PHONE FAX 685 Carnegle Dur Ste 265 (AIC, No, Est), (909) 886-9861 (AfC' Ne);(909) 886-2013 San Bernardino, CA 92408 Ji?&R11L%ss: mschwartz@alliant.com INSURER(S) AFFORDING COVERAGE NAIC 0 INSURER A; Travelers Property Casualty Company of America 25674 INSURED INSURER B EDCO Disposal Corporation INSURER c 6670 Federal Blvd INSURER D! Lemon Grove, CA 91945-1392 INSURER E _ INSURER F: COVERAGES CERTIFICATE NUMBER: 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 INSRADDL,SUBR ( POLICY EFF POLICY EXP . bTS...,...... w _.TYPE OF INSURANCEINS.t1...kM�t?...m......................................POLICY NUMBER LIMITS...((MlMI/PpIYKXI�d._...0!11MlRRl1(XX.II'I ............. COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE '$ i, CLAIMS -MADE N OCCUR DAMAGE TO RENTED PREMISE$ (Ea o4wurrenoa) $ GEN"L AGGREGATE LIMIT APPLIES PER: POLICY I .PI&;CT LOC OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AIU��T��OppS ONLY AUTOS �r p AbI S ONLY AU rCfS' (7N�.Y UMBRELLA LIAB OCCUR EXCESS LImAR CLAIMS -MADE DED P RETENTION $ -.............. .. A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y M N ANY PROPRIETOR/PARTNER/EXECUTIVE ppFFICER/MEMBER EXCLUDED? N N / A ('Mandatory in NH) IF yes, describe under ..................., f?FSg..RIPTION OF OPERATIONS below MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ COMBINED SINGLE LIMIT (Ea aoaidantJ, $ -BODILY INJURY' (Per Iaerson) _ $ BODILY INJURY (Per accident) $ P 0PERTY AMAGE ( aararcldarLl $ EACH OCCURRENCE $ AGGREGATE $ ER N ERH $ X 9/19/2020 F L EACH ACCIDENT $ 1,000,000 E.L. DISEASE • EA EMPLOYEE $ 1,000,00011 E.L. DISEASE • POLICY LIMiT 1,000,000 DE'SC'RIPTION OF OPERATIONS i LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Waiver of Subrogation applies per attached endorsement. City of EI Segundo Public Works Dept. 350 Main Street EI Segundo, CA 90245 .............. . ..... .....__"__ I ACORD 25 (2016/03) 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. AUTHORIZED REPRESENTATIVE I (,{�clU�4/dRfi11� ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ATRAVELER5.1k WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A) — ool POLICY NUMBER: (UB -3N219785 -19-51-K) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be o . o % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. 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 09/19/19 Insured: Edco Disposal Corporation Insurance Company Policy No.UB-3N219785-19-51-K Countersigned by Endorsement No. Premium DATE OF ISSUE: 09-13-19 ST ASSIGN: Page 1 of 1