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HomeMy WebLinkAboutWaste Connections, Inc. - SLO GarbageACS CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/22/2016 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 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 Aon Risk Insurance Services West, Inc. Portland Oregon Office CONTACT NAME: wCNNv. Ext : <866) 283-7122 NC Nu , (800) 363-0105 E-MAIL ADDRESS: 851 SW 6th Avenue suite 385 Portland OR 97204-1309 USA HDOG INSURER(S) AFFORDING COVERAGE NAIC # INSURED - INSURER A: ACE American Insurance Company A44 xy 22667 Waste Connections, Inc. Waterway Square Place AUG 01 2016 suite 110 INSURER B: Indemnity Insurance Co of North America 43575 A4j6. INSURER C: The woodlands TX 77380 USA INSURER D: CITY CLERK INSURER E: INSURER F: ��(_0 COVERAGES CERTIFICATE NUMBER: 510063106911 REVISION NUMBER: THIS 1S 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 LTR TYPE OF INSURANCE INSD WYD POLICY NUMBER MMIDDWYYYDDIYYYY MMI LIMITS A X COMMERCIAL GENERAL LIABILITY 990 Palm Street San Luis Obispo CA 93401 USA HDOG O,� /T / 4 EACH OCCURRENCE $1,000,000 CLAIMS -MADE ❑X OCCUR A $5,000 PREMISES Ea occurrence MED EXP (Any one person) EXCI uded PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $5,000,000 X POLICY ❑ PRO - LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: A AUTOMOBILE LIABILITY ISA H08872016 08/011201608/01/2017 COMBINED SINGLE LIMIT $5,000,000 Ea accident BODILY INJURY ( Per person) X ANY AUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLYAUTOS HI REDAUTOS NON -OWNED ONLY AUTOS ONLY PROPERTYDAMAGE (Per accident) UMBRELLA LIABOCCUR EACH OCCURRENCE AGGREGATE EXCESS LIAB CLAIMS -MADE DED RETENTION B 'A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y + N ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? MNIA (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below 7LRC48131128 AOS 'WLR C4813113A CA, MA 0 08/01/2016 08/01/2017 08/01/2017 X PER OTH- STATUTE JER E.L EACH ACCIDENT $1,500,000 E.L DISEASE -EA EMPLOYEE $1,500,000 E L DISFASE-POL ICY LIMIT $1,500;000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Named Insured includes: San Luis Garbage Company. The City of San Luis Obispo, Council members, its officers, officials, employees and agents are included as Additional Insured with respect to General Liability and Automobile Liability policies as required by written contract or agreement with the Insured. Coverage provided is Primary and Non -Contributory with respect to General Liability policy as respect to The City of San Luis Obispo, Council members, its officers, officials, employees and agents. CERTIFICATE HOLDER CANCELLATION ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD X%/ r 0 co 0 0 F- N O Z N cc N V w CD CD U Aq �a 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 San Luis Obispo AUTHORIZED REPRESENTATIVE Attn: City clerk 990 Palm Street San Luis Obispo CA 93401 USA �/ /I xn (�K�/�S ._ /0 Sf'WW1M Y��o O,� /T / 4 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD X%/ r 0 co 0 0 F- N O Z N cc N V w CD CD U Aq �a