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CERTIFICATE OF LIABILITY INSURANCE (678)ACORDTM, CERTIFICATE OF LIABILITY INSURANCE 1/1/2017 DATE(MM /DD/YYYY) 1 12/7/2015 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 LOCKTON COMPANIES 5847 SAN FELIPE, SUITE 320 HOUSTON TX 77057 866 - 260 -3538 NAME: A/c No Exe : A/C, No): E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # y INSURER A: ACE American Insurance Comoany 22667 1/1/2016 INSURED ' WASTE MANAGEMENT HOLDffiJ2r8 INC. & ALL AFFILIATED, 1300299 PANIES INCLUDING: PINELLAS TRANSFER STATION INSURER B: Indemnity Insurance Co of North America 43575 INSURER C : ACE Pro perry & Casualty Insurance Co 20699 INSURER D: ACE Fire Underwriters Insurance Company 20702 12950 40TH STREET NORTH INSURER E: CLEARWATER FL 33762 INSURER F: 5,000,000 COVERAGES FLCLEA01 CERTIFICATE NUMBER: 4/657151 RFVLCInN NIIMRFR• XXXXXXX 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM /DD POLICY EXP MM /DD LIMITS A X COMMERCIAL GENERAL LIABILITY y y HDO G27403311 1/1/2016 1/1/2017 EACH OCCURRENCE 5,000,000 CLAIMS -MADE OCCUR X DAMAGE TO RENTED PREMISES Ea occurrence 5,000,000 MED EXP (Any one person) XXYY.XXX XCU INCLUDED _2L ISO FORM CG00010413 PERSONAL & ADV INJURY $ 5,000,000 _2L GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JE� LOC GENERAL AGGREGATE $ 6,000,000 PRODUCTS - COMP /OP AGG $ 6,000,000 OTHER A AUTOMOBILE LIABILITY Y Y MMT H08866326 1/1/2016 1/1/2017 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X ANY AUTO X AUT OWNED SCHEDULED BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ X HIRED AUTOS X NON-OWNED PROPERTY acciden DAMAGE $ XXXXXXX X MCS -90 $ XXXXx x C X UMBRELLA LIAB X OCCUR Y Y XOO G27929242 001 1/1/2016 1/1/2017 EACH OCCURRENCE $ 15 000 000 AGGREGATE $ 15:000:000 EXCESS LIAB CLAIMS-MADE DED I I RETENTION $ $ XXXXXXX B A D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER/EXECUTIVE Y/N OFFICER/MEMBEREXCLUDED? N❑ N/A Y WLR 048596769 AOS) WLR C48596800 CA&MA) SCF 048596848 ( ) 1/1/2016 1/1/2016 1/1/2016 1/1/2017 1/1/2017 1/1/2017 PER OTH- X STATUTE FIR E.L. EACH ACCIDENT $ 3,000,000 E.L. DISEASE - EA EMPLOYEE s 3,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 3,000,000 A EXCESS AUTO LIABILITY y y XSA H08866314 1/1/2016 1/1/2017 COMBINED SINGLE LIMIT $9,000,000 (EACH ACCIDENT) DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT WHERE PERMISSIBLE BY LAW. CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMPEL) WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT. RE: ITB # 67 -15 FOR SOLID WASTE DISPOSAL SERVICES (TIPPING FEES). ADDITIONAL INSURED IN FAVOR OF THE CITY OF CLEARWATER ON ALL POLICIES (EXCEPT WORKERS' COMPENSATION/EL) WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT. 22 DEC 2015 09:39 13657153 THE CITY OF CLEARWATER ATTN: PURCHASING DEPARTMENT, ITB # 67 -15 PO BOX 4748 CLEARWATER FL 33758 -4748 ACORD 25 (2014/01) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ©1988 -2014 ACORD CORPORATIOIQ. All rights reserved The ACORD name and logo are registered marks of ACORD