Certificates of Insurance 71T2
(MM/DD/YYYY)
ACCORD® CERTIFICATE OF LIABILITY INSURANCE
l/l/20247/2022
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 LOCKTON COMPANIES CONTACT
NAME:
3657 BRIARPARK DRIVE,SUITE 700 PHONE FAX
A/C No Ext: A/C No):
HOUSTON TX 77042 E-MAIL
866-260-3538 ADDRESS.
INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A:ACE American Insurance Company 22667
INSURED WASTE MANAGEMENT HOLDINGS,INC.&ALL AFFILIATE INSURER B:ACE Property and Casualty Insurance Company 20699
1484363 RELATED&SUBSIDIARY COMPANIES INCLUDING: INSURER C:Indernnity Insurance Co of North America 43575
ADVANCED DISPOSAL SERVICES,INC. INSURER D:ACE Fire Underwriters Insurance Company 20702
90 FORT WADE RD.
PONTE VEDRA FL 32081 INSURER E:
INSURER F
COVERAGES CERTIFICATE NUMBER: 17111008 REVISION NUMBER: 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY
A X COMMERCIAL GENERAL LIABILITY Y Y HDO G72955924 1/1/2023 1/1/2024 EACH OCCURRENCE $ 5,000,000
DAMAGE
CLAIMS-MADE X OCCUR PREM SESOEa occurrDence $ 5,000,000
X XCU INCLUDED MED EXP(Any one person) $ XXXXXXX
X 1SO FORM CGO0010413 PERSONAL&ADV INJURY $ 5,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 6,000,000
POLICY n PRO LOC PRODUCTS-COMP/OP AGG $ 6,000,000
JECT
OTHER: $
A AUTOMOBILE LIABILITY Y Y MMT H25575398 1/1/2023 1/1/2024 COMBINED SINGLE LIMIT $
Ea accident 1,000,000
X ANY AUTO BODILY INJURY(Per person) $ X'X'X'X'X'X'X'
X, OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS XXXXXXX
X HIRED X NON-OWNED PROPERTY DAMAGE $ XXXXXXX
AUTOS ONLY AUTOS ONLY Per accident
X MCS-90 $ XXXXXXX
B X UMBRELLA LIAB X OCCUR Y Y XEUG27929242 008 1/1/2023 1/1/2024 EACH OCCURRENCE $ 15,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE $ 15,000,000
DED RETENTION$ $ XXXXXXX
WORKERS COMPENSATIONPER OTH-
C AND EMPLOYERS'LIABILITY Y WLR C70311094 AOS) 1/1/2023 1/1/2024 X STATUTE ER
* ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WLR C70311057(AZ,CA&MA) 1/1/2023 1/1/2024 E.L.EACH ACCIDENT $ 3,000,000
D OFFICER/MEMBER EXCLUDED? NI N/A SCF C70311136(WI) 1/1/2023 1/1/2024
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 3,000,000
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 3,000,000
A EXCESS AUTO Y Y XSA H25575350 1/1/2023 1/1/2024 COMBINED SINGLE LIMIT
LIABILITY $9,000,000
(EACH ACCIDENT)
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (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'COMP/
EL)WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT.
M 12 22 2O22
CERTIFICATE HOLDER CANCELLATION WMW t -X
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
17111008 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
County of Monroe Solid Waste ACCORDANCE WITH THE POLICY PROVISIONS.
Attn:Cheryl Sullivan
1100 Simonton St,Rm 2-231 AUTHORIZED REPRESENTATIVE
Key West FL 33040
cf 3�-
@ 1988-2015 ACORD CORPORATIOIT All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
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