Loading...
HomeMy Public PortalAbout2013 Certificate of Liability Insurance.tifACORD. Client#: 18927 IESI CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 4/12/2013 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 HUB International Ins Svcs Inc P 0 Box 90756 Albuquerque, NM 87199-0756 800-8005661 / CA Lic# 0757776 Meer Margie Blackmon PHONE EeC 505-828-4000 FAX INC. N ow. Nol: 866-487-3972 0006005: margie.blackmon@hubinternational.com INSURER(5) AFFORDING COVERAGE NAIC$ INSURER A: Greenwich Insurance Company 22322 INSURED Waste Services, Inc. 8 its Subsidiaries 2893 Executive Park Dr Ste 305 FL 33331 INSURER e: Catlin Specialty Insurance Comp 15989 INSURER C: Liberty Insurance Underwriters 19917 ce Coma Great American Assurance an INSURER D : Compan 26344 INSURER E: Arch Insurance Company 11150 INSURER F: CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE 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. TR TYPE OF INSURANCE LSUBR IN R MD POUCY NUMBER (NNVDVDO/YYri) (MINDINYYYPY)POLI 16008 A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY X GEC002511806 12/31/2012 12/31/2013 $1,000,000 EE�AAACCL1IIqT0;�00CT��URR�REENt�NTCCEE PREMISESIEaom rtnm) $100,000 MED EXP (Any one poison) $5,000 CLAIMS -MADE © OCCUR PERSONAL AAOVINJURY $1,000,000 X ContractualLiability GENERAL AGGREGATE $2,000,000 PRODUCTS • COMP/OP AGG $2,000,000 GENL AGGREGATE LIMIT APPLIES PER: —1 POLICY I A J 1I LOC $ E AUTOMOBILEW1BIITY X — _ X XMCS-9O ANY AUTO ALL OWNED AUTOS HIRED AUTOS ENDT SCHEDULED AUTN-O NOOS WNED X Aprp5 41CAB4928007 12/31201212/31/2013 MazBINeEOsInGTFUMIT $2,000,000 BODILY INJURY (Per pere0n) $ BODILY INJURY( Per =olden() $ PROPERTY DAMAGE (Per acdtlant) $ $ B C D X UMBRDLLALIAB EXCESS MB X OCCUR CLAIMS -MADE UMC936341213 EXCSF1839428 EXC2101131 12/31/2012 12/312012 121312012121312013 12/31/2013 12/31/2013 EACH OCCURRENCE $25,000,000 AGGREGATE $25,000,000 s OED RETENTIONS E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY OFFICEWMEIMBER EXCLUDED? CUT © (Mandatory In NH) 115y0e0e desolbe OPERATIONS OEScRIPTION CF OPERATIONS below NIA 41 WC1492780T 12/31/2012 12/31/2013 X W(CC STATUU- 1 V.1"' EL EACH ACCIDENT El,000,000 ELCIS EASE -EA EMPLOYEE $1,000,000 EL DISEASE - POLICY LIMIT $1,000,000 DESCRIP ION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, ACd1enal Remarks Schedule, E men space Is requ Fed) Village of Key Biscayne is included as Additional Insured per attached form CG2010 0704 where required by written contract. Workers Compensation coverage is evidence only. CERTIFICATE HOLDER CANCELLATION Village of Key Biscayne 88 West McIntyre Street Key Biscayne, FL 33149 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 0) 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are regist red marks of ACORD #82200025!M1959145 KR01 POLICY NUMBER: GEC002511806 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Locations) Of Covered Operations ANY PERSON OR ORGANIZATION THAT YOU ARE REQUIRED IN A WRITTEN CONTRACTOR.! WRITTEN AGREEMENT TO INCLUDE AS/AN ADDITIONAL INSURED PROVIDED THE "BODILY INJURY' OR "PROPERTY DAMAGE" OCCURS SUBSEQUENT TO THE EXECUTION OF THE WRITTEN CONTRACT OR WRITTEN AGREEMENT ON FILE WITH COMPANY 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 indude as an additional insured the persons) 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. 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. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to 'bodily injury" or "property damage" occurring after: 1. M work, including materials, parts or equip- ment fumished in connection with such work, on the project (other than service, mainte- nance or repairs) to be performed by or on behalf of the additional Insured(s) at the loca- tion of the covered operations has been com- pleted; or 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. CG 20 10 07 04 Copyright, ISO Properties, Inc., 2004 Page 1 UNIFORM POLICY NUMBER:GEC002511806 COMMERCIAL GENERAL LIABILITY CG 02 2410 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EARLIER NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Number of Days' Notice 30 (If no entry appears above, information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement.) For any statutorily permitted reason other than Policy Condition or as amended by an applicable nonpayment of premium, the number of days state cancellation endorsement, is increased to the required for notice of cancellation, as provided in number of days shown in the Schedule above. paragraph 2. of either the CANCELLATION Common CG 02 2410 93 Copyright, Insurance Services Office, Inc., 1992 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EARLY NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM TRUCKERS COVERAGE FORM GARAGE COVERAGE FORM Common Poky Conditions, A. Cancellation, 2. is amended to read. 2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least: a. ( or b. ( 10 ) days before the effective date of cancellation if we cancel for nonpayment of premum; 90 ) days before the effective date of cancellation If we cancel for any other reason. All other terms and conditions of the Policy remain the same Endorsement Number' Policy Number' 4 1CAB4 928007 Named Insured: IESI CORPORATION This endorsement is effective on the inception date of this policy unless otherwise stated herein. Endorsement Effective Date: 12-31-2012 00 CA0081 00 04 08 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSU RAN CE POLICY EARLIER NOTICE OF CANCELLATION PROVIDED BY US ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attached clause" is to be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on (Date) at 12:01 A M. standard time, forms a pan of Policy No. 41WCI4927807 Issued to IESI CORPORATION (Named Insured) of the ARCH INSURANCE COMPANY Insurance Company Authorized Representative For any statutorily permitted reason other than nonpayment of premium, the number of days requited for nonce of cancellation, as provided in paragraph 2. of either the CANCELLATION Common Policy Condition of as amended by an applicable state cancellation endorsement, is mcreased to the number of days shown in the Schedule below. All the terms and conditions of the Policy which are not inconsistent with this endorsement continue to apply. SCHEDULE Number of Days' Notice: 90 DAYS EXCEPT 10 DAYS FOR NON PAYMENT OF PREMIUM 00 WC004 00 11 03 Page I of 1 ADVANCE COPY UMC936341213 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. Cancellation 1. The first Named Insured shown in the Declara- tions may cancel this policy by mailing or de- livering to us advance written notice of cancel- lation. 2. We may cancel this policy by mailing or deliv- ering to the first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancel- lation if we cancel for nonpayment of pre- mium; or b. 30 days before the effective date of cancel- lation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured's last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 6. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. The cancellation will be ef- fective even if we have not made or offered a refund. 6. If notice is mailed, proof of mailing will be suf- ficient proof of notice. B. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declara- tions is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and rec- ords as they relate to this policy at any time during the policy period and up to three years afterward. D. Inspections And Surveys 1. We have the right to: a. Make inspections and surveys at any time; IL 00 17 11 98 b. Give you reports on the conditions we find; and c. Recommend changes. 2. We are not obligated to make any inspections, surveys, reports or recommendations and any such actions we do undertake relate only to in- surability and the premiums to be charged. We do not make safety inspections. We do not un- dertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions: a. Are safe or healthful; or b. Comply with laws, regulations, codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us, but also to any rating, advisory, rate service or similar organization which makes insurance inspections, surveys, reports or recommendations. 4. Paragraph 2. of this condition does not apply to any inspections, surveys, reports or recom- mendations we may make relative to certifica- tion, under state or municipal statutes, ordi- nances or regulations, of boilers, pressure ves- sels or elevators. E. Premiums The first Named Insured shown in the Declara- tions: 1. Is responsible for the payment of all premiums; and 2. Will be the payee for any return premiums we Pay. F. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named in- sured. If you die, your rights and duties will be trans- ferred to your legal representative but only while acting within the scope of duties as your legal rep- resentative. Until your legal representative is ap- pointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. IL 0017 11 98 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 0