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J\ <br /> 7 <br /> TRUCKED NONHAZARDOUS WASTE DISPOSAL PERMIT <br /> Terms and Conditions <br /> �63Addendum B <br /> �ar�ruo CERTIFICATION OF COMMERCIAL <br /> GENERAL LIABILITY INSURANCE <br /> 241 <br /> N.k.. 's ;i � ,a -•�;Fr��'' .3' ��y�. z4r� t-•� S: .. .�`A,'w i � ,r � 'r- � 1 <br /> s. •- j ii y }x _ '�,lY 'SfA' 0 TA <br /> f <br /> irho :R;isis`•I; 1 ;.? � a t . .-:cx .:hZc_ .� u. .a �' 4 '.'-- �� '"'. �:lia�- ` 'fi e. 'o i8dx: r• _.�51n <br /> e <br /> THE FOLLOWING DESCRIBED POLICY HAS BEEN ISSUED TO: <br /> District Permit Number: (Completed by EBMUD) <br /> Insured: V <br /> Address: <br /> LOCATION AND DESCRIPTION OF PROJECT/AGREEMENT: <br /> Tracked non-hazardous waste permitted for disposal at designated EBMU?D Wastewater Treatment facilities <br /> TYPE OF INSURANCE:Commercial General Liability Coverage/Endorsements as required by agreement. <br /> L-IMITS•OF-LIABIL-ITY;. - <br /> (MINIMUM) $9,000,000/Occurrence,Bodily Injury,Property Damage-General Liability <br /> SELF INSURED RETENTION($)., (CGL) �P(0CC:> <br /> Aggregate limits CGL 9_ 00 0 <br /> INSURANCE COMPANY(IES): CGL <br /> POLICY NUMBER(S): (CGL) I (� <br /> POLICY TERM: From: CGL D To: CGL <br /> THE FOLLOWING COVERAGES OR ENDO 3 ENTS ARE INCLUDED IN THE POL C (IE <br /> 1. ® The District,its Directors,Officers and Employees are Additional Insureds In the policy(ies)as to work being performed <br /> under this agreement. ENDORSEMENT NO,TD <br /> 2. ® The coverage is Primary to any other applicable insurance carried by the District. <br /> 3. ® The pollcy(ies)covers waiver of subrogation by the Carrier(s)against the District and its Directors,officers,agents,and <br /> employees. <br /> 4. ® The policy(ies)covers contractual liability. <br /> 5. ® The pollcy(ies)is written on an occurrence basis, <br /> 6. ® The policy(ies)covers District Properly in tate care,custodyr and control of the Contractor. <br /> 7. ® The policy(ies)covers personal injury(libel,slander,and wrongful entry and evlction)liability. <br /> 8. ® The pollcy(ies)covers products and completed operations, <br /> 9. ® The policy(ies)shall cover pollution liability for claims related to the release or the threatened release of pollutants into <br /> the environment arising out of or resulting from Consultant's performance under this agreement. <br /> i <br /> 10. ® The policy(ies)will not be canceled nor reduced without 30 days written notice to East Bay Municipal Utility District at <br /> the address above, <br /> IT IS HEREBY CERTIFIED that the above policies provide liability insurance as required by the agreement between the <br /> East Bay Municipal Utilityy District and the insured. <br /> Signed �IAM _ Firm -- _ - <br /> Address S V� t v Date <br /> Phone � �tG� ! � <br /> RM O1$ A1Q2 UFOPt}-".m.dw <br />