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ACCPRIf) CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />07/21/2023
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />CONTACT
<br />NAME:
<br />PHONE
<br />(A/C. No. Eat):
<br />E-MAIL
<br />ADDRESS:
<br />FAX
<br />(A/C, Not:
<br />NAIC INSURER(S) AFFORDING COVERAGE
<br />19445
<br />PRODUCER
<br />Marsh USA LLC
<br />1717 Arch Street
<br />Philadelphia, PA 19103-2797
<br />CN103174067-CEES-GAWUP-23-
<br />19399 INSURER B: AIU Insurance Co INSURED
<br />Clean Earth Environmental Solutions, Inc
<br />933 First Avenue, Ste. 200
<br />King of Prussia, PA 19406
<br />16535
<br />INSURER D : Lexington Insurance Company 19437
<br />INSURER E
<br />INSURER F:
<br />INSURER A: National Union Fire Insurance Co.
<br />INSURER c : Zurich American Insurance Company
<br />COVERAGES
<br />
<br />CERTIFICATE NUMBER:
<br /> CLE-007057156-01
<br />
<br />REVISION NUMBER: 1
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTVVITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR TYPE OF INSURANCE ADDL
<br />INSD
<br />SUER
<br />INVD POLICY NUMBER
<br />POLICY EFF
<br />(MM/DD/YYYY)
<br />POLICY EXP
<br />(MM/DD/YYYY) LIMITS
<br />A x COMMERCIAL GENERAL LIABILITY X 6547157 06/30/2023 06/30/2024 EACH OCCURRENCE $ 5,000,000
<br />DAMAGE TO RENTED
<br />PREMISES (Ea occurrence) $ 5,000,000 CLAIMS-MADE X OCCUR
<br />MED EXP (Any one person) $ 100,000
<br />PERSONAL & ADV INJURY $ 5,000,000
<br />GENERAL AGGREGATE $ 5,000,000 GEN'L
<br />X
<br />AGGREGATE
<br /> POLICY
<br />OTHER:
<br />x
<br />LIMIT APPLIES
<br />Taf
<br />PER:
<br />LOC PRODUCTS - COMP/OP AGG $ 5,000,000
<br />$
<br />A
<br />A X
<br />—
<br />AUTOMOBILE LIABILITY
<br />ANY AUTO
<br />OWNED
<br />AUTOS ONLY
<br />HIRED
<br />AUTOS ONLY
<br />— SCHEDULED
<br />AUTOS
<br />NON-OWNED
<br />AUTOS ONLY
<br />X 7030964 (AOS)
<br />7030965 (VA)
<br />06/30/2023
<br />06/30/2023
<br />06/30/2024
<br />06/30/2024
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />$ 5,000,000
<br />BODILY INJURY (Per person) $
<br />BODILY INJURY (Per accident) $
<br />PROPERTY DAMAGE
<br />(Per accident) $
<br />$
<br />C X — UMBRELLA LIAB
<br />EXCESS LIAB
<br />X _ OCCUR
<br />CLAIMS-MADE
<br />X AUC7364403-05 06/30/2023 06/30/2024 EACH OCCURRENCE $ 10,000,000
<br />AGGREGATE $ 10,000,000
<br />$ DED RETENTION $
<br />A
<br />B
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANYPROPR1ETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBEREXCLUDED7
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />Y / N
<br />N N / A
<br />WC015825014 (AOS) SIR: $750k
<br />WC015825015 (CA)
<br />XWC1647426 (OH, PA, WA)
<br />06/30/2023
<br />06/30/2023
<br />06/30/2023
<br />06/30/2024
<br />06/30/2024
<br />06/30/2024
<br />. X .1?.f-F 1,RTUTE OTH-
<br />ER
<br />EL. EACH ACCIDENT $ 3,000,600
<br />E.L. DISEASE - EA EMPLOYEE $ 3,000,000
<br />EL DISEASE - POLICY LIMIT $ 3,000,000
<br />D Excess Liability 62785768 06/30/2023 06/30/2024 Limit
<br />Excess of
<br />15,000,000
<br />10,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />RE: HHW Consolidation, 210 E. Wetmore Ave., Manteca, CA 95337
<br />San Joaquin COUNTY, and the incorporated Cities within the geographical boundaries of the COUNTY are included as Additional Insureds under General Liability per Endorsement Form #1, Automobile Liability,
<br />Pollution Liability as required by written contract, subject to policy terrns and conditions and Umbrella/Excess Liability.
<br />CERTIFICATE HOLDER
<br /> CANCELLATION
<br />City of Manteca
<br />1001 W C,enter St
<br />Manteca, CA 95337
<br />1
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />Wecz,r-a.‘ -7-€.5"...,-4, -"'" ---"W
<br />0 1988-2016 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03)
<br /> The ACORD name and logo are registered marks of ACORD
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