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DocuSign Envelope ID:813A5323-29B6-4DDD-A2B8-22B7F4A4A68C Page 1 of 2
<br /> ACCORD DATE(MM/DD/YYYY)
<br /> ® CERTIFICATE OF LIABILITY INSURANCE 05/31/2017
<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 /> PRODUCER CONTACT
<br /> NAME:
<br /> Willis of Massachusetts, Inc. PHONE 1-877-945-7378 FAX 1-888-467-2378
<br /> c/o 26 Century Blvd (A/C,No,Ext): (A/C,No):
<br /> E-MAIL certificates @willis.com
<br /> P.O. Box 305191 ADDRESS:
<br /> Nashville, TN 372305191 USA INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURERA: ACE American Insurance Company 22667
<br /> INSURED INSURER B: American Guarantee and Liability Insurance Company 26247
<br /> Clean Harbors Environmental Services, Inc.
<br /> and its affiliates INSURER C: Indemnity Insurance Company of North America 43575
<br /> 42 Longwater Drive INSURER D:
<br /> Norwell, MA 02061
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:W2449677 REVISION NUMBER:
<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. NOTWITHSTANDING 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP W LIMITS
<br /> LTR INSD VD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY)
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br /> DAMAGE TO CLAIMS-MADE X OCCUR PREMISES(Ea occur ence ) $ 500,000
<br /> A X XCU MED EXP(Any one person) $ 5,000
<br /> X Contractual N N HD0G27858478 11/01/2016 11/01/2017 PERSONAL&ADVINJURY $ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
<br /> POLICY X IM LOC PRODUCTS-COMP/OPAGG $ 4,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 5,000,000
<br /> (Ea accident)
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> A X OWNED SCHEDULED N N ISAH09051107 11/01/2016 11/01/2017 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X
<br /> HIRED X NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY (Per accident)
<br /> X MCS-90 $
<br /> X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 10,000,000
<br /> B
<br /> EXCESSLIAB CLAIMS-MADE N N AUC 4275262-12 11/01/2016 11/01/2017 AGGREGATE $ 10,000,000
<br /> DED X RETENTION$0 $
<br /> WORKERS COMPENSATION X PER 0TH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> YIN 2,000,000
<br /> C ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
<br /> OFFICER/MEMBER EXCLUDED? No N/A N WLRC49103554 (AOS) 11/01/2016 11/01/2017 2,000,000
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
<br /> If yes,describe under 2,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> A Work Comp & Emp Liab N N WLRC49103530 (AZ, CA, MA) 11/01/2016 11/01/2017 EL Each Accident $2,000,000
<br /> Per Statute EL Disease - Each Emp$2,000,000
<br /> EL Disease - Policy $2,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> All operations of the Named Insured.
<br /> SEE ATTACHED
<br /> CERTIFICATE HOLDER CANCELLATION
<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 /> Orange County Solid Waste
<br /> Attn: Cheryl Young AUTHORIZED REPRESENTATIVE
<br /> P.O. Box 17177 O,,A,-�`ntlqi
<br /> Chapel Hill, NC 27516
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br /> SR ID: 14657638 BATCH: 336246
<br />
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