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DocuSign Envelope ID: 88A54057 -CC31- 4328 - 9012- 2B021842D3E4
<br />Page 1 of 2
<br />ACdRO� CERTIFICATE OF LIABILITY INSURANCE
<br />��.
<br />rDA�TE 13ii2017
<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
<br />CONTACT
<br />NAME:
<br />Willis of Massachusetts, Inc.
<br />c/o 26 Century Blvd
<br />P.O. Box 305191
<br />PHONE 1- 877 - 945 -7378 FAX 1- 888 - 467 -2378
<br />(.1C' No Ext : AIC No
<br />E -MAIL
<br />ADDRESS: certificates @willis.com
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />Nashville, TN 372305191 USA
<br />INSURERA: ACE American Insurance Company
<br />22667
<br />INSURED
<br />Clean Harbors Environmental Services, Inc.
<br />INSURERB: American Guarantee and Liability Insurance company
<br />26247
<br />INSURER C: Indemnity Insurance Company of North America
<br />43575
<br />and its affiliates
<br />INSURER D:
<br />42 Longwater Drive
<br />Norwell, MA 02061
<br />INSURER E,
<br />$ 500,000
<br />INSURER F:
<br />MED EXP (Any one person)
<br />$ 5,000
<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
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICYNUMBER
<br />POLICY EFF
<br />MM /DDIYYYY
<br />POLICY EXP
<br />MM /DDIYYYY
<br />LIMITS
<br />Chapel Hill, NC 27516V1I""`'"``�
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS -MADE � OCCUR
<br />PREM SES (Ea olccur ence )
<br />$ 500,000
<br />X
<br />MED EXP (Any one person)
<br />$ 5,000
<br />A
<br />XCU
<br />X
<br />Contractual
<br />N
<br />N
<br />HDOG27858478
<br />11/01/2016
<br />11/01/2017
<br />PERSONAL & ADV INJURY
<br />$ 2,000,000
<br />GEML
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />POLICY jE LOC
<br />PRODUCTS - COMP /OP AGG
<br />$ 4,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 5,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />A
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />N
<br />N
<br />ISAH09051107
<br />11/01/2016
<br />11/01/2017
<br />X
<br />BODILY INJURY (Per accident)
<br />$
<br />X
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />X
<br />$
<br />MCS -90
<br />B
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />AGGREGATE
<br />$ 10,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />N
<br />N
<br />AUC 4275262 -12
<br />11/01/2016
<br />11/01/2017
<br />DED X RETENTION $ 0
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANYPROPRIETOR /PARTNER /EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? No
<br />(Mandatory in NH)
<br />NIA
<br />N
<br />WLRC49103554 (AOS)
<br />11/01/2016
<br />11/01/2017
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 2,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 2,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 2,000,000
<br />A
<br />Work Comp & Emp Liab
<br />N
<br />N
<br />WLRC49103530 (AZ, CA, MA)
<br />11/01/2016
<br />11/01/2017
<br />EL Each Accident
<br />$2,000,000
<br />Per Statute
<br />EL Disease - Each Em
<br />$2,000,000
<br />EL Disease - Policy
<br />$2,000,000
<br />DESCRIPTION OF OPERATIONS I 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 />©1988 -2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />sH ID: 14657638 BATCH: 336246
<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 />AUTHORIZED REPRESENTATIVE
<br />Attn: Cheryl Young
<br />P.O. Box 17177
<br />Chapel Hill, NC 27516V1I""`'"``�
<br />©1988 -2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />sH ID: 14657638 BATCH: 336246
<br />
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