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Insurance Certificates 2022/23 Burrtec Waste & RecyclingClient#: 437902 BURRTWASTE ACORD.. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 2/28/2022 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 have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Marsh & McLennan Agency LLC PHONE FAX A/C, No, Ext : A/C, No): Marsh &McLennan Ins. Agency LLC constructioncerts@marshmma.com ADDRESS: PO Box 85638 INSURER(S) AFFORDING COVERAGE NAIC # San Diego, CA 92186 Lexington Insurance Company 19437 INSURER A : 9 P Y INSURED INSURER B: Everest Premier Insurance Company 16045 Burrtec Waste Group, Inc. INSURERC: Navigators Specialty Insurance Company 36056 9890 Cherry Avenue Fontana, CA 92335 INSURER D INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. LT R LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR X 023627374 3/01 /2022 03/01/2023 EACH OCCURRENCE $1,000,000 PREMISES EaoN.0 RENTED $300,000 MED EXP (Any one person) $ O PERSONAL & ADV INJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY XI JECT LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OPAGG $2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY X RMlCA00068221 3/01/2022 03/01/202 CMINED EaaccidenSINGLELIMIT $5,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 021391622 3/01/2022 03/01/2023 EACH OCCURRENCE s5,000,000 X AGGREGATE s5,000,000 DED X RETENTION $1 O 000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A X RM1WC00083221 03/01/2022 03101/2023 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 C Excess Liability XS of $5M CH22EXC8680571C 3/01/2022 3/01/2023 $4M Per Occ/Agg DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Job: Operations pertaining to named insured for certholder. City of La Quinta, its elective and appointive boards, commissions, officials, employees, agents and volunteers are additional insureds, primary and non-contributory per endorsements attached. Um ILO] aY I I a PfG\ IIRS III PJ A.J aG "L'\C Pf a A AG\ I PJ0 City of La Quinta 78495 Calle Tampico La Quinta, CA 92253-2839 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 ACORD 25 (2016/03) 1 of 1 #S10492216/M10492195 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WSADH ADDITIONAL REMARKS SCHEDULE Page 1 of 2 AGENCY NAMEDINSURED Marsh & McLennan Insurance Agency LLC Burrtec Waste Group, Inc. CARRIER I NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Named Insured Schedule Burrtec Waste Group, Inc. Burrtec Waste Industries, Inc. Agua Mansa MRF, LLC AVCO Disposal, Inc. Burr Group, LP Burr Group, Inc Burr Properties, LLC Burr Properties, G.P. Bun -line, LLC Burrtec Environmental, LLC Burrtec Recovery & Transfer, LLC Burrtec Waste & Recycling Services, LLC Burrtec Retirement Savings Plan Burrtec Waste Industries, Inc. (formerly PSP Waste Services, Inc.) Burrtec Waste Industries, Inc. DBA: Burbank Recycling Burrtec Waste Industries, Inc. DBA: Agua Mansa Recycling & Transfer Co. Burrtec Waste Industries, Inc. DBA: Burrtec Recycling & Transfer Co. Burrtec Waste Industries, Inc. DBA: Burrtec Recycling Center Burrtec Waste Industries, Inc. DBA Coachella Valley Compost Burrtec Waste Industries, Inc. DBA Coachella Valley Transfer Station Burrtec Waste Industries, Inc. DBA Desert Disposal Burrtec Waste Industries, Inc. DBA: East Valley Recycling & Transfer Burrtec Waste Industries, Inc. DBA: Inland Empire Recycling Burrtec Waste Industries, Inc. DBA:Marks Disposal Burrtec Waste Industries, Inc. DBA: Tri-Co Burrtec Waste Industries, Inc. DBA: Tri-County Disposal Burrtec Waste Industries, Inc. DBA: Trico Disposal Burrtec Waste Services, LLC Crestline Disposal Currans Rubbish Disposal, Inc. E. Cole Burr, individually E. Cole Burr, Trustee of the Burr Family Trust Edward G. Burr Sandra L. Burr Cole Burr Tracy A. Burr Burr Properties Empire Disposal, LLC Fontana Rubbish Collectors, Inc. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AC"R" ADDITIONAL REMARKS SCHEDULE AGENCY NAMEDINSURED Marsh & McLennan Insurance Agency LLC Burrtec Waste Group, Inc. CARRIER I NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Named Insured Schedule Inland BioEnergy, LLC Jack's Disposal, Inc. DBA Yukon Disposal Jack's Disposal, Inc. Kaiser Recycling Corporation KGB Properties, LLC (formerly Burr Girls, LLC Lake Arrowhead Disposal Lucerne Valley Disposal Monte Vista Disposal , Inc. Mountain Disposal Services, Inc. Rancho Disposal Service, Inc. Rialto Services, Inc. Running Springs Disposal TECMEC Maintenance Enterprise, Inc. Tracy A. Burr, individually Tracy A. Burr, Trustee Tri-County Disposal, Inc. Tri-County Disposal, Inc. DBA: Gary's Disposal Victorville Disposal, Inc. West Valley MRF, LLC West Valley Recycling and Transfer, Inc. Yucaipa Disposal, Inc. Desert Properties, LLC Burr Family Trust Yukon Disposal Cal Disposal Co., Inc. Page 2 of 2 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD INSURED: Burrtec Waste Group, Inc. POLICY #: 023627374 POLICY PERIOD: 03/01/2022 TO 03/01/2023 PRI ARYINON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided by the policy: Notwithstanding any other provision of the policy to the contrary, the insurance afforded by this policy for the benefit of the Additional Insured shall be primary insurance, but only with respect to any. claim, loss or liability arising out of the Named Insured's operations; and any insurance maintained by the Additional insured shall be non-contributing. All other terms and conditions of the policy remain the same. Authorized Representative OR Countersignature (In states where applicable) LX9838 (oams) INSURED: Burrtec Waste Group, Inc. POLICY#: 023627374 POLICY PERIOD: 03/01/2022 TO: 03/01/2023 ENDORSEMENT By: LEXINGTON INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED REQUIRED BY WRITTEN CONTRACT SCHEDULE Name of Person or Organization: AS REQUIRED BY WRITTEN CONTRACT A. Section II - Who Is An Insured is amended to include the person or organization shown in the Schedule above that you are required to include as an additional insured on this policy by a written contract or written agreement in effect during this policy period and executed prior to the "occurrence" of the "bodily injury" or "property damage." B. The insurance provided to the above described additional insured under this endorsement is limited as follows: 1. COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE (Section I - Coverages) only. 2. The person or organization is only an additional insured with respect to liability arising out of "your work" or "your product" for that additional insured. 3. In the event that the Limits of Insurance provided by this policy exceed the Limits of Insurance required by the written contract or written agreement, the insurance provided by this endorsement shall be limited to the Limits of Insurance L X4285 (02/14) required by the written contract or written agreement. This endorsement shall not increase the Limits of Insurance stated in the Declarations under Item 3. Limits of Insurance pertaining to the coverage provided herein. 4. The insurance provided to such an additional insured does not apply to "bodily injury" or "property damage" arising out of an architect's, engineer's or 1. surveyor's rendering of or failure to render any professional services including: i The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and ii Supervisory, inspection, architectural or engineering activities. 5. This insurance does not apply to "bodily injury" or "property damage" arising out of "your work" or "your product" included in the "products -completed operations hazard" unless you are required to provide such coverage by written contract or written agreement and then only for the period of time required by the written contract or written agreement and in no event beyond the expiration date of the policy. 6. Any coverage provided by this endorsement to an additional insured shall be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance apply on a primary and non-contributory basis. C. Subparagraph (1)(a) of the Pollution exclusion paragraph 2.f., Exclusions of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY (Section I Coverages) does not apply to you if the "bodily injury" or "property damage" arises out of "your work" or "your product" performed on premises which are owned or rented by the additional insured at the time "your work" or "your product" is performed. D. In accordance with the terms and conditions of the policy and as more fully explained in the policy, as soon as practicable, each additional insured must give us prompt notice of any "occurrence" which may result in a claim, forward all legal papers to us, cooperate in the defense of any actions, and otherwise comply with all of the policy's terms and conditions. LX4285 (02/14) Includes copyrighted information of the Insurance Services Offices, Inc., with its permission. All rights reserved. INSURED: Burrtec waste Group, Inc. POLICY#: 023627374 POLICY PERIOD: 03/01/2022 TO: 03/01/2023 ENDORSEMENT LEXINGTON INSURANCE COMPANY AGGREGATE LIMITS OF INSURANCE - PER LOCATION AMENDMENT AND OVERALL GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the policy: Subject to the Overall General Aggregate Limit stated in Item 3 of the Declarations, the General Aggregate Limit under LIMITS OF INSURANCE (Section III) applies separately to each of your "locations". It is further understood and agreed that the following changes are made to the policy: (1) Item 3, Limits of Insurance in the Declarations is amended by the addition thereto of the following Limit: Overall General Aggregate Limit - $5 , 000, 000 (2) SECTION III -LIMITS OF INSURANCE is amended by the addition thereto of the following paragraph under paragraph 6. 7. The Overall General Aggregate Limit is the most we will pay under Coverages A and B for the sum of all Limits of Insurance as provided in this SECTION III regardless of the number of your "locations"; except for damages because of "bodily injury" and "property damage" included in the "products -completed operations hazard". For the purpose of this endorsement, "locations" means premises involving the same lot, or connecting lots or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. All other terms and conditions remain unchanged. Authorized Representative OR Countersignature (In states where applicable) L X9493 (Ed. 02/04) POLICY NUMBER: RMlCA00068221 COMMERCIAL AUTO CA2001 1013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LESSOR - ADDITIONAL INSURED AND LOSS PAYEE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Burrtec Waste Group, Inc. Endorsement Effective Date: SCHEDULE Insurance Company: Policy Number: RMlCA00068221 Effective Date: 03/01/2022 Expiration Date: 03/01/2023 Named Insured: Burrtec Waste Group, Inc. Address: Additional Insured (Lessor): Blanket where required by written contract Address: Blanket where required by written contract Designation Or Description Of "Leased Autos": Blanket where required by written contract CA 20 01 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 2 Coverages Limit Of Insurance Covered Autos Liability $ Each "Accident" Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus Comprehensive $ Deductible For Each Covered "Leased Auto" Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus Collision $ Deductible For Each Covered "Leased Auto" Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus Specified $ Deductible For Each Covered "Leased Auto" Causes Of Loss Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Coverage 1. Any 'leased auto" designated or described in the Schedule will be considered a covered "auto" you own and not a covered "auto" you hire or borrow. 2. For a "leased auto" designated or described in the Schedule, the Who Is An Insured provision under Covered Autos Liability Coverage is changed to include as an "insured" the lessor named in the Schedule. However, the lessor is an "insured" only for "bodily injury" or "property damage" resulting from the acts or omissions by: a. You; b. Any of your "employees" or agents; or c. Any person, except the lessor or any "employee" or agent of the lessor, operating a "leased auto" with the permission of any of the above. 3. The coverages provided under this endorsement apply to any 'leased auto" described in the Schedule until the expiration date shown in the Schedule, or when the lessor or his or her agent takes possession of the "leased auto", whichever occurs first. B. Loss Payable Clause 1. We will pay, as interest may appear, you and the lessor named in this endorsement for "loss" to a "leased auto". 2. The insurance covers the interest of the lessor unless the "loss" results from fraudulent acts or omissions on your part. 3. If we make any payment to the lessor, we will obtain his or her rights against any other party. C. Cancellation 1. If we cancel the policy, we will mail notice to the lessor in accordance with the Cancellation Common Policy Condition. 2. If you cancel the policy, we will mail notice to the lessor. 3. Cancellation ends this agreement. D. The lessor is not liable for payment of your premiums. E. Additional Definition As used in this endorsement: "Leased auto" means an "auto" leased or rented to you, including any substitute, replacement or extra "auto" needed to meet seasonal or other needs, under a leasing or rental agreement that requires you to provide direct primary insurance for the lessor. Page 2 of 2 © Insurance Services Office, Inc., 2011 CA 20 01 10 13 INSURED Burrtec Waste Group, Inc. POLICY# RM 1 CA00068221 POLICY PERIOD: 03/01/2022 TO: 03/01/2023 COMMERCIAL AUTO ECA 04 62104 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED ORGANIZATION This endorsement modifies insurance provided under the following: IC1�110111:RSW111[00K01T19:7_[el011111;1MW 21 SCHEDULE I Name Of Additional Insured Organization I NAMED INSURED TO BE NAM ED AS AN ADDITIONAL INSURED ON THIS POLICY WITH REGARD TO THEIR OPERATION; MAINTENANCE, OR USE OF A COVERED "AUTO". Information required to complete this Schedule if not shown above will be shown in the Declarations. The following is added to the Who Is An Insured paragraph under Section 11- Liability Coverage: The organization shown in the Schedule with respect to the operation, maintenance, or use of a covered "auto" if you are required to add such organization to this policy as an additional insured in order to comply with the terms of a written "insured contract" or written agreement. This does not apply when such contract or agreement: A. Involves the owner or anyone else from whom you hire or borrow a covered "auto" unless it is a "trailer' connected to a covered "auto" you own; or B. Is executed after the date of "loss". This paragraph does not apply if: I. The terms and conditions of the written "insured contract" had been agreed upon prior to the "accident" or`loss-, and 2. You can definitively establish that the terms and conditions of the written "insured contract" ultimately executed are the same as those which had been agreed upon prior to the "accident" or "loss" ECA 04 521 0414 Copyright, Everest Reinsurance Company, 2014 Includes copyrighted material of Insurance Services Office; Inc., used with its permission Page 1 of 1 INSURED COPY INSURED: Burrtec Waste Group, Inc. POLICY #: RMlWC00083221 POLICY PERIOD: 03/01/2022 TO: 03/01/2023 WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be of the California workers' compensation pre-mium otherwise due on such remuneration. Schedule Person or Organization Job Description ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED,EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION WC 252 (4-84) WC 04 03 06 (Ed. 4-84) Page 1 of 1