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Insurance Certificates 2023/24 Burrtec Waste & Recycling/ A� o® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) E(MM/D /Y 23 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh & McLennan Agency LLC Marsh & McLennan Ins. Agency LLC PO Box 85638 San Diego CA 92186 License#: 0H18131 CONTACT NAME: PHONE FAX (A/C, No, Ext): (A/C, No): ADDRESS: constructioncerts@marshmma.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Lexington Insurance Company 19437 INSURED BURRTWASTE Burrtec Waste Group, Inc. 9890 Cherry Avenue Fontana, CA 92335 INSURER B: Everest Premier Insurance Company 16045 INSURER C: Navigators Specialty Insurance Company 36056 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1712669737 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 CONTRACT OR 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. INSR TYPE OF INSURANCE IADDL NSD SWUBR VD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y N 023627374 3/1/2023 3/1/2024 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE RETED PREMISESO(Ea occurrence) $ 300,000 X Ded: $50,000 MED EXP (Any one person) $ 0 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE X LIMIT APPLIES ' PER: LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE X X X LIABILITY ANY AUTO OWNED X SCHEDULED AUTOS NON -OWNED Y N RM1CA00068231 3/1/2023 3/1/2024 COMBINED SINGLE LIMIT (Ea accident) $ 5,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X O OCCUR CLAIMS -MADE N N 021391622 3/1/2023 3/1/2024 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED X RETENT ON $ 10.000 $ g WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N N/A N RM1WC00083231 3/1/2023 3/1/2024 X PER STATUTE OTH- 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 CH23EXC8680571C 3/1/2023 3/1/2024 Limit: $5M 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. Excess/Umbrella follows form to primary policies. CERTIFICATE HOLDER CANCELLATION 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 Twit ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD INSURED: Burrtec Waste Group, Inc. POLICY#: 023627374 POLICY PERIOD: 03/01/2023 TO: 03/01/2024 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 LX4285 (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. ACC0RE,, ADDITIONAL REMARKS SCHEDULE Page 1 of 2 AGENCY Marsh & McLennan Insurance Agency LLC CARRIER NAIC CODE NAMED INSURED Burrtec Waste Group, Inc. 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. Burrline, LLC Burrtec Environmental, LLC Burrtec Recovery & Transfer, LLC Burrtec Waste & Recycling Services, LLC Burrtec Retirement Savings Plan Burrtec Waste Burrtec Waste Burrtec Waste Burrtec Waste Burrtec Waste Burrtec Waste Burrtec Waste Burrtec Waste Burrtec Waste Burrtec Waste Burrtec Waste Burrtec Waste Burrtec Waste Burrtec Waste Industries, Inc. (formerly PSP Waste Services, Inc.) Industries, Inc. DBA: Burbank Recycling Industries, Inc. DBA: Agua Mansa Recycling & Transfer Co. Industries, Inc. DBA: Burrtec Recycling & Transfer Co. Industries, Inc. DBA: Burrtec Recycling Center Industries, Inc. DBA Coachella Valley Compost Industries, Inc. DBA Coachella Valley Transfer Station Industries, Inc. DBA Desert Disposal Industries, Inc. DBA: East Valley Recycling & Transfer Industries, Inc. DBA: Inland Empire Recycling Industries, Inc. DBA:Marks Disposal Industries, Inc. DBA: Tri-Co Industries, Inc. DBA: Tri-County Disposal 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 ACCU? EP ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY Marsh & McLennan Insurance Agency LLC CARRIER NAIC CODE NAMED INSURED Burrtec Waste Group, Inc. 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 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: 03/01/2023 TO 03/01/2024 PRIMARY/NON 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, oleim, 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. ii Authorized Representative OR Countersignature (In states where applicable) LX9838 (08/05) Burrtec Waste Group, Inc. LX9838 (08/05) INSURED: Burrtec Waste Group, Inc. POLICY#: 023627374 POLICY PERIOD: 03ro1/2023 TO: 03/01/2024 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 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. (2) All other terms and conditions remain unchanged. Authorized Representative OR Countersignature (In states where applicable) L X9493 I d . 02/04) INSURED: Burrtec Waste Group, Inc. RM 1 CA00068231 POLICY#: POLICY PERIOD: 03/01/2023 TO: 03/01/2024 COMMERCIAL AUTO ECA 04 521 0414 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART SCHEDULE Name Of Additional Insured Organization ALL ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT WITH THE NAMED INSURED TO BE NAMED 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 II — 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 ECA 04 521 04 14 B. Is executed after the date of "loss". This paragraph does not apply if: 1. 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" 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. 03/01/2023 TO: 03/01/2024 POLICY #: RM1WC00083231 POLICY PERIOD: 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. Person or Organization 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 Schedule Job Description WC 252 (4-84) WC 04 03 06 (Ed. 4-84) Page 1 of 1