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Home My WebLink About(0018) K&S Disposal COI May 2021.pdfACORO� CERTIFICATE OF LIABILITY INSURANCE DATE(MIADDAYM 05106/2021 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 pollcy(les) 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 CONTANAME: Tonya Riggs Keystone Southwest Insurance PiHO Na (972) T71-3861 c No : (972) 772'1021 member of K & S Group, Inc. AIL hi s kswins.com ADDRESS: 9g P O BOX 1747 IISURER(S)AFFORDING COVERAGE NAIC0 Rockwall TX 75087-1747 INSURERA: Cincinnati Specialty Underwriters Ins. Co. INSURED INSURER B : rog Pressive Insurance Co. K&S Disposal, LLC INSURER C : Texas Mutual Insurance Co. 22945 WT Site Management, LLC INSURER D : Ohio Casualty Insurance Company P.O, Box 310 INSURER E: Crandall TX 75114 INSURER F COVERAGES - cFRTIFICATF NI IIURPR. 20/21 ALL LINES RFVIRInN NI II61RFR- 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 SUBJECTTO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE AUDLINUtSK INSD WVO POLICYNUMBER POLICY E MMID 1-WITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE ® OCCUR PREMISES jEa�occurrence) $ 100,000 MED EXP (Any one person) S 5,000 PERSONAL BADVINJURY $ 1,000,000 A CSU0116551 06/16/2020 06/16/2021 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑ PRO- LOC PRODUCTS -CO IP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea exJdenl $ 1,000,000 BODILY INJURY (Per person) S ANYAUTO B OWNED SCHEDULED 02983423-0 12/11/2020 12/11/2021 BODILY INJURY (Per accident) S AUTOS ONLY AUTOS PROPERTY DAMAGE amdenl S HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY Uninsured motorist $ 1,000,000 UMBRELLA LIAR OCCUR ...,....... .........y,.. ,...... EACH OCCURRENCE S HCLAWS-MADE AGGREGATE $ EXCESS LIAB DELI I I RETENTIONS S WORKERS COMPENSATION PER OTH- STATUTE ER AND EMPLOYERS' LIABILITY Y/ N EL. EACH ACCIDENT S 1,000,000 C ANY PROPRIETORIPARTNERIEXECUTNE ❑ N / A 0002016501 06/16/2020 06/16/2021 E.L. DISEASE - EA EMPLOYEE S 1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - POLICY LIMB S 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below Roll -Off Containers $125,000 D Inland Marine BM060775911 02/04/2020 02/042021 Deductible $1,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If mom space Is required) General Liability and Auto Liability policies includes Blanket Waiver of Subrogation and Blanket Additional Insured when required by written contract. Workers Compensation policy includes blanket waiver of subgrocation when required by written contract SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Worth ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 123941 AUTHORIZED REPRESENTATIVE Fort Worth TX 76121 4-��a_ek_ n nGn^nAor r%U All . h0a ^..Marl ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD