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HomeMy WebLinkAboutORD 11-071 ORDINANCE NO. 11-071 ENTITLED AN ORDINANCE GRANTING A FRANCHISE FOR SOLID WASTE COLLECTION AND TRANSPORTATION SERVICES TO ENVIRO WASTE SOLUTIONS (EWS). WHEREAS, Enviro Waste Solutions (EWS) (the "Company") has requested a franchise to operate a solid waste collection and transportation service within the City of Beaumont, Texas (the "City"); and, WHEREAS, the City desires to grant such franchise; NOW, THEREFORE, BE IT ORDAINED BY THE CITY OF BEAUMONT: THAT the statements and findings set out in the preamble to this resolution are hereby, in all things, approved and adopted; and Section 1. Grant of Authority There is hereby granted by the City to Enviro Waste Solutions (EWS)the right and privilege to operate and maintain within the City a solid waste collection and transportation service (the"service"). For purposes of this franchise, the term"solid waste collection and transportation service"shall mean the regular business of collection,hauling ortransporting any garbage, rubbish, waste or refuse from locations in the City, and the disposal of such material in accordance with law. The franchise granted herein is nonexclusive, and franchises may be granted to other persons for service. Section 2. Term of Franchise The franchise herein granted shall take effect and be in force sixty (60) days after the final passage hereof as required by law and upon the filing by the Company of an acceptance with the City Clerk, and shall continue in force and effect until one (1) year thereafter. The acceptance required hereunder must be in writing and filed with the City Clerk within thirty (30) days after final passage hereof. Upon the expiration of the term hereof, this franchise shall continue on a month-to-month basis until terminated by either party or extended or replaced. Section 3. Rates The Company shall establish rates for service which are uniform as to customer class based upon such criteria as type of waste, container size, frequency of collection, and distance of travel. The Company shall file its initial rates for service with its acceptance as required herein. Such rates shall, unless modified by the City, be effective with the effective date of this franchise. Any modifications in rates by the Company shall first be filed with the City Clerk and City Attorney and shall be effective thirty(30)days after such filing unless modified by City as provided herein. Nothing herein shall prevent the Company from charging uniform rates which are less than the rates filed with the City. The City shall have the right to establish rates charged by Company for services performed hereunder, after notice and hearing. Rates established by the City shall be sufficient to allow the Company an opportunity to earn a reasonable return on its invested capital used in providing such services. Section 4. Franchise Fee The Company shall pay to the City, on or before the fifteenth (15th) day of each month, a sum equal to SEVEN PERCENT(7%)of the gross revenues received for service in the previous month as payment for the use of the City's streets, alleys and rights-of-way. i i The payments herein provided do not relieve Company from the payment of ad valorem taxes, special assessments,charges,or other fees applicable to the public generally. City shall have the right, at any reasonable time, to audit the books and records of the Company and the Company is hereby required to make such books and records available at the request of City. Upon written acceptance, the Company shall furnish to the City a listing of customers served, including customer name, address,frequency of pick-up, size of container or type of service and charge for same. The following report shall be tiled monthly with the City Manager or his designee along with the street rental payment required herein: Upon written request and within thirty(30)days of receipt,the Company shall furnish to the City adequate reconciliation of reported revenues which would include: a listing of names and addresses of all customers served,frequency of pick-up,size of container or type of service and charge for same,and date service was initiated and discontinued. Section 5. Indemnity. Insurance and Bond The Company shall at all times during the effective period of this franchise, carry liability insurance as provided herein. The Company covenants and agrees at all times to indemnify and save harmless the City, its officers, agents, employees, and any member of the public against any and all injuries, damages, claims, causes of action or loss of compensation arising or resulting from Company's operations underthis franchise,whether or not such loss was caused by the negligence of the City, its agents, servants or employees. Upon notice given Company by City, Company must defend at its own expense, any action or suit brought against the City because of any work or other acts done by the Company under the terms of this franchise. Counsel chosen by Company to defend City must be satisfactory to City. Company will pay any final judgment which might be obtained against City by reason of any work or acts done hereunder by Company, its agents, servants or employees,and Company will pay all damages occurring to any person or property, public or private, resulting from any fault or neglect on its part or on the part of its agents or employees. The Company agrees to carry insurance as follows: 1) Workers' Compensation The Company shall furnish the City Clerk a certificate of insurance indicating workers' compensation coverage as required by the State of Texas. 2) Automobile Liability Insurance The Company shall carry, in its own name, a policy in comprehensive form to insure the automobile liability of its operation with limits of not less than Five Hundred Thousand Dollars ($500,000.00) per occurrence for bodily injury and, in addition, not less than One Hundred Thousand Dollars ($100,000.00) property damage. This policy shall name City as an additional insured and provide for thirty(30)days notice to City prior to cancellation. A certificate of insurance certifying such coverage shall be filed with the City Clerk before the effective date of this franchise, and it shall be maintained in force during the term of the franchise. 3) General Liability The Company shall carry, in its own name, a comprehensive liability insurance policy including contractual coverage for operations other than automobile with limits of not less than Five Hundred Thousand Dollars($500,000.00)per occurrence for bodily injury, and One Hundred Thousand Dollars ($100,00.00) per occurrence for property damage. The policy shall name the City as named insured and provide for thirty (30) days notice to City prior to cancellation. A certificate of insurance certifying such coverage shall be filed with the City Clerk before the effective date of this franchise and maintained in force during the term of the franchise. Section 6. Compliance with Laws and Ordinances The Company shall, at all times during the term of this franchise, be subject to all lawful exercise of police power by the City and to such reasonable regulations as the City shall hereafter by ordinance provide. In addition,the Company will observe all city,county, state, and federal laws regulating the collection and disposal of solid waste. Section 7. Service Standard and Equilment The Company shall maintain and operate its collection system and equipment in good order to render efficient service subject to the terms of this franchise. All vehicles, containers, and equipment used for the collection and transportation of solid waste shall be constructed, operated and maintained to prevent loss of liquid or solid waste material and to minimize health and safety hazards to solid waste management personnel and the public. Such vehicles, containers, and equipment used shall be maintained in a clean, sanitary condition and free from odors at all times. All vehicles and equipment shall comply with federal, state, and local regulations. Collection vehicles and all bulk, commercial,and roll-off type containers shall be painted and numbered and shall have the Company's name and telephone number painted in letters of a contrasting color. Such containers may not be placed on any street or right-of-way within the City. All collections shall be made directly from the premises of the customer and any emptied containers returned directly to such premises. Section 8. Providing Services The Company shall provide service to any person, firm, corporation, association or entity inside the City of Beaumont who requests such service and is not delinquent in the payment of collection charges due the Company. Section 9. Office The Company shall establish and maintain an office with telephone service and shall keep said office open for business from 9:00 A.M. to 5:00 P.M. each and every day except Saturday, Sunday and holidays. Section 10. Interruption of Service - In the event that service shall be interrupted for any reason for more than forty-eight (48) hours, the City shall have the right to make temporary independent arrangements for the purposes of continuing this necessary service to its residents in order to provide or protect the public health and safety. If the interruption in service mentioned herein continues for a period of seventy-two (72) hours, then the City shall have the right to terminate the rights and privileges granted in this franchise. Section 11. Termination In the event that any provision of this franchise is violated by the Company,the City may serve written notice upon the Company of its intention to terminate this franchise. The notice shall contain the reasons for such intention to terminate the franchise. Unless within ten (10)days after mailing such notice by City to the Company, such violation shall cease, or satisfactorily arrangements for correction be made by Company, the City Council may, after a public hearing in which Company is provided an opportunity to present evidence concerning such violation, declare the franchise terminated and serve written notice upon the Company of the termination and the termination of the franchise shall be effective upon the mailing of such notice. Section 12. Transfer of Franchise Rights Franchise rights granted hereunder shall not be transferred to another without the approval of City. A single transfer or a series of transfers of Company's stock which constitute a transfer of a majority interest in Company is subject to the prior approval of City. Section 13. Notices Where written notices are provided for in this ordinance, same shall be sufficient to notify Company when provided by certified mail to: Enviro Waste Solutions (EWS) 2300 Hwy 365 Nederland, TX 77627 Notice to City is sufficient if mailed by certified mail to: City Manager City of Beaumont P.O. Box 3827 Beaumont, TX 77704 Section 14. If any section,sentence, clause, paragraph or phrase of this ordinance, other than Section 4, is for any reason held to be invalid or illegal, such invalidity shall not effect the remaining portions of this ordinance. If Section 4 hereof is held to be invalid for any reason, the ordinance shall be immediately invalid. Section 15. It is agreed by City and Company that venue of any legal proceedings under this franchise agreement shall be in Jefferson County, Texas. Section 16. Vehicle Permits Twenty (20) days prior to the effective date of this franchise, the Company shall i furnish to the City a list of all vehicles to be providing solid waste collection and disposal service under this franchise. Such list shall include state license number, year, make, model and manufacturer's rated capacity for each vehicle. Vehicles not having a valid City of Beaumont landfill permit will not be allowed to operate under this agreement nor utilize the City refuse disposal facility. If at any time a vehicle or equipment is found to be in noncompliance with Section 7 of this franchise,the Company will be notified of its violation and said equipment or vehicle shall be removed from service upon receipt of written notification. Failure to comply with this provision or to falsify the information concerning the location of the service of the vehicle shall be a material breach of this franchise. Should City decide not to terminate this franchise because of any violation of this Section, Company's disposal fee at City's landfill shall be doubled for all of Company's vehicles for a period of sixty (60) days. PASSED BY THE CITY COUNCIL of the City of Beaumont on first reading this the 20th day of September, 2011. PASSED BY THE CITY COUNCIL of the City of Beaumont on second reading this the 4th day of October, 2011. PASSED BY THE CITY COUNCIL of the City of Beaumont on final reading this the 25th day of October, 2011 C� hoyor, City of Beaumont - ACCEPTANCE: � `,� Enviro Waste olu n ' ,, By: ( ompany Owner/Rep sentative) 1M lndulat #TRANSPORTATION a, 4w Waste LLC 060", "1004PY Finance Department City of Beaumont P.O. Box 3827 2300 HWY 365, Suite 400 Nederland TX 77627 Phone: 409-722-6880 Toll Free: 877-664-4645 Fax: 409722-5480 Re: Transfer of Solid Waste Collection and Transportation Service Franchise Agreement The intent of this letter is to request the transfer of Enviro Waste Solution's franchise, agreement to industrial Transportation Waste, LLC to operate in the city of Beaumont We appreciate your time and resources involved to transfer the franchise agreement. Please contact me anytime. K� 14 IndustriaL 0m, TRANSPORTATION WaSte LLC el * Mobile: (409)728-2067 Fax: (409)724-2911 Office: (409)727-3335 www.ITWasteLLC.com ENVIRO WASTE SOLUTIONS 2300 Hwy 365, Suite 400 Tel: 409-722-6880 Nederland, Texas 77627 Fax: 409-722-5480 Todd Simoneaux, Controller Finance Department City of Beaumont P.O. Box 3827 Beaumont, TX 777704-3827 Re: Transf6r of Solid Waste Collection and Transportation Service Franchise Agreement Dear Mr. Simoneaux: The intent of this letter is to request the transfer of Enviro Waste Solution's franchise agreement to Industrial Transportation Waste, LLC to operate in the city of Beaumont. Please contact me anytime if you have any questions. Sincer y, w � Victor Cash Business Manager Enviro Waste Solutions (409) 293-7917 2300 HWY 365, Suite 400 Nederland TX 77627 Phone: 409-722-6880 Toll Free- 877-664-4645 Fax: 409-722-5480 Todd Simoneaux, Controller Finance Departtnent City of Beaumont P.O. Box 3827 Beaumont, TX 777704-3827 Re: Transfer of Solid Waste Collection and Transportation Service Franchise Agreement Dear Mr. Simoneaux: Industrial Transportation Waste, LLC is owned 50% by Industrial Transportation, Inc. and 50% by Enviro Waste Solutions. ITI is owned by John L. May, whereas EWS is owned by Robert, Howard, and Karl Romero. ITW is a transportation company involved in the transport of industrial, commercial, and residential waste. ITW was formed in April of 2015. We strive to provide reliable and safe methods of transport for our clients and are very pleased to do business in the Beaumont area as well as utilize the Beaumont landfill for our disposal needs. We look forward to servicing our Beaumont clients and the continuous use of the landfill just as EWS did in the past. Thank you for your time. Please contact me if you have any questions regarding ITW. Kin. st Regards, Y-ed Laver Business Manager IndustriaL TRANSPORTATION ow Masts «< Mobile: (409)728-2067 Fax: (409)724-2911 Office: (409)727-3335 www.ITWasteLLC.com X25 PM 10/28/15 Accrual Basis Industrial Transportation Waste LLC Balance Sheet As of October 28, 2016 ASSETS Current Assets Checking/Savings 1001 - Bridge City Bank 1002 - Chase Checking 1003. Third Coast Checking Total CheckingfSavings Accounts Receivable 1200. Accounts Receivable Total Accounts Receivable Other Current Assets 12000. *UndepGsfted Funds 1301 - Prepalds 1301.04. Prepaid Insurance Total 1301 - Prepaids Total Other Current Assets Total Current Assets Fixed Assets 1601 - Computer Software 1502. Trucks 1502.01 - Trk # 11995 Vac Truck 1502.02. Trk 421976 Mack Vac Truck 1502.03 • Trk #4 2006 Mack Rolloff I502.04 - Trk #5 2007 Chev Toilet Truck 1502-05 - Trk #6 2003 Chev shop Truck I502.06 - Trk #7 2005 Volv Vac Truck 1502.07 - Trk #8 2005 Mack Rolloff 1502.09. Trk #112013 FISO 1502.10 - Trk #106 2006 Mack Rolloff 1502.11 - Tirk#107 2006 Mack Rolloff 1502.12. Trk #108 2007 Peterbuilt Rollof 1502.13. Trk#109 2008 PeteAuift Rollof 1502.14 - Trk #M 2013 Ford 1502.16 - Trk #276 2014 Ford 1502.16. Trk #276 2014 Ford 1602.26. 2015 F250 #282 Total 1502. Trucks I W5. Equipment 1505.07 - 20 YD Rolloff Boxes (62) 1505.08. 25 YD Rolloff Boxes (20) 1505-09 - 30 YD Rolloff Boxes (73) 1505.10. 40 YD Rolloff Boxes (93) 1505.11 - Portable Toilets (140) 1505.12 - Handicap POL (10) 1505.13 - Holding Tanks (35) 1505.14 - Hand Washing Stations (36) 1505.15 - Quad POL (2) 1505.16 - Polly Tanks (3) 1505.17 - Quadifft Equipment (2) iws.la - Portable Toilets (112) 1505.19. Holding Tanks (20) 1505.20 - Handwashing Stations 1505.21 . Handwashing Station (12) 105.22 - Handwashing, Stations (10) Total 1505 - Equipment 1551 - Accumulated Depreciation Total Fixed Assets ASSETS Oct 28, 15 695.24 39,760.25 10,782-21 51,237.70 988,096.58 988,096.58 -37,344.25 223,511.10 223,511.10 186,166.85 1,225,501.13 322.75 9,500.00 3,500.00 78,600.00 20,500.00 9,000.00 88,000.00 78,000.00 22,907.74 88,900.00 89,200.00 113,500.00 115,900.00 18,000.00 36,500.00 36,500.00 36,580.11 210,000-00 55,555.00 211-,935.00 272,547.00 64,539.00 1*1500.00 11,000.00 0,500.00 Z300-00 3,000.00 1,800-00 47,712.00 6,100-00 Z525-00 4,200.00 3,500-00 918,713.00 -222,009.94 1,541,513-66 2,767,014.79 Page I ITW - Equipment ROL/POL Unit # Make Model Year Vin Lice Plate No. State of Plates Type Tank Size Gross Weight 1 Ford F800 1995 IFDXFSCCXSVA61590 K036939 1M2AG11C06M026688 K009202 IG8X7C1397F404764 K036941 4V4MC9GG45N392414 K036942 1M2AG11YX5M019922 R125512 1NPSLPDX3DD184279 K000645 1M2AG11C16M029633 R125513 1M2AG11C76M027112 R122514 1NPALOOX77D748667 R122515 1NPSLOOXX8D750418 R122516 Texas Vac truck 2550 13000 R4 Mack CV713 2005 Texas Roll Off NA 80000 V5 Chevrolet 2007 Texas Vac truck 1500 19000 V7 Volvo VNM64T 2005 Texas Vac truck 3200 54000 R8 Mack CV713 2008 Texas Roll Off NA 80000 R9 Peterbilt 365 2013 Texas Roll Off NA 80000 106 Mack 2006 Texas Roll Off NA 80000 107 Mack 2006, Texas Roll Off NA 80000 208 Peterbilt 2007 Texas Roll Off NA 80000 109 Peterbilt 2008 Texas Roll Off NA 80000 2- 5 q.2.6 i=atth Na, COBi Editn D018! 1211Z 7012 Page t of 3 Mow, CIERTIFICATE OF INSURANCE This farm is for informational purposes only and certifies that policies of insurance listed below have been issued to insured named below and are in force at this time. Not withstanding any requirements, terra or condition of any contract or other document with respect to which this certificate may be issued or may pertain, insurance afforded by policies described herein is subject to all terms, exclusions and conditions of such policies. Prior to the beginning of work, the vendor shall obtain the minimum insurance and endorsements specified. Agents must complete the form providing all requested information and submit by fax, U.S. mail or e-mail as requested by the City of Beaumont ("COW). The endorsements listed below are required as attachments to this certificate; copies ofthe endorsements are also acceptable, PLEASE ATTACH ALL ENDORSEMENTS TO THIS FORM AND INCLUDE THE MATCHING POLICY NUMBER ON THE ENDORSEMENT. Only City of Beaumont certificates of insurance are acceptable; commercial carriers' certificates are not. This certificate shall be completed by a licensed insurance agent: Name and Address of Agency; Insgs-oup, Inc. 1455 West Loop South, 9th Floor Houston, TX 77027 Phone: 713 i 541-7272 Name and Address of Insured: industrial ,^.ranBportation Waste, LLC 2300 Highway 365, Suite 400 Nederland, TX 77627 phone: 409 j 722-6880 Prime or Sub -Contractor?: Name of Prime Contractor, if different from Insured: City of Beaumont Reference: Project Name: Project Location: Managing Dept.: Project Mgr.: Insurers Affording Coverages: Insurer A. AIG Specialty Insurance Company Insurer B: Texas Mutual Insurance Company Insurer C: Argonaut Insurance Company Insurer D. Commerce & Industry Insurance '�.• -�' '�' Fi, -a �a H nn YS trM ry R3.Cn � rl� NN. ME-` L"�'�"���V Chi, a �:_• -I i' f i 11 f 1 i Ifl Ill= r1771P61=-- =11-10741--Ir ■ ,- f 11 11SION I T5W DEPT. OF INSti;ZANCE ,USi`IN, TES 19PRO'VFn ,;r:o 7 7 711tl 25,00 0,000 SvX31 `NILLSF1v uoIluoism pamsul iowo an! 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Siop Uoa -- ON El Sax t� pUaotl3l2pufj - ON Cl seA � 83*F0 .- aN D 90A.Ejj 9 jo z esed zwMiEZi :Qle3 urns MOD 'ON unad (? z b 2 I CdAm v l Z � j 2. Farm No. caB1 Edition Oate: 1211 W2012 Page 3 of 3 AGENT CERTIFICATION:. THIS IS TO CERTIFY TO THE CITY OF BEAUMONT thatfhe insurance policies alcove are in full force and effect. Name of Insurance Company: Insgroup, Inc. Name of Authorized Agent Henry Hochman Company Address: 1455 West Loop South, 9th Floor Agint'e Address: 1455 West Loop South, 9th Floor Citr Hour. ton State: Tx Zip.77027 atr Houston State: TX Zip: 77027 Authorized Agent's phone Number (Inotuding Area Code) 713-541-7272 Ofiglnhr Agent X. flats: p CERTIFICATE HOt_DER: City of Beaumont P. 0. Box 3827 Beaumont, Texas 77704-3827 DATE ISSUED: 3-0/O8/2015 aW4&��, . AUTI-lORIZE-6A&RESENTATIVE SIGNATURE Licensed Insurance Agent Printed Name, E:LM WNW J Qt:I€rjft:i TEXAS DEPT. OF INSURANO: .AUSTIN, TEXAS APPRO VE-m A`� Q® CERTIFICATE OF LIABILITY INSURANCE DATE lo�%20 15 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 be endorsed. If SUBROGATION IS WANED, 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 endorseme s . PRODUCER Insgroup, Inc. 1455 W. Loop South, 9th Floor Houston T% 77027 CONTACT Cheryl Smith PHCNE (713)350-6395 FAX o AJ(713)314-3943 C ADORess csmith@insgroup.net INSURE S AFFORDING COVERAGE NAIC# INSURERAAIG Specialty Insurance Company 26883 INSURED Industrial Transportation Waste, MC Enviro Waste Solutions LLC 2300 Highway 365, Suite 400 Nederland T8 77627 INSURERB:TexaS Mutual Insurance Company 22945 INSURER C-Ar onaut Insurance Company 19801 INSURERD:COMMerce & industry Insurance INSURERE: 1 INSURERF: COVERAGES CERTIFICATE NUMBER-CL1571371746 I REVISION NUMRER- 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. L'fRR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MM ODtyYYY) POLICY EXP (MMfDI)ryYyYl LIMITS A $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE % OCCUR Contractors Pollution EG15434438 7/18/2015 7/18/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES LEa occurrence $ 1,000,C00 % MED EXP. (Anyone person) $ 25,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY a JECT LOC - OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMPIOPAGG $ 2,000,000 PILL CvgD&CvgELimit $1,000,000 Each ]J AUTOMOBILE % LIABILITY ANY AUTO ALL OWNED SCHEDULEDCA6061933 AUTOS AUTOS NON -OWNED 1 HIREDAUTOS AUTOS % MSC90 1 7/18/2015 7/18/2016 0O,",,'ZD1SINGLELIMIT $ 1,000,000 ROD ILY I NJURY (Per person)_ $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE P i n $ Medical paments $ A X UMBRELLALIA11 EXCESS LIAR % OCCUR CLAIMS -MADE I 111=543443-9 7/18/2015 7/18/2016 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DLL I I RETENTION$ 1 $ g C WORKERS COMPENSATION AND EMPLOYERS'LIABILIY YIN ANY PROPRIETORIPARTNERIEXECURVE OFFICERJMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA TX: TSF-0001284954 w/USLH IA: WC928005401074 w/USLE 3/21/2015 3/21/2015 3/21/2016 3/21/2016 % SAME ERRH EL EACH ACCIDENT $ 1,000,000 E.LDISEASE -EAEMPLOYE $ 1,000,000 EL DISEASE- POLICY LIMIT I $ 1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) SEE ATTACHED COVERAGE PROVISIONS. FIULULK City of Beaumont P.O. Box 3827 Beaumont, TX 77704-3827 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 Hochman/XM04 ©1938-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) IALcn99; /7n 4AMI The ACORD name and logo are registered marks of ACORD � a AC RQ CERTIFICATE OF LIABILITY INSURANCE - DATE (MMIDDNYYY) F 1a/8/2o1s THIS CERTIFICATE 1S 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 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 endarsemen s . PRODUCER Insgroup, Inc. 1455 W. Loop South, 9th Floor' Houston TX 77027 CnINIEADT Cheryl Smith PHONE (AIC No• (713) 350-6395 F N._ (713)314-3443 E D ASS csm!th@inS u .net INSUR S AFFORDING COVERAGE NAICI) INSURERAAIG Specialty Insurance Company 26883 INSURED Industrial, Transportation Waste, LLC Enviro Waste Solutions LLC 2300 Highway 365, Suite 400 Nederland TX 77627 INSURERB:Texas Mutual Insurance CompgRy 22945 INSURER CArgonaut Insurance Company 19801 INSURERD:CO=erCe & industry Insurance INSURERE: INSURER : rrn%1=onr_ca CERTIFICATE NUMRFR,CL1571371748 REVISION NUMBER: vTHIS +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 NTH 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. ILTSRR TYPE OF INSURANCE ADDL sUBR POLICY NUMB POLICY EFF POLICY EXP MT DO LIMITS X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-CLAIMS-MEo OCCUR DAMAGE TO RENTED PREMISES Ea occurrence) $ 1000000 X MED EXP (Arty one person) $ 25,000 Contractors Pollution EGIS434438 7/10/2015 7/18/2016 PERSONALBADVINJURY $ 1,000,000 _ GEITL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMPIOPAGG $ 2,000,000 POLlCY� jEa [J LOC OTHER PILL Cvg D&Cvg ELimit $1,000,000 Each AUTOMOBILE LIABILITY CO aB1Idaar SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ D X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS ANON-OWNEDPROPERTY X MSC90 CA6061933 7/18/2015 7/18/2016 BODILY INJURY (Per accident) $ DAMAGE er acc d $ I Medics( Payments $ UMBRELLALIAB XCLAIMS-MADEJ OCCUR EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10 000 000 X EXCESS LIAe DED RETENTION$ $ BGW-5434439 7/18/2015 7/18/2016 B C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROP JETORfPARTNF_R/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? a (Mandatory in NH) MIA TX: TSF-OU01284954 w/USLH LA: WC928008401074 w/USLH 3/21/2015 3/21/2015 3/21/2016 3/21/2016 X PTATUTE Eft ML EACH ACCIDENT $ 1,000 000 E.L DISEASE - EA EMPLOYE $ 1, 000 , 000 E,L DISEASE- POLICY LIMIT $ 1 000 0.00 "yes, descdbe under DESCRIPTI OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is rerluired) SEE ATTACHED COVERAGE PROVISIONS. f city Of Beaumont. P.O. Boat 3827 Beaumont, TX 77704-3827 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 Hochman/KM04 V iaoo-cva•tr�rvnai�.v,wrv,.�.........�.,...y..«............,._. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD i rogwn tonannai COMMENTS/REMARKS X, C, U is not excluded on the referenced CGL/CPL policy. 1- OFREMARK COPYRIGHT 2000, AMS SERVICES INC_ I Additional Named Insureds Other Named Insureds Solutions, LLC Limited Liability Company Industrial Logistics I OFAPPINF (02/2007) 1 COPYRIGHT 2007, AMS SERVICES INC I COMMENTS/REMARKS CGL & POLLUTION LEGAL LIABILITY (Cvg A, B, C, E) includes but is not limited to: The assignment of additional insured when required by written contract per the terms & conditions of the policy; Contractual Liability under the exception to the exclusion and thepolicy definition of "Insured Contract"; Primary & Non-contributory & assignment of Waiver of Subrogation provisions when required by written contract per the terms & conditions of the policy; 30 Day Notice of Cancellation (except 10 days for nonpayment of premium) to the certificate holder will be provided when required by written contract. CONTRACTORS POLLUTION LIABILITY - CVG E: Does Not Exclude Sudden & Accidental Pollution and Includes Cvg E-4: Transportation of Cargo AUTO LIABILITY includes but is not limited to: Assignment as an additional "insured" as required by contract per the terms & conditions of the policy. Waiver of Subrogation as required by written contract per the terms & conditions of the policy. Al coverage form is primary for any liability assumed under an "insured contract" per the terms & conditions of the policy. - 30 Day Notice of Cancellation (except 10 days for nonpayment of premium) to the certificate holder will be provided when required by written contract. WORKERS COMPENSATION includes but is not limited to: BLANKET Waiver of Subrogation as required by written contract per the terms & conditions of the policy. Assignment of Alternate Employer where required by written contract. 30 Day Notice of Cancellation (except 10 days for nonpayment of premium) to the certificate holder will be provided when required by written contract. EXCESS LIABILITY is a Follow Form policy and provides the terms and conditions included on the scheduled underlying liabilities, per the terms & conditions of the policy: CGL/CPL AL EL 30 Day Notice of Cancellation (except 10 days for nonpayment of premium) to the certificate holder will be provided when required by written contract. CONTRACTORS EQUIPMENT: Hanover Insurance Company 7/18/2015 - 7/18/2016 Policy #IHD847527210 Equipment Leased or Rented from others: $600,000 maximum per occurrence $400,000 maximum per item OFREMARK COPYRIGHT 2000, AMS SERVICES INC. COMMERCIAL GENERAL LIABILITY POLLUTION LEGAL LIABILITY necessary litigation expenses incurred by us in connection with such defense and necessary, litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of paragraph 2.b.(2) of SECTION I - COVERAGES, COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY or paragraph 2.b. (2) of SECTION I - COVERAGES, COVERAGE E ADDITIONAL POLLUTION LEGAL LIABILITY, such payments will not be deemed to be damages for bodily injury and property damage and, under Coverage E, environmental damage and will not reduce the limits of insurance. Our obligation to defend an insured's indemnitee and to pay for attorneys' fees and necessary litigation expenses as Supplementary Payments ends When: a. We have used up the applicable limit of insurance in the payment of judgments or settlements; or b_ The conditions set forth above, or the -terms of the agreement described in paragraph 2f. above, are no longer met SECTION 11 - WHO IS AN INSURED Applicable to Coverages A, B, C and E Each of the following is an insured under Coverages A, B, C and E: 1. If you are designated in the Declarations as: a. An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, you are an insured. Your members, your partners, and their spouses are also insureds, but only with respect to the conduct of your business. c. A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. d. An organization other than a partnership, joint venture or limited liability company, you are an insured. Your executive officers and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. 2. Each of the following is also an insured: Your volunteer workers only while performing duties related to the conduct of your business or your employees, other than either your executive officers (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these employees or volunteer workers are insureds for: (1) Bodily injury or personal and advertising injury: (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company); (b) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraphs (1)(a) above; or (c) Arising out of his or her providing or failing to provide professional health care services, except as respects any physician, dentist, nurse, emergency medical technician or paramedic who is employed by you to provide such services, provided you are not engaged in the business of providing such seances. 103124 (05/14) C 15506 Page 23 of 46 (2) Property damage or environmental damage to property: (a) Owned, occupied or used by, (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by you, any of your employees, volunteer workers, any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). b. Any person (other than your employee or volunteer worker) or any organization while acting as your real estate manager. c. Any person or organization having proper temporary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this Policy. e. Any subsidiary, associated, affiliated or allied company or corporation, including subsidiaries thereof, of which you have more than 50% ownership interest as of the inception date of this Policy. 3. Any organization you newly acquire or form, other than a partnership, joint venture, or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only (a) until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier, (b) provided that you give us written notification within 180 days of the date of such acquisition or formation or before the end of the policy period, whichever is earlier, and (c) an additional premium to be charged at our discretion, determined by the rates utilized at policy inception, is paid when due; b. Coverages A and E do not apply to bodily injury, property damage, environmental damage or emergency response costs that occurred before you acquired or formed the organization; and c. Coverage B does not apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization. 4. Any person or organization, other than a third party carrier, with whom you agreed to include as an insured, because of a written contract, written agreement or permit, but only with respect to bodily injury, property damage, environmental damage, emergency response costs or personal and advertising injury caused, in Mole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf, arising out of your operations, your work, equipment or premises leased, rented or owned by you, or your products which are distributed or sold in the regular course of a vendor's business, however: As respects vendors, this insurance does not apply to: a. Bodily injury, property damage, environmental damage or emergency response costs for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. Any express warranty unauthorized by you; 103124 (05/14) Page 24 of 46 C15506 c. Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e. Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; f. Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or h. Bodily injury, property damage, environmental damage or emergency response costs arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to; (1) The exceptions contained in Sub -paragraphs d. or f. above; or (2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. As respects a manager or lessor of premises, a lessor of leased equipment, or a mortgagee, assignee, or receiver, this insurance does not apply to: (a) Any occurrence which takes place after the equipment lease expires or you cease to be a tenant (b) Structural alterations, new construction or demolition operations performed by or on behalf of the manager or lessor of premises, or mortgagee, assignee, or receiver. 5. Any person or organization that has at least a 50% controlling interest in you but only with respect to bodily injury, property damage, environmental damage, emergency response costs or personal and advertising injury caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf, arising out of their financial control of you. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture, or limited liability company unless a current or past partnership, joint venture, or limited liability company is an insured pursuant to paragraphs 1. through 5. above. Applicable to Coverage D Each of the following is an insured under Coverage D: The Named Insured designated in the declarations and any past or present director, officer, partner, member or employee thereof, while acting within the scope of his or her duties as such and any customer with whom you have agreed in writing to include, prior to a claim being made or loss being incurred with respect to such customer, as an insured for loss arising from your storage, handling, treatment, processing or disposal of their product or waste on any insured property. SECTION III - LIMITS OF INSURANCE AND DEDUCTIBLE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of: a. Insureds; 103124 (06/14) Page 25 of 46 C15506 4. Other Insurance Applicable to Coverages A, B and E If other valid and collectible insurance is available to the insured for damages or loss we cover under Coverages A, B or E of this Policy, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in c. below. However, regardless of whether b. below applies, in the event that a written contract or agreement or permit requires this insurance to be primary for any person or organization with whom you agreed to insure and such person or organization is an insured under this policy, we will not seek contributions from any such other insurance issued to such- person or organization. b. Excess Insurance This insurance is excess over: (1) Any of the other insurance, whether primary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for your work; (b) That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner; (c) That is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you or temporarily occupied by you with permission of the owner; or (d) If the damages or loss arises out of the maintenance or use of aircraft, autos or watercraft to the extent not subject to Exclusion g. of Coverage A. (2) Any other insurance available to you covering liability for damages arising out of the premises or operations for which you have been added as an additional insured by attachment of an endorsement.. When this insurance is excess, we will have no duty under Coverage A, B or E to defend the insured against any suit if any other insurer has a duty to defend the insured against that suit. if no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights .against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the damages or loss, if any, that exceeds the sum of: (1) The total amount that all -such other insurance would pay for the damages or loss in the absence of this insurance; and (2) The total of all deductible and self -insured amounts under all that other insurance. We will share the remaining damages or loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Policy. c. Method of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this 103124 (05/14) Page 30 of 46 C15506 ENDORSEMENT NO. 11 This endorsement, effective 12:01 AM, July 18, 2015 Forms a part of Policy No: EG 15434438 Issued to: INDUSTRIAL TRANSPORTATION WASTE, LLC By: AIG SPECIALTY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY_ AGAINST OTHERS TO US ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY AND POLLUTION LEGAL LIABILITY COVERAGE FORM It is hereby agreed as follov�s: SECTION IV - CONDITIONS, Paragraph 7. Transfer of Rights of Recovery Against Others to Us - Applicable to Coverages A, B, C and E is amended by the addition of the following at the end of such subparagraph: We waive any right of recovery we may have against the person or organization shown in the Schedule below because of payments we make under Coverage A, B, C and E for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products -completed operations hazard. This waiver applies only to the person or organization shown in the Schedule below. SCHEDULE Name of Person or Organization: BLANKET WHERE REQUIRED BY WRITTEN CONTRACT EXECUTED PRIOR TO CLAIM OR LOSS. All other terms, conditions, and exclusions shall remain the same. I AUTHORIZED REPRESENTATIVE or countersignature (in states where applicable) 94283 (3/07) PAGE 1. OF 1 C13021 ENDORSEMENT NO. 10 This endorsement, effective 1201 AM, July 18, 2015 Forms a part of Policy No.: EG 15434438 Issued to: INDUSTRIAL TRANSPORTATION WASTE, LLC By: AIG SPECIALTY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED ADVICE OF CANCELLATION TO ENTITIES OTHER THAN THE NAMED INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY AND POLLUTION LEGAL LIABILITY COVERAGE FORM It is hereby agreed that the following is added to SECTION IV - CONDITIONS: In the event that we cancel this Policy for any reason other than non-payment of premium, and 1. the cancellation effective date is prior to this Policy's expiration date; 2. you are under an existing contractual obligation to notify a certificate holder when this Policy is canceled (hereinafter, the "Certificate Holder(s)") and have provided to us, either directly or through your broker of record, the email address of a contact at each such entity; and 3. we received this information after you received notice of cancellation of this Policy and prior to this Policy's cancellation effective date, via an electronic spreadsheet that is acceptable to us, we will provide advice of cancellation (the "Advice") via e-mail to each such Certificate Holders within 30 days after you provide such information to us. Proof of our emailing the Advice, using the information provided by you, will serve as proof that we have fully satisfied our obligations under this Endorsement. This Endorsement does not affect, in any way, coverage provided under this Policy or the cancellation of this Policy or the effective date thereof, nor shall this Endorsement invest any rights in any entity not insured under this Policy. Al other terms, conditions, and exclusions shall remain the same. n 1 AUTHORIZED REPRESENTATIVE or countersignature (in states inhere applicable) 109821(9111) PAGE 1 OF 1 C 15040 AUTO LIABILITY 1g Mobile Equipment Only those "autos" that are land vehicles and that would qualify under the Subject To definition of "mobile equipment" under this policy if they were not subject Compulsory Or to a compulsory or financial responsibility law or other motor vehicle Financial insurance law where the are licensed or principally Responsibility y P P y garaged. Or Other Motor Vehicle Insur- ance Law Only B. Owned Autos You Acquire After The Policy Begins 1. If Symbols 1, 2, 3, 4, 5, 6 or 19 are entered next to a coverage in Item Two of the Decla- rations, then you have coverage for "autos" that you acquire of the type described for the remainder of the policy period. 2. But, if Symbol 7 is entered next to a coverage in Item Two of the Declarations, an "auto" you acquire will be a covered .auto" for that coverage only if: a. We already cover all "autos" that you own for that coverage or it replaces an "auto" you previously owned that had that coverage; and b. You tell us within 30 days after you acquire it that you want us to cover it for that coverage. C. Certain Trailers, Mobile Equipment And Temporary Substitute Autos If Covered Autos Liability Coverage is provided by this Coverage Form, the following types of vehicles are also covered "autos" for Covered Autos Liability Coverage: 1. 'Trailers" with a load capacity of 2,000 pounds or less designed primarily for travel on public roads. 2. "Mobile equipment" while being carried or towed by a covered "auto".' 3. Any "auto" you do not own while used with the permission of its owner as a temporary substitute for a covered "auto" you own that is out of service because of its: a. Breakdown; b. Repair; c. Servicing; d. "Loss"; or e. Destruction. SECTION 11 — COVERED AUTOS LIABILITY COVERAGE A. Coverage We will pay all sums an "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, caused by an "accident" and resulting from the ownership, maintenance or use of a covered "auto". expense" to which this insurance applies, caused by an "accident" and resulting from the ownership, maintenance or use of covered "autos". However, we will only pay for the "covered pollution cost or expense" if there is either "bodily injury" or "property damage" to which this insurance applies that is caused by the same "accident". We have the right and duty to defend any "insured" against a "suit" asking for such damages or a "covered pollution cost or expense". However, we have no duty to defend any "insured" against a "suit" seeking damages for "bodily injury" or "property damage" or a "covered pollution cost or expense" to which this insurance does not apply. We may investigate and settle any claim or "suit" as we consider appropriate. Our duty to defend or settle ends when the Covered Autos Liability Coverage Limit of Insurance has been exhausted by payment of judgments or settlements. 1. Who 1s An Insured The following are "insureds": a. You for any covered "auto". b. Anyone else while using with your permission a covered "auto" you own, hire or borrow except: (1) The owner or anyone else from whom you hire or borrow a covered "auto This exception does not apply if the covered "auto" is a "trailer" connected to a covered "auto" you own. (2) Your "employee" if the covered "auto" is owned by that "employee" or a member of his or her household. (3) Someone using a covered "auto" while he or she is working in a busi- ness of selling, servicing, repairing, parking or storing "autos" unless that business is yours. (4) Anyone other than your "employ- ees", partners (if you are a partner- ship), members (if you are a limited liability company) or a lessee or borrower or any of their "em- ployees", while moving property to or from a covered "auto"_ We will also pay all sums an "insured" legally (5) A partner (if you are a partnership) or must pay as a "covered pollution cost or a member (if you are a limited liability Page 2 of 11 0 Insurance Services Office, inc., 2011 CA 00 01 10 13 ❑ company) for a covered "auto" owned by him or her or a member of his or her household. c. Anyone liable for the conduct of an "insured" described above but only to the extent of that liability. 2. Coverage Extensions a. Supplementary Payments We will pay for the "insured": (1) All expenses we incur. (2) Up to $2,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (3) The cost of bonds to release attach- ments in any "suit" against the "insured" we defend, but only for bond amounts within our Limit of Insurance. (4) All reasonable expenses incurred by the "insured" at our request, in- cluding actual loss of earnings up to $250 a day because of time off from work. (5) All court costs taxed against the "insured" in any "suit" against the "insured" we defend. However, these payments do not include attorneys' fees or attorneys' expenses taxed against the "insured". (6) All interest on the full amount of any, judgment that accrues after entry of the judgment in any "suit" against the "insured" we defend, but our duty to pay interest ends when we have paid, offered to pay or depos- ited in court the part of the judgment that is within our Limit of Insurance. These payments will not reduce the Limit of Insurance. b. Out-of-state Coverage Extensions While a covered "auto" is away from the state where it is licensed, we will: (1) Increase the Limit of Insurance for Covered Autos Liability Coverage to meet the limits specified by a compulsory or financial responsibility law of the jurisdiction where the covered "auto" is being used. This extension does not apply to the limit or limits specified by any law governing motor carriers of passengers or property. (2) Provide the minimum amounts and types of other coverages, such as no-fault, required of out-of-state vehi- cles by the jurisdiction where the covered "auto" is being used. We will not pay anyone more than once for the same elements of loss because of these extensions. B. Exclusions This insurance does not apply to any of the following: 1. Expected Or Intended Injury "Bodily injury" or "property damage" ex- pected or intended from the standpoint of the "insured". 2. Contractual Liability assumed under any contract or agreement. But this exclusion does not apply to liability for damages: a. Assumed in a contract or agreement that is an "insured contract", provided the "bodily injury" or "property damage" occurs subsequent to the execution of the contract or agreement; or b. That the "insured" would have in the absence of the contract or agreement. 3. Workers' Compensation Any obligation for which the "insured" or the "insured's" insurer may be held liable under any workers' compensation, disability benefits or unemployment compensation law or any similar law. 4. Employee Indemnification And Employer's Liability "Bodily injury" to: a. An "employee" of the "insured" arising out of and in the course of: (1) Employment by the "insured or (2) Performing the duties related to the conduct of the "insured's" business; or b. The spouse, child, parent, brother or sister of that "employee" as a conse- quence of Paragraph a. above. This exclusion applies: (1) Whether the "insured" may be liable as an employer or in any other capacity; and (2) To any obligation to share damages with or repay someone else who must pay damages ' because of the injury. But this exclusion does not apply to "bodily injury to domestic "employees" not entitled to workers' compensation benefits or to liability assumed by the "insured" under an "insured contract". For the purposes of the Coverage Form, a domestic "employee" is a person engaged in household or domestic work performed principally in connection with a residence premises. CA 00 01 10 13 0 Insurance Services Office, Inc., 2011 Page 3 of 11 0 POLICY NUMBER: CA 606-19-33 COMMERCIAL AUTO CA 04 44 10.13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) 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: INDUSTRIAL TRANSPORTATION WASTE, LLC Endorsement Effective Date: 07/18/2015 SCHEDULE Name(s) Of Person(s) Or Organization(s): WHERE REQUIRED BY CONTRACT OR AGREEMENT I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. r CA 04 44 10 13 0, Insurance Services Office, Inc., 2011 Page 1 of 2 0 The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. Page 2 of 2 0 Insurance Services Office, Inc., 2011 CA 04 44 10 13 0 ENDORSEMENT # This endorsement, effective 12:01 A.M. 07/18/2015 forms a part of Policy No. CA 606-19-33 issued to INDUSTRIAL TRANSPORTATION WASTE, LLC Sy COMMERCE AND INDUSTRY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED ADVICE OF CANCELLATION TO ENTITIES OTHER THAN THE FIRST NAMED INSURED This policy is amended as follows: In the event that the Insurer cancels this policy for any reason other than non-payment of premium, and 1. the cancellation effective date is prior to this policy's expiration date; 2. the First Named Insured is under an existing contractual obligation to notify a certificate holder when this policy is canceled (hereinafter, the "Certificate Holder(s)") and has provided to the Insurer, either directly or through its broker of record, either: (a) the name of the entity shown an the certificate, a contact name at each such entity and the U.S. Postal Service address of each such entity; or (b) the email address of a contact at each such entity; and 3. the insurer received this information after the First Named Insured receives notice of cancellation of this policy and prior to this policy's cancellation effective date, via an electronic spreadsheet that is acceptable to the Insurer, the Insurer will provide advice of cancellation (the "Advice") to such Certificate Holders within _3Q days after the First Named Insured provides such information to the Insurer; provided, however, that if a'specific number of days is not stated above, then the Advice will be provided to such Certificate Holder(s) as soon as reasonably practicable after the First Named Insured provides such information to the Insurer. Proof of the Insurer emailing or mailing the Advice, using the information provided by the First Named Insured, will serve as proof that the Insurer has fully satisfied its obligations under this endorsement. This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or the effective date thereof, nor shall this endorsement invest any rights in any entity not insured under this policy. The following Definitions apply to this endorsement: 1. First Named Insured means the Named Insured shown on the Declarations Page of this policy. 2. Insurer means the insurance company shown in the header on the Declarations Page of this policy. All other terms, conditions and exclusions shall remain the same. 4r) (,/,) Authorized Representative 107232 (03/1 1) Page 1 FORM MCS-90 Revised 08/27/2013 OMB No.: 2126-0008 Expiration: 06/30/2016 FOR FMCSA USE ONLY I Docket Number: A Federal Agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this Information collection is 212"008. Public reporting for this collection of information is estimated to be approximately 2 minutes per response, including the time for reviewing instructions, gathering the data needed, and completing and reviewing the collection of information. All responses to this collection of Information are mandatory_ Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal Motor Carrier Safety Administration, MC-RRA, Washington, D.C. 20590. United -States Department of Transportation �r Federal Motor Carrier Safety Administration Endorsement for Motor Carrier Policies of insurance for Public Liability under Sections 29 and 30 of the Motor Carrier Act of 1980 FORM MCS-90 issued to _INDUSTRIAL TRANSPORTAT i ON WASTE, LLC of 2300 HIGHWAY 365 SUITE 400 NEDERLAND, TX 77627 (Motor Carrier name! (Motor Carrier state) Dated at 175 WATER STREET, NEW YORK, NY 10038 on this 17TH day of JULY . 2015 Amending Policy Number: CA 6061933 Effective Date 07/18/2015 Name of Insurance Company Countersigned by: (authorized company representative) The policy to which this endorsement is attached provides primary or excess insurance, as indicated for the limits shown (check only one)- This Insurance is primary and the company shall not be liable for amounts in excess of $ 1 , 000 , 000 for each accident. This insurance is excess and the company shell not be liable for amounts in excess of $ for each accident In excess of the underlying limit of S for each accident. Whenever required by the Federal Motor Carrier Safety Administration (FMCSA), the company agrees to furnish the FMCSA a duplicate of said policy and all its endorsements. The company also agrees, upon telephone request by an authorized representative of the FMCSA, to verify that the policy Is in force as of a particular date. The telephone number to call is: 212-458-5000. Cancellation of this endorsement may be effected by the company or the insured by giving (1) thirty-five (35) days notice in writing to the other party (said 35 days notice to commence from the date the notice is mailed, proof of mailing shall be sufficient proof of notice), and (2) if the insured is subject to the FMCSA's registration requirements under 49 U.S.C. 13901, by providing thirty (30) days notice to the FMCSA (said 30 days notice to commence from the date the notice is received by the FMCSA at its office in Washington, D.C.). )EFINITIONS AS USED IN THIS ENDORSEMENT Accident includes continuous or repeated exposure to conditions which results in bodily injury, property damage, or environmental damage which the insured neither expected nor intended. Motor Vehicle means a land vehicle, machine, truck, tractor, trailer, or semitrailer propelled or drawn by mechanical power and used on a highway for transporting property, or any combination thereof. Bodily Injury means injury to the body, sickness, or disease to any person, including death resulting from any of these. Property Damage means damage to or loss of use of tangible property. Environmental Restoration means restitution for the loss, damage, or destruction of natural resources arising out of the accidental discharge, dispersal, release or escape into or upon the land, atmosphere, watercourse, or body of water, of any commodity transported by a motor carrier. This shall include the cost of removal and the cost of necessary measures taken to minimize or mitigate damage to human health, the natural environment, fish, shellfish, and wildlife. Public Liability means liability for bodily injury, property damage, and environmental restoration. (continued on next page) Form MCS-90 (page 1 of 2) =ORM MCS-90 Revised 08/27/2013 The insurance policy to which this endorsement is attached provides automobile liability insurance and is amended to assure compliance by the insured, within the limits stated herein, as a motor carrier of property, with Sections 29 and 30 of the Motor Carrier Act of 1980 and the rules and regulations of. the Federal Motor Carrier Safety Administration (FMCSA). In consideration of the premium stated in the policy to which this endorsement is attached, the insurer (the company) agrees to pay, within the limits of liability described herein, any final judgment recovered against the insured for public liability resulting from negligence in the operation, maintenance or use of motor vehicles subject to the financial responsibility requirements of Sections 29 and 30 of the Motor Carrier Act of 1980 regardless of whether or not each motor vehicle is specifically described in the policy and whether or not such negligence occurs on any route or in any territory authorized to be served by the insured or elsewhere. Such insurance as is afforded, for public liability, does not apply to injury to or death of the insured's employees while engaged in the course of their employment, or property transported by the insured, designated as cargo. It is understood and agreed that no condition, provision, stipulation, or limitation contained in the policy, this endorsement, or any other endorsement thereon, or violation there - SCHEDULE OF LIMITS -PUBLIC LIABILITY OMB No.: 2126-0008 Expiration: 06/30/2016 of, shall relieve the company from liability or from the payment of any final judgment, within the limits of liability herein described, irrespective of the financial condition, insolvency or bankruptcy of the insured. However, all terms, conditions, and limitations in the policy to which the endorsement is attached shall remain in full force and effect as binding between the insured and the company. The insured agrees to reimburse the company for any payment made by the company on account of any accident, claim, or suit involving a breach of the terms of the policy, and for any payment that the company would not have been obligated to make under the provisions of the policy except for the agreement contained in this endorsement. i It Is further understood and agreed that, upon failure of the company to pay any final judgment recovered again the insured as provided herein, the judgment creditor may maintain an action in any court of competent jurisdiction against the company to compel such payment. The limits of the company's liability for the amounts prescribed in this endorsement apply separately to each accident and any payment under the policy because of any one accident shall not operate to reduce the liability of the company for the payment of final judgments resulting from any other accident. Type of carriage Commodity transported January 1, 1985 (1) For -hire (In interstate or foreign commerce, with a Property (nonhazardous) $ 750,000 gross vehicle weight rating of 10,000 or more po- unds). (2) For -hire and Private (In interstate, foreign or intr- Hazardous substances, as defined in 49 CFR 171.8, astate commerce, with a gross vehicle weight ra- ting transported in cargo tanks, portable tanks, or hopper- $ 5,000,000 of 10,000 or more pounds). type vehicles with capacities In excess of 3,500 water gallons; or in bulk Division 1.1., 1.2, and 1.3 materials. Division 2.3, Hazard Zone A, or Division 6.1, Packing Group I, Hazard Zone A material; in bulk Division 2.1 or 2.2; or highway route controlled quantities of a Class 7 material, as defined in 49 CFR 173.403_ (3) For -hire and Private (In interstate or foreign com- Oil listed in 49 CFR 172.101; hazardous waste, haz- g 11000,000 merce, in any quantity, or in intrastate commerce, in ardous materials, and hazardous substances defined in bulk only; with a gross vehicle weight rating of 10,000 49 CFR 171.8 and listed in 49 CFR 172.101, but not or more pounds). mentioned in (2) above or (4) below. (4) For -hire and Private (In interstate or foreign Any quantity of Division 1.1, 1.2, or 1.3 material; any commerce, with a gross vehicle weight rating of less quantity of a Division 2.3, Hazard Zone A, or Division $ 5,000,000 than 10,000 pounds). 6.1, Packing Group 1, Hazard Zone A material; or high- way route controlled quantities of a Class 7 material as defined in 49 CFR 173.403. *The schedule of limits shown does not provide cover- age.The limits shown in the schedule are for infor- mation purposes only. Form MCS-90 (page 2 of 2) WORKERS COMPENSATION EMPLOYERS LIABILITY 1 Ti WORKERS'COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY ine uranceC'=pW WC 42 03 04 B TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. Schedule I- ( ) Specific Waiver Name of person or organization ( X ) Blanket Waiver Any, person or organization for whom the Named Insured has agreed by written contract to fumish this waiver. 2. Operations: ALL TEXAS OPERATIONS 3. Premium The premium charge for this endorsement shall be 2.130 percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Advance Premium INCLUDED, SEE INFORMATION PAGE. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on at 12-01 A.M. standard time, forms a part of Policy No. TSF-0001284954 20150321 of the Texas Mutual Insurance Company Issued to INDUSTRIAL TRANSPORTATION WASTE LLC Premium $ NCCI Carrier Code 29939 Endorsement No. Authorized Representative WC42030413(ED. 6-01 2014) INSURED'S COPY QUSER 3-24-2015 WORKERS COMPENSA'OON AND EMPLOYERS LIABILITY INSURANCE POLICY we 00 03 is (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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 rewires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Blanket - la Where recluired by written contract. I This endor-sement changes the policy to which it Is attached and is effective on the date issued unless otherwise stated. (ihe information below is required only when this endorsement Is towed eubsequent to preparation of the policy.) Endorsement Effective Elate:03/21/2015 Policy No, WC 928008401074 Endorsement No. Policy Effective Date: 03/21/2015 to 03/21/2016 Premium § Insured. nMUSTRYAT TRANSPORTATION WASTE LLC DBA: CarderName/ Code: Argonaut insurance Company WC 00 03 13 Countersigned by (Ed. 4-84) 0IM Nidluner Council on Cornpun gon rnaurmice. Page 1 of 1 EXCESS LIABILITY AIG SPECIALTY INSURANCE COMPANY COMMERCIAL EXCESS FOLLOW FORM CERTAIN PROVISIONS IN THIS POLICY RESTRICT COVERAGE. READ THE ENTIRE POLICY CAREFULLY TO DETERMINE YOUR RIGHTS AND DUTIES, AND WHAT IS AND IS NOT COVERED. NOTICE: THE DESCRIPTIONS IN ANY HEADINGS OR SUB -HEADINGS OF THIS POLICY ARE INSERTED SOLELY FOR CONVENIENCE AND DO NOT CONSTITUTE ANY PART OF THE TERMS OR CONDITIONS HEREOF. Throughout this Policy the words "you" and "your" refer to the Named Insured shown in the Declarations and any other person or organization qualifying as a Named Insured under this Policy. The words "we", "us" and "our" refer to the Company providing this insurance. The word "insured" means any person or organization qualifying as .such in underlying insurance. Defined terms, other than headings, appear in bold face type. Refer to SECTION VII - DEFINITIONS. This Policy is issued in reliance upon the statements in the Application, deemed to be annexed hereto. In consideration of the payment of the premium and pursuant to all of the terms and conditions of this Policy, we agree to provide coverage as follows: SECTION I - INSURING AGREEMENTS COVERAGE A - EXCESS FOLLOWING FORM LIABILITY A. We will pay on behalf of the insured, when the total applicable limits of underlying insurance have been exhausted by payment of losses thereunder, those sums that the insured becomes legally obligated to pay as damages by reason of exhaustion of all applicable underlying insurance limits because of bodily injury, property damage, personal injury, advertising injury, environmental damage, emergency response costs, cleanup costs or loss to which this insurance applies, due to: 1. Liability imposed upon the insured by law, or 2. Liability, assumed by the insured under an insured contract. B. The amount we will pay for damages is limited as described in SECTION IV - LIMITS OF INSURANCE. C. This Policy applies to bodily injury, property damage, personal injury, advertising injury, environmental damages, emergency response costs, cleanup costs or foss only if and to the extent covered by underlying insurance. The insurance afforded under this Policy is subject to the insuring agreements, exclusions, definitions and conditions contained in the underlying insurance in effect on the inception date of this Policy, except as to premium, duty to defend, limits of liability and notice, and except as to any other provisions in this Policy inconsistent with those in the underlying insurance. To the extent such provisions alter or conflict, the provisions of this Policy will control. COVERAGE B - CRISISRESPONS?AND CRISIS MANAGEMENT A. Advancement of CrisisResponse° Costs during a Crisis Management Event We will pay CrisisResponse costs on your behalf that may be associated with damages covered by this NOTICE: THIS INSURER IS NOT LICENSED IN THE STATE OF NEW YORK AND IS NOT SUBJECT TO ITS SUPERVISION 105616 (11/13) Copyright, American International Group, Inc., 2010. All rights reserved. Page 1 of 13 C 15344 ENDORSEMENT NO. 12 This endorsement, effective 12:01 AM, July 18, 2015 Forms a part of Policy No: EGU 15434439 Issued to: INDUSTRIAL TRANSPORTATION WASTE, LLC By: AIG SPECIALTY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED ADVICE OF CANCELLATION TO ENTITIES OTHER THAN THE NAMED INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL EXCESS FOLLOW FORM POLICY It is hereby agreed that the following is added to SECTION VI - CONDITIONS: In the event that we cancel this Policy for any reason other than non-payment of premium, and 1. the cancellation effective data is prior to this Policy's expiration date; 2. you are under an existing contractual obligation to notify a certificate holder when this Policy is canceled (hereinafter, the "Certificate Holder(s)") and have provided to us, either directly or through your broker of record, the email address of a contact at each such entity; and 3. wa received this information after you receive notice of cancellation of this Policy and prior to this Policy's cancellation effective date, via an electronic spreadsheet that is acceptable to us, we will provide advice of cancellation (the "Advice") via e-mail to each such Certificate Holders within 30 days after you provide such information to us. Proof of our emailing the Advice, using the information provided by you, will serve as proof that we have fully satisfied our obligations under this Endorsement This Endorsement does not affect in any way, coverage provided under this Policy or the cancellation of this Policy or the effective date thereof, nor shall this Endorsement invest any rights in any entity not insured under this Policy. All other terms, conditions and exclusions shall remain the same. _-�ffDL AUTHORIZED REPRESENTATIVE or countersignature (in states where applicable) 109822 (9/11) PAGE 1 OF 1 C 15037 12-5q 16 ' Fomn No. C091 Edition Date., 12112/2o12 Page t of 3 CERTIFICATE OF INSURANCE s This _form is for informational purposes only and certifies that policies of insurance listed below have been issued to insured named below and are in force at this time. Not withstanding any requirements, term or condition of any contract or other dacurnent with respect to which this certificate maybe Issued or may pertain, insurance afforded by policies described herein is subject to all terms, exclusions and conditions of such policies. Prior to the beginning of work, the vendor shall obtain the minimum Insurance and endorsements specified. Agents must complete the form providing all requested information and submit by fax, U.S. mail or e-mail as requested bythe City of Beaumont (°COBS). The endorsements listed below are required as attachments to this certiftate; copies of the endorsements are also acceptable. PLEASE ATTACH ALL ENDORSEMENTS TO THIS FORM AND INCi_UDE THE MATCHING POLICY NUMBER ON THE ENDORSEMENT. Only City of Beaumont certificates of insurance are acceptable; commercial carriers' certificates are not. This certificate shall be oompleted by a licensed insurance agent: Name and Address of Agency: City of Beaumont Reference: Insgroup, Inc. Pro)ect Name: 1455 west Loop south, 9th Floor Pmlect location: Houston, TX 77027 Phone: 713 s41-7272 Managing Dept.: ProJect Mgr,: Name and Address of Insured: Industrial Transportation Waste, LLC 2300 Highway 365, Suite 400 Nederland, TX 77627 Phone: 409 / 722-6880 Prime or Sub -Contractor?: Insurers Afforel),Ing_Coverages: Insurer A: AIG Specialty Insurance Company Insurer B: Texas Mutual Insurance Company Insurer C: Argonaut Insurance Company Name of Prime Contractor, If different from Insured: Insurer D:. Commerce & Industry Insurance commercial General Each Occurrence $1, 0 0 0, 0 0 0 A Liability Policy G154344 7/18/2015 7/18/2016 GeneralAggragate $2,000,000 Asdeftnedinthe Poky, does the Poricy provide: g8 #§ Yes 13 No — Completed OperatiorW12foduots Completed Operations/ $2 , 000, 000 Products Aggregate Yes ❑ No — Contractual I,Iabilly Personal &Advertising $11000, 000 Injury t9 p No Explosion InsbRlon ; $Cvg D1-D2:Yes Insured Cvg El-E4 : $ TEXAS DEPT. OF I]NSURANC:E AUSTir4, TEXAS APPROVES cto 9 7 9nTl ;25, 00 0,000 Form No. COBI Edition Data: 12112/2D12 Page 2 of 3 Yes El No — Collapse Yes 0 No — Undarground Yes El No — Contractors/Subcontractors Work Yes 0 No — Aggregate Limits per Project Form CG 2503 Yes 0 No — Additional Insured Form — CG 2010 Coverage provided with,.n the policy form :C Yes 0 No — 30 Day Notice of Cancalleflon Form - CG 0205 COvemqd provid ad within the policy form a Yes 0 No — Waiver of 5ubrcgation Form - CG 2404 coverage provided w: thin the policy f orm Pollution I Envimrunental EG154344 7/IB/2015 7/18/2016 OccurrenceD $1,000,CO �1 nnn -F 0 Impahrrient Policy CPL $2,QOQ,000 38 eta D Auto Liability PoUcyfin As deed In the Policy, CA6061933 7/18/2015 I 7/18/2016 C-SL $1,000,000 does the Policy provide: Bodily Injury S (Per Incident) 25 Yes CM — Any Auto Bodily Injury (Per Person) M Yes E3 No — All Owned Autos Property Damage (Per Accident) Yes 0 No — Mn-Owned Autos Yes 0 No Hired Autos Yin 0 No Waterer ol'Subrogation -CA0444 Yes 13 No 30 Day Notice of Cancellation - CA0244 0 Yes C1 No AddVional insured -=048COverage in provided within the policy form 6 Yes 0 No MCS so Excess liability Occurrence $10,000,000 0 Umbrella Foun EGMS4344 7/18/2015 7/18/2016 I M Follow Excess Liability39 Aggregate $10,000,000 Form I Workers Compans2don& TSF-OOD12 29 Statutory Employom Liability 84954 3121/2015 3/21/2DI6 As defined in the Policy, does to Policy provide Fach Aoddattt $1,000,000 OYes ONo — Waiver of8ubragatlon - WIC42033% ol'sona. Policy LIMIt $ 1,000,0DO 9YAs E]No — 30 Day Notice of Cancellation - W042DBol Disease - Each -$ 1,00(),00() Emotoyee Is a Builders Risk or Installation Insurance Policy provided? 0 Yes M No CI Yes 9 No — Is the Cft shown as Ions aeftnortgggee? Professional Liability Each claim $ As defined in the Policy, I T does the Polley provide- 0 Yes � No — M Day Notice of COnC01191110a Deductible or Self V Retroactive Date: Insured Retention DEPT. OF INSURANCE AUSTIN, TEXAS I 1 V1 Z� Form No. COBI Ed2lion Date: 12MV2092 Page 3 of 3 AGENT CERTIFICATION: THIS IS TO CERTII=Y TOTHE CITY OF BEAUMONT that the insurance policies above are in full force and effect. Name of Insurance Company, Insgroup, Inc. Name of Authorized Agent: Henry Hochman Company Address: 1455 West Loop South, 9th Floor AgerWa Address: 1455 West Loop South, 9th Floor City, Rouston State: TX zip; 77027 Cm,; Houston State: TX zip: 77027 Authorized Agent's Phone Number (including Area Code) 713-541-7272 Original I tore of Auth rite Agent X Date: b — CERTIFICATE HOLDER: DATE ISSUED: 10/08/201 City of Beaumont /- i1 . i, j P. O. Box 3827 ' AUTHORIZED -REPRESENTATIVE SIGNATURE Beaumont, Texas 77704-3827 Licensed Insurance Agent Printed Name:, I:t,(As I�fj�,IW flocKt� TEXAS DEFT. OF INSURANCl: AUSTIN, TEXAS APPROVEO FEB 2 7 9013