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OMNIPOINT (T-MOBILE) (2)
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OMNIPOINT (T-MOBILE) (2)
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Last modified
8/12/2019 11:29:24 AM
Creation date
3/13/2019 11:26:37 AM
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Template:
Contracts
Company Name
OMNIPOINT (T-MOBILE)
Contract #
A-2008-290-01
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Council Approval Date
11/17/2008
Expiration Date
9/20/2024
Insurance Exp Date
4/1/2020
Destruction Year
2029
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a� 20 CERTIFICATE OF LIABILITY INSURANCE <br />page 1 o£ 2 <br />03/29/28 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the poliey(ies) must have ADDITIONAL INSURED be <br />provisions or endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement <br />on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />!CONTACT <br />Willis of Pennsylvania, Inc. <br />c/o 26 Century Blvd. <br />PHONE <br />. 2LO.PXTr 877=9945_7378 .,, _J�g�,�0y 888-467-2378 <br />— <br />P. 0. Box 3IL <br />Nashville, TN 7230-5191 <br />TN 3 <br />--- <br />ADDRESS Ce=ti£ig8tee@Willie�c .m -._. .... <br />INSURE�)AFFORDINGCOVERAOE <br />INSURER A: Federal Insurance Company <br />�20281-005 <br />.. <br />INSURED ^^�� A� p +�� <br />Crown Castle International �JtJG L'�d y%!,Y <br />-- <br />INSURERS: Travelers Property CaBualty Co of Amer <br />25679-001 <br />See Attached Named Insured List <br />LINSURERC:Berkehire Hathaway Specialty Inrance Co <br />su <br />22276.001 <br />1220 Augusta Dr. Suite 600 <br />Houston, TX 77057 <br />--- <br />INSURER <br />INSURER E: <br />NSURERF: <br />GUVCKAULS CERTIFICATE NI IMRFR• a A t qA c al ecvrmnu unaaocre. <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSION_SAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY_ HAVE BEEN REDUCED BY PAID CLAIMS. <br />iN8R TYPE OFINSURANCE DOL <br />SURR POLICY NUMBER <br />POLICYEFF <br />_ <br />POLICYEXP� LIMITS <br />A lX COMMERCIALGENERAL LIABILITY Y Y 7021-02-26 <br />CLAIMS -MADE OCCUR <br />4/1/2016 <br />4/1/2019 EACH OCCURRENCE <br />.P�ruEJ(psEd�vaSPrgnce) <br />6_ 1.0 <br />S 1r000a000 <br />S 5.000 <br />MEDEXP(Anycrcepersan) <br />S �_0O oio 00 <br />GEN'LAGGREGATE LIMIT APPLIES PER: <br />' 1 PRO- <br />XPOLICY n JECT L-! LOC <br />OTHER: <br />PERSONAL$ADV INJURY _ _ <br />'GENERALAGGREGATE_ <br />PRODUCTS _CO ON- PAGG�S <br />$ 000 _ Q9S <br />S <br />S <br />AUTOMOBILE <br />LIABILITY Y .I Y!!TC2JCAP-474N9749TIL7814/l/2018 <br />ANY AUTO l <br />OWNED SCHEDULED <br />AUTOSONLY AUTOS l <br />HIRED NON OWNED <br />AUTOS ONLY AUTOSONLY I <br />4/1/2019 i, BINEoDSINGLE LIMIT <br />BODILY INJURY(Perpenan) <br />Y <br />IBODILY INJURY(PerauJd.Q <br />"7170PER MA <br />(pereccMent <br />jS 11000,000 <br />_X <br />I$ <br />- <br />'S <br />C <br />X] <br />UMBRELLA UAB I X I OCCUR Y Y 47-LI40-303445-02 <br />i4/1/2018 <br />4/1/2019 EACH OCCURRENCE <br />$ 5, QO0�000 <br />IS 5, 000 OQQ_._ <br />EXCESS LIAR CLAIMS-MAOE� <br />OED I X RETENTIONS 25,000 <br />AGGREGATE ._ <br />$ <br />® <br />B <br />woRXERs coMPENeAnoN I TRRUB-474N970-1-16 '4/1/2018 <br />ANDEMPLOYERS'UABIUTY YIN <br />ANY PROPRIETORIPARTNERIEXECUTIVE r'��i NIA Y TC2JVB-474N969-4-18 <br />OFFICERIMEMBER EXCLUDED? <br />IandatoZin NH) <br />ry <br />/l/2018 <br />4/1/2019 X�Ta t)�_ .I—�ER_ <br />4/1/2019 E.L EACH ACCIDENT <br />E.L. DISEASE -EA EMPLOYEE <br />_ <br />$ 1, 000, 000 <br />IS 1, 000, 000 <br />$ 11000,000 <br />MNIP TIONOFOPERATIONSbelow <br />EL DISEASE POLICY LIMIT <br />i I y <br />DESCMPTIONOFOPERATIONSILOCAIONSIVEHICLBS IACOR01E1,Addi110nal Ramarx05ch0tlula,mayhe altaehedff mom space Is requIted),1 <br />BU #828440 - TN3009 El Salvador Park <br />See attachedt <br />G ���. . <br />City of Santa Ana <br />Attn1 Insurance Compliance <br />20 Civic Center Plaza <br />P.O. Box 1968 <br />Santa Ana, CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Coll: <br />AL,UKU 2n (LUTmU3) <br />Certr26194691 <br />The ACORD name and logo are registered marks of ACORD <br />All rights reserved <br />
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