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Francine R. Villareal vu'°dn""tle,raro�e w,.mzrab_raisr..am4rage 1 0£ 2 ACOR6r CERTIFICATE OF LIABILITY INSURANCE �/ DATE 04/2021 05/4/2021 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 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 Willie Towers Watson Northeast, Inc. c/o 26 Century Blvd CONTACT Crown Castle International NAME: PHONE FAX A/C No: EMAIL COIRe ADDRESS: quest@crowncastle.com P.O. Box 305191 INSURERS AFFORDING COVERAGE NAIC If Nashville, TN 372305191 USA INSURER A: Federal Insurance Company 20281 INSURED Crown Castle International Insurance INSURER B: National Union Fire InrCompany of P 19445 INSURER C: Berkshire Hathaway Specialty Insurance Cam 22276 See Attached Named Insured nisi INSURER D: AID Insurance Company 19399 1220 Augusta Dr. Suite 600 Houston, 79r 77057 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: W20873940 REVISICIN NIIMRFR- 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 LTR TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF MMIDONYYY) POLICY EXP IMMIDDINTNY'l LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR EACHOCCURRENED $ 1,000,000 DAMAGE TO RENTEO PREMISES Ea occurrence $ 1, 000 , 0o0 MED E%P (Any one person) $ 10,000 A y y 3605-33-35 LIO 04/01/2021 04/01/2022 PERSONAL &ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: PRO- POLICY ❑ PRO- ❑ LOC JECT GENERALAGGREGATE $ 2,D00,000 GEN'L X PRODUCTS $ 2,000,000 $ OTHER: I AUTOMOBILELIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BOD ILY INJ LEY (Per Person) $ ANY AUTO B OWNED SCHEDULED AUTOS ONLY AUTOS Y Y CA 7030894 04/01/2021 04/01/2022 BODILY INJURY Per accident) -PROPERTY $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY -DAMAGE Per accident $ C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE y 47-UMO-303445-07 04/01/2021 04/01/2022 DED I X I RETENTION$ 25,000 S D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETDRIPARTNERIEXECUTIVE No OFFICER/MEMBER EXCLUOE07 NIA y WC 016393106 04/01/2021 04/01/2022 XI PER OTH- STATUTE ER E.L. EACH ACCIDENT g 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,000 (Mandatory in NN) If yes, describe under EL.DISEASE -POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS) LOCATIONS) VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: MUNICIPAL FACILITIES LICENSE AGREEMENT - Site Location: Public Rights -of -Way - Various Site Locations - Named Insured: Crown Castle Fiber LLC City of Santa Ana (Licensor), its council members, officers, and employees are included as Additional Insureds under the General Liability and Auto Liability policies as their interest may appear and as required by written agreement and only with respect to the liability arising out of the operations performed by or on behalf of the Named Insured. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana Risk Management Division AUTHORED REPRESENTATIVE 20 Civic Center Plaza"_� Manigumni ot Santa Ana, CA 92702 Y-getWi e1M" ierm&APPRovED Y: V \ REVIEWED6 APPRWED BY: ©1988-2016 ACORD C ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD RnkManagtrrKntanaryst sa xo: 21058122 srxc5: 2081195