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mn „rmmw Francine R. Villareal w:..,( on.mzros.is�saausuaPage 1 0£ 2 ACORO� CERTIFICATE OF LIABILITY INSURANCE OS/04/2021 D05/04ATE I/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 Willis Tow Towers Watson Northeast, Inc. c/o 26 Century Blvd CONTACT C...Castle International NAME: PHONE FAX A/C No: E�AIL ADDRESS: COIRe4u eat@crowncastle. com P.O. Beer 305191 INSURERS AFFORDING COVERAGE NAICk Nashville, TN 372305191 USA INSURERA: Federal Insurance Company 20281 INSURED Crown Castle International INSURER B: National Union Fire Insurance Company of P 19445 INSURER C: Berkshire Hathaway Specialty Insurance Com 22276 See Attached Named Insured List INSURERD: AID Insurance Company 19399 1220 Augusta Dr. Suite 600 Houston, TX 77057 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: W20873940 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF MMIDD/YYYY POLICV EXP MMIDOIYYYY LIMITS X COMMERCIAL GENERALLIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence) PREMISES Ea occurrence $ 1,000,000 MEO EXP (Any one person) $ 10,000 A y y 3605-33-35 LID 04/01/2021 04/01/2022 PERSONAL &ADV INJURY $ 1,D00,000 GENT X AGGREGATE LIMIT APPLIES PER: POLICY❑PRO- ❑ JECT LOC GENERAL AGGREGATE S 2,D00,000 PRODUCTS-COMP/OP AGG $ 2,D00,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acrid m $ 1,000,000 BODILY INDRY(Par person) $ X ANY AUTO B AUTOSOWNESCHEDULED AUTOS ONLY AUTOS I Y CA 7030894 04/01/2021 04/01/2022 BODILY INJURY Per accitlent ( ) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accitlen[ $ Is C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE Y 47- ONO -303445-07 04/01/2021 04/01/2022 DED I X I RETENTION$ 25,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOWPARTNEREXECUTIVE OFFICER/MEMBEREXCWDED9 No NIA I WC 016393106 04/01/2021 04/01/2022 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE. POLICY LIMIT $ 1,000, 000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached Names space is retained) 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. City of Santa Ana Risk Management Division 20 Civic Center Pleas Santa Ana. CA 92702 ACORD 25 (2016103) 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 (T�ATIVE VEPlDyw- ©1988.2016 AC The ACORD name and logo are registered marks of ACORD -- Ir: 21058122 earru: 2081195 RENEMIED & APPRcAIED Sr. 1 F"L , Z V [CWAI Alligililmom Ruk Management Analyst