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Ace•E® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> 5/1/2025 10/23/2024
<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 policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER Lockton Companies,LLC NAME:
<br /> Three City Place Drive,Suite 900 PH NE Ball' I FAX
<br /> INC.No):
<br /> St.Louis MO 63141-7081 E-MAIL
<br /> (314)432-0500 ADDRESS:
<br /> midwesteertificates@lockton.com lockton.com INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER A:Continental Casualty Company 20443
<br /> INSURED T-Mobile US,Inc. INSURER B:The Continental Insurance Company 35289
<br /> 1358772 Its Subsidiaries and Affiliates, INSURER C:Transportation Insurance Company 20494
<br /> including Sprint Corporation INSURER D:
<br /> 12920 SE 38th Street INSURER E
<br /> Bellevue WA 98006
<br /> INSURER F: I
<br /> COVERAGES CERTIFICATE NUMBER: 20181160 REVISION NUMBER: XXXXXXX
<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 /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR ADDL SUER
<br /> LTR TYPE OF INSURANCE INSD WI D POLICY NUMBER POLICY EFF POLICY EXP
<br /> (MMIDD/VYYY),LMMIDDIYYYY) LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY y Y 7012343900 5/1/2024 5/1/2025 EACH OCCURRENCE S 10,000,000
<br /> —DAMAGE RENTED
<br /> CLAIMS-MADE X OCCUR P EM SESO(Ea occurrence) S 10,000,000
<br /> MED EXP(Any one person) S 25,000
<br /> PERSONAL&AOV INJURY S 10,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 20,000,000
<br /> POLICY PRO- I
<br /> -
<br /> JECT X LOC PRODUCTS-COMPIOP AGG $ 20,000,000_
<br /> OTHER: S
<br /> A AUTOMOBILE LIABILITY y y 7012343878 5/1/20%1 5/1/2025 {Ea MBBIN EDISINGLE LIMIT S 5,000,000
<br /> x ANY AUTO BODILY INJURY(Per person) $ XXXXXXX
<br /> OWNED SCHEDULED ( ) XX}(XXXX
<br /> _AUTOS ONLY AUTOS BODILY INJURY Per accident $
<br /> HIRED NON-OWNED PROPERTY DAMAGE -- -
<br /> _ AUTOS ONLY AUTOS ONLY (Per accident) $ XXXXXXX
<br /> S XXXXXXX
<br /> B I X I UMBRELLA LIAB X OCCUR N N 7014886953 5/1/2024 5/1/2025 EACH OCCURRENCE _ s 5,000,000
<br /> B EXCESS LIAB CLAIMS-MADE SIR applies per policy AGGREGATE S 5,000,000
<br /> B — terms&conditions
<br /> DED X RETENTION S 10,000 S XXXXXXX
<br /> WORKERS COMPENSATION N PER OTH-
<br /> B AND EMPLOYERS'LIABILITY 7012343895 l(SAp$) 5/10024 5/1/2025 X I STATUTE I ER
<br /> B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 7012343881(CA) 5/1/2024 5/1/2025 E.L EACH ACCIDENT S 2,000,000
<br /> C OFFICER/MEMBER EXCLUDED? N N/A 7012447142((((AZ,MA,OR,WI) 5/1/2024 5/1/2025
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 2,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 2,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
<br /> THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER,APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S)REFERENCED.
<br /> The Certificate Holder and other entities defined by written contract,statute,permit application or written agreement are additional insureds on a primary and non-contributory
<br /> basis under general liability and are additional insured under automobile liability as required by written contract.Waiver of Subrogation applies under general liability and
<br /> automobile liability as required by written contract.**Sec Attached Endorsements** LA33827A-3319 3/4 West Chestnut Ave. Santa Ana,CA
<br /> CERTIFICATE HOLDER CANCELLATION See Attachments
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> 20181160 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> City of Santa Ana
<br /> Risk Management Division
<br /> 20 Civic Center Plaza, 4th Floor AUTHORIZED REPRESENTATI
<br /> Aar
<br /> Santa Ana CA 92701
<br /> 1
<br /> ©1988-2 CORD CORPORATI N. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD trifiVAQ61- ij j £?
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<br /> 1*60
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