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A CERTIFICATE OF LIABILITY INSURANCE Page 1 of 2 1212912� 5)
<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 be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the Policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />Willis of Pennsylvania, Inc.
<br />c/o 26 Century Blvd.
<br />P. 0. Box 305191
<br />Nashville, TN 37230-5191
<br />Crown Castle International
<br />See Attached Named Insured List
<br />1220 Augusta Dr. Suite 500
<br />Houston, TX 77057
<br />COVFRAGFS
<br />CFRTIFICATF NIIMRFR•. 741)RR754
<br />INSURERA: Federal Insurance Company 20281-
<br />INSURERS:North American Elite Insurance Company 29700-
<br />INSURER C: _
<br />INSURER D'
<br />INSURER E:
<br />INSURER F:
<br />RFVISIGN NIIMRFR•coo am.on roe
<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' rypE OF INSURANCE OOL SUB POLICY NUMBER POLICY EFF i POLICY ESP LIMITS
<br />A X
<br />_
<br />COMMERCIAL GENERAL LIABILITY Y
<br />CLAIMS-MADE1_X. OCCUR
<br />Y
<br />7021-02-28
<br />4/1/201$
<br />14/1/2016
<br />EACH OCCUR PENCE $ 1,000,000
<br />ppgqMMgqGGEETTpp}��2ENTED
<br />PRLMISLSILa occurence) $ 11000,000
<br />MEDEXP(Anyonepemo
<br />PERSONAL&ADVINJURV IS 1,000,000
<br />_
<br />AGGREGATE LI MIT APPLIES PER:
<br />GENERAL AGGREGATE 'S 2,000,000
<br />GENT
<br />X
<br />PRO-
<br />POLICY JECT LOG
<br />_
<br />PRODUCTS - COMPIOPAGG $ 2,000,000
<br />$
<br />OTHER
<br />A
<br />I AUTOMOBILE LIABILITY Y
<br />Y
<br />7021-02-29
<br />4/1/2015
<br />4/1/2016
<br />COMBINED SINGLE LIMIT
<br />000
<br />'Eaaccident)I$ 1,000,000
<br />j X ANYAUTO
<br />BODILY INJURY(Pefpefson)
<br />- —
<br />$
<br />AU OS - SCHEDULED
<br />AUTOS AUTOS
<br />HIRED AUTOS NON -OWNED',
<br />AUTOS ',
<br />BODILY INJURV(Peraccitlent)
<br />$
<br />_
<br />'PROPERTY DAMAGE
<br />(Per accident)
<br />$
<br />_ __. _
<br />$
<br />B
<br />X
<br />UMBRELLA LIAR
<br />X
<br />OCCUR 'IY
<br />Y
<br />UMB 2000165-01
<br />4/1/2015
<br />4/1/2016 1 EACH OCCURRENCE
<br />$ _5.,000,000
<br />$ _ 5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGATE _
<br />DED I X RETENTION$ 25,00
<br />I
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY
<br />ANYPROPRIETORIPARTNERIEXECUTIVEVNN
<br />OFFICER/MEMBER EXCLUDED? _
<br />'Mandatory in NH)
<br />ff yes, descrlbe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />Y
<br />7171-06-98
<br />4/1/2015
<br />A
<br />nnll
<br />Vvv
<br />4/1/2016
<br />`f
<br />)e'
<br />PER
<br />'�,X jSTATUTE.
<br />-
<br />EL. EACH ACCIDENT
<br />$ 1,000,000_
<br />EL DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />$ 1,0001000
<br />DISEASE -POLICY LIMIT
<br />T7eras
<br />DESCRIPTION OF OPERATIONS I LOCATIONS (VEHICLES(ACORD 101, Additonal Remarks N f Baps retl)
<br />THIS VOIDS AND REPLACES PREVIOUSLY ISSUED CERTIF3� WITH ID: 22979162
<br />�DR�IVEI?iW
<br />BU#845344 - DOWNTOWN SANTA ANA, 1104 CIVIC CENTS ANA, CA 92703 (951 3/4 West 6th
<br />Street).
<br />City of Santa Ana, its officers, agents, employees and volunteers are included as Additional
<br />Insureds under the General, Automobile, and Excess Liability policies as required by written
<br />acureement and only with respect to the liability arising out of the operations performed by or on
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Parks, Rec. & Community Services
<br />20 Civic Center Plaza
<br />PO Box 1988, M-23
<br />AUTH _ZED REPRES 1 ATIVE
<br />Santa Ana, CA 92702
<br />Coll:4825328 Tpl:1934693 Cert:24055754 ©1988-2014ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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