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Attachment to ACO" Certificate for T-Mobile USA, Inc. <br />The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage <br />afforded by the insurer(s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the policy. <br />INSURED <br />T-Mobile USA, Inc. <br />its Subsidiaries and Affiliates <br />12920 SE 38th Street <br />Bellevue WA 98006 USA <br />INSURER <br />INSURER <br />ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD <br />certificate form for policy limits. <br />INSR <br />LTR ADD'L <br />INSRD <br />TYPE OF INSURANCE POLICY NUMBER <br />POLICY DESCRIPTION POLICY <br />EFFECTIVE <br />DATE POLICY <br />EXPIRATION <br />DATE <br />LIMITS <br /> WORKERS COMPENSATION <br /> <br />C D003w00411 <br />NVN] 5/01/2010 05/01/2011 <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEFIICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />maintained by the Additional Insured is excess and non-contributory. <br />Certificate No : 570039298856