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SBACO -1 OP ID: NC
<br />" DATE' "DDIYYYY)
<br />CERTIFICATE OF LIABILITY" INSURANCE 03109r2d16
<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(iosi 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 />certificates holder In lieu of such endorsement(s).
<br />PRODUCER
<br />4enderson Brothers, Inc.
<br />X20 Ft Duquesne Blvd
<br />Pittsburggh, PA 16222
<br />Clem J. Mrldrisco, III
<br />INSURED SBA Communications Corporation
<br />Thomas Hunk, Esquire
<br />5900 NW Broken Sound Parkway
<br />Baca Raton, FL 33487
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<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 />LTR 'TYPE OF INSURANCE ..... POLICY NUMBER .. _._, _ ..._ POLICY EFF ...,,..t�OL &CYEX.P....4. _.__...... ..._. - _._....._ ._.._ _ .......
<br />It1SR AINSR UDR MMIDDIYYYY ) IMMDDfYYYYI LIMITS
<br />GENERAL LIABILITY
<br />A Ih X COMMERCIAL GrN!ERALI..IADILITY X
<br />TJEXGL474Mti138T1L16 0311612015
<br />0311512016� PREMISES,( Ea ,
<br />PA Eaoneui�sog'
<br />. ..._._ _900000
<br />900,000
<br />L X accuR
<br />CLAIMS -MADE f
<br />^^.._._ d......_ p �r...
<br />$
<br />$100,000 SIR
<br />PERSONAL a ADV IN tURY
<br />$ 900,00
<br />__.._ _
<br />'I
<br />GENERAL AGGREGATE �
<br />00 ,
<br />$ 2,000 00
<br />.. _..
<br />GEN'L AGGREGATE LIMIT APPLIES PER
<br />PRODUCTS - COMPIOP AGG
<br />$ 2,000 00
<br />PRO-
<br />POLICY POLICY X LOC
<br />AUTOMOBILE L %ABILITY
<br />!,
<br />COMBINED SINGLE LIMIT
<br />(Ea accident) .... ....... ..w_
<br />_ 1,000,000
<br />—
<br />A X ANY AUTO
<br />TC2JCAP474M814ATIL16 03116/2016 Q311612d16
<br />BODILY INJURY (Per person)
<br />$
<br />I ALL. OWN O SCHEDULED
<br />BBD Y (Per accident)
<br />BODILY INJURY
<br />$
<br />AUTOS AU' TOS
<br />DaJ
<br />X "DS
<br />PEFiTYDNT)l-
<br />$ —
<br />1 "dREDAUTO _- AUI
<br />X 100,000 DED- HCPD.,,,_
<br />I �
<br />(PLr2ACClD(tIN,;Tl
<br />$
<br />)(� k6APDM ELLA LIA8 X OCCUR
<br />i I
<br />EACH OCCURRENCE
<br />$ 25,000,00
<br />EXCESS LIAR i � CLAIMS MADE
<br />ZUP16N3T40616NF 03116/2016 03/16!2016
<br />AGGREGATE
<br />1 $ 25,ddQ,Od
<br />DEO X TtETENTION $ 10,000
<br />WOFtYLEitSCOMt�EWBAT %ON
<br />ANDS L E YIN W
<br />TC2JUB476M437816 �AOSi. 0311612016 0311612016
<br />_-
<br />X 4VCSTAI °U q "IWr
<br />_ To LIMITS FR
<br />1,000,00
<br />A ANY PRC7PRIETC RrExECUTIVc
<br />OrYIPROPRIMD1RIPAR TNER
<br />. _� NIA
<br />A (Maaodcrt�r,r In NH) r:tcLUIIEDO N �
<br />TRJUB476M438A16 03111612016 0311612016
<br />E L EACH ACC %DENT
<br />EL DISEASE- EAEMPLDYEE
<br />- — -
<br />$
<br />$ 1,000,00
<br />1'$
<br />If es, dssceb under 1
<br />DSCRIPTION OF OPERATIONS krolow
<br />E_L. DISEASE - POLICY LIMIT
<br />1,000,00
<br />C 01ROFESSIONAL
<br />0311"12011
<br />CLAIMIAGG
<br />5,000,00
<br />POLLUTION
<br />]COOG24541800005
<br />1
<br />l
<br />SIR
<br />100,00
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space. Is required)
<br />Number: CA45892 -A -0, Site Name: Heritage 2, CA, 4815 W. Camille Street
<br />Site
<br />Santa Ana, CA"
<br />CA46892
<br />City of Santa Ana, Executive
<br />Director Parks, Rec, and
<br />Community Services (M -23)
<br />28 Civic Center Plaza„ M -76
<br />Santa Ana, CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE, WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />W 15t$ii -LU1U AUUKU l::UKf'UKA I IUN, All rlgnts reservecl.
<br />ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD
<br />
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