|
�r SBACO -1 OP Iii: RC
<br />DATE(MMIDDIYYYY)
<br />, cca n CERTIFICATE OF LIABILITY INSURANCE
<br />+..�.. --. 03109'12015
<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 IS'S'UING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate Molder is an ADDITIONAL INSURED', the poiicy(les) 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 />PRODUCER.
<br />Henderson Brothers, Inc,
<br />920 Ft Duquesne Blvd'
<br />Pittsburg®h, PA 16222
<br />Clem J. 91, III
<br />INSURED SBA, Communications Corporation
<br />Thomas Hunt, Esquire
<br />5900 NW Broken Sound Parkway
<br />Boca Raton, FL 33457
<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
<br />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 13 SUBJECT TO ALL THE
<br />TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR .,..... TYPE OF INSURANCE p.DDLSUIBR POLICY NUMBER
<br />LTR
<br />T M'diAIDD /YYYY MM1DD YTYY LIMITS
<br />_
<br />GENERAL LIABILITY '',..
<br />EACH OCCURRENCE
<br />$
<br />900,000
<br />A X COMMERCIAL GENERAL LIABILITY X �TJEXGL474M8138TIL15
<br />0311612016 0311512016
<br />DAIVIAGD'r0 RENTED .
<br />P,RENHISES (Ea occurrence .
<br />1
<br />$..
<br />....... m...
<br />900,000
<br />_..
<br />CI.AIMSMADE OCCUR
<br />MED EXP (Any one person) I
<br />S
<br />NI
<br />X $100,000 SIR
<br />PERSONAL & ADV INJURY 1
<br />-
<br />S -
<br />900,000
<br />y
<br />GENERAL AGGREGATE I
<br />$
<br />2000,00..
<br />GEN'L AGGREGATE LIMIT APPL.ILS PEI'd
<br />PROD UCTS - COMPIOP AGG '
<br />$
<br />2,000,00
<br />POLICY f X PO Lf?C �
<br />AUTOMOBILE LIABILITY `
<br />(E dpD SINGLE LIMIT .
<br />$
<br />1,000,000
<br />A X ANY AUTO
<br />T
<br />0311612015 ! 03/1612016
<br />BODILY INJURY (Per person)
<br />g
<br />...._.
<br />ALL OWNED SCHEDULED
<br />__ _ .
<br />BODILY INJURY (Per accldenl)
<br />.._..
<br />S
<br />.m ....
<br />AUTOS AUTO"
<br />WOW - OWNED
<br />ly P &II %FD AUTOS X'
<br />X 100,000 DED MCPD
<br />.M
<br />�•
<br />PRQPEIZPH DFSWACaE
<br />(NEFI ACCIDEN'f1
<br />S
<br />...w
<br />X INMIBRELLA LIAR X OCCUR
<br />EACH OCCUR._RENCE
<br />. _
<br />$
<br />26,000,000
<br />EXCESS LIAR
<br />B CIAIMS MAriF�
<br />�ZUP16N3740616NF
<br />0311612016 0311612016
<br />AGGREGATE
<br />$
<br />25,000,00
<br />a..
<br />DED X I'iETENI'ION$ 10,'000
<br />$
<br />WORKERS COMPENSATION
<br />�ER..�..$
<br />T1,000,000''
<br />AND OPRIETORMARBTINETYEXECUTIVEYI„N� WIA
<br />A
<br />EXCLUDED? fv...)
<br />TC2JUB476M43781S(AOS)
<br />0311612015
<br />031151201E
<br />1, El. EACHACCIDENT
<br />IC ER/MEMBER
<br />A iMandata'ry in NH} ',.
<br />TRJUB476fJW38A16
<br />03/16120151(
<br />031161201E
<br />E.L. DISEASE, « LJA EMPLOYEE
<br />S
<br />1,000,001]
<br />H yes, describo under
<br />...... ....._......
<br />I Wff
<br />11000,000
<br />DESCRIPTION OF OPERATIONS Wow
<br />E.L. DISEASE - POLICY
<br />$
<br />C PROFESSIONAL
<br />COOG24541800006
<br />0311612015
<br />03111612016
<br />CLAIMIAGG
<br />6,000,00
<br />(POLLUTION
<br />SIR
<br />100,00
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attache. ACORD 1.01, Additional Remarks Schedule, If mare space is re+qulredl
<br />Site Number: CA45903 -A -0, Site Name: Salgado Center, 706 N. Newhope, Santa.
<br />Area"
<br />�� y \\
<br />CA45903
<br />City of Santa Ana, Executive
<br />Director' Parka, Rec, and
<br />Community Services (M-23)
<br />25 Civic Center Plaza, RI «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 REPRESENTATIV E
<br />V lt$Utl -ZUIU AIL.:VKL7IwVKI'UKA I IVN. Au rlgnis reserveo.
<br />ACORD 26 (2010106) The ACORD name and logo are registered marks of ACORD
<br />
|