Laserfiche WebLink
Page 1 of 2 <br /> AC' 1 R 00 DATE(MMI/2025I) <br /> CERTIFICATE OF LIABILITY INSURANCE 03/272025 <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 CONTACT Crown Castle Inc. <br /> NAME: <br /> Willis Towers Watson Northeast, Inc. PHONE FAX <br /> c/o 26 Century Blvd fA/C,No.Extl: (A/C,No): <br /> P.O. Box 305191 ADDRESS: COIRe4u est@crowncastle.com <br /> A <br /> Nashville, TN 372305191 USA INSURER(S)AFFORDINGCOVERAGE NAIC# <br /> INSURERA: ACE American Insurance Company 22667 <br /> INSURED <br /> INSURER B <br /> Crown Castle Inc. <br /> See Attached Named Insured List INSURER C: <br /> 8020 Katy Freeway INSURER D: <br /> Houston, TX 77024 <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:W38382427 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 /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR INSD WVD POLICY NUMBER .J /Y MM/DDYYYUMM/DD/YYYY), <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 <br /> CLAIMS-MADE X OCCUR DAMAGETORENTED <br /> PREMISES((Ea occurrence) $ 1,000,000 <br /> A MED EXP(Any one person) $ 10,000 <br /> Y Y HDO G48933889 04/01/2025 04/01/2026 PERSONAL&ADVINJURY $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 <br /> X POLICY PRO- <br /> JECT LOC PRODUCTS-COMP/OPAGG $ 4,000,000 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000 <br /> (Ea accident) <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> A OWNED SCHEDULED Y Y ISA H11357131 04/01/2025 04/01/2026 BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY (Per accident) <br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 <br /> EXCESSLIAB CLAIMS-MADE Y Y XEUG47458262 002 04/01/2025 04/01/2026 AGGREGATE $ 5,000,000 <br /> DED X RETENTIONS 25,000 $ <br /> WORKERS COMPENSATION X PER OTH- <br /> AND EMPLOYERS'LIABILITY STATUTE ER <br /> Y N <br /> A ANYPROPRIETOR/PARTNER/EXECUTIVE / E.L.EACH ACCIDENT $ 1,000,000 <br /> OFFICER/MEMBEREXCLUDED? n N/A Y WLR C72611251 04/01/2025 04/01/2026 <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> If yes,describe under 1,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS f VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) <br /> BU#845344 — DOWNTOWN SANTA ANA, 1104 CIVIC CENTER DRIVE, SANTA ANA, CA 92703 (951 3/4 West 6th Street) . <br /> �Igi[ally signetl <br /> Tu Iran byTUTran APPROVED <br /> Nguyen <br /> Nguyen bete:Zg=S.e4t ByTu Tran Nguyen at 10:15 am,Apr 01,2025 <br /> 10:1:13-07'00' P <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 /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> CITY OF SANTA ANA <br /> PO BOX 1988 <br /> PARES RECREATION AND COMMUNITY AUTHORIZED REPRESENTATIVE <br /> ATTN ROBERT CARROLL pp <br /> ,y ,SANTA ANA, CA 92702 l 1 <br /> ©1988-2016 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br /> SR ID: 27488978 BATCH: 3893028 <br />