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T-MOBILE WEST CORPORATION - 2010
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T-MOBILE WEST CORPORATION - 2010
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Last modified
5/31/2016 4:02:24 PM
Creation date
8/10/2010 12:29:49 PM
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Contracts
Company Name
T-MOBILE WEST CORPORATION
Contract #
A-2010-133
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Council Approval Date
7/19/2010
Expiration Date
7/19/2020
Insurance Exp Date
1/1/2017
Destruction Year
2025
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4coR ®® CERTIFICATE OF LIABILITY INSURANCE <br />�Ir.../ <br />DATEIMMIDD/YYYY) <br />04/2112016 <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 />PRODUCER <br />CONTACT <br />NAME: <br />Automatic Data Processing Insurance Agency, Inc. <br />1 Adp Boulevard <br />AICNNO ExtExtL__. __ . JAIC <br />AD RIESS, <br />Roseland, NJ 07066 <br />_ <br />INSURER(S) AFFORDING COVERAGE <br />NAICH <br />INSURER A: Technology Insurance Company, Inc. <br />42376 <br />EACH OCCURRENCE <br />INSURED PHOENIX TOWER INTERNATIONAL INVEST <br />INSURER B: <br />INSURER C: <br />_ <br />DBA: Phoenix Tower International Investment LLC <br />1001 YAMATO RD SUITE 105 <br />INSURER D: <br />Boca Raton, FL 33431 <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 479810 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 />ILTR <br />TYPE OF INSURANCE <br />INSD <br />B <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM /DDIYYYV <br />- POLICY EXP <br />MWDDIYVYY <br />LIMITS <br />Suite 105 <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />Boca Raton, FL 33431 <br />AUTHORIZED REPRESENTATIVE <br />EACH OCCURRENCE <br />$ <br />- -- <br />$ <br />DAMAGE REITr <br />PREMISES RERTurrence <br />_ <br />MED EXP (Any one person) <br />$ <br />PERSONAL &ADV INJURY <br />GEN'LAGGREGA_TE LIMITAPPLIES PER <br />__$ <br />GENERAL AGGREGATE <br />$ <br />_ POLICY r - PRO- <br />JECT [::] LOC <br />JI <br />-- <br />PRODUCTS - COMP /O_P_AGG <br />$ <br />$ <br />CTHER: <br />AUTOMOBILE LIABILITY <br />I COMBINED SINGLE LIMIT <br />Fa Ea accident) <br />$ <br />_ <br />ANY AUTO <br />I'. BODILY INJURY (Per person) <br />$ <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />'BODILY INJURY (Per adent <br />( cci_ <br />$ <br />_ -- NON -OWNED <br />HIRED AUTOS AUTOS <br />PROPERTY DAMAGE -- <br />(Per accident) <br />$ <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />EXCESS LIAB <br />._CLAIMS -MADE <br />AGGREGATE <br />$ <br />DED <br />RETENTION$ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR /PARTNER/EXECUTIVE <br />OFFICE / / /Men NHR EXCLUDED? ❑N rvIA <br />(Mandatory ) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N <br />TWC3524415 <br />12/21/2015 <br />11/12/2016 <br />X I PER OT <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />_ <br />EL DISEASE -EA EMPLOYEE <br />$ 1,000,000 <br />E. L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />i <br />LHIYLCLLH I I V N <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Phoenix Tower International Investment LLC <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />1001 Yamato Road <br />Suite 105 <br />Boca Raton, FL 33431 <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />
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