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<br />,a?coKO- CERTIFICATE OF LIABILITY INSURANCE <br />?? a/1/2012 DATE (MM/DD/YYYY) <br />3/16/2011 <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 NE TIVELY A E D, XTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DO??T,??I??J UT?? C?DIY?/iCT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the cerflflcate holder fa an ADDITJ(JJV4?4 JN$,yRED, ?? ppl y(IpsJ ?rylst be endorsed. If SUBROGATION IS WAIVED, subJect to <br />the tarma and conditions of the policy, certain p I s tnay_r,Aqu[?e an;e A statement on this certlflcate does not confer rights to the <br />certlflcate holder In Ilau of such endorsement(s). ._- , ?_ '.' I..., r- !'y r ? <br />PRODUCER Lockton Com anies, LLC-1 Kansas Ci[y <br />444 W. 47th Street, Suite 900 <br />Kansas Cit MO 641 1 2 <br />1 906 A/ No E:c , ac No <br />- <br />(816) 960-000 E-MAIL <br /> <br /> INSURER A : CDntJTl etltal CaSUaI COm an 20443 <br />INSURED SPRINT PCS ASSETS, L.L.C. INSURER B : American Casual Com an of Readin PA 20427 <br />14966 6480 SPRINT PARKWAY <br />OVE <br />R <br />LAND PARK KS 66251 INSURER C c Trans onation Insurance Com an 20494 <br /> <br />/ <br />? <br />1 1 , <br />? _ ?? <br />fT !J<V? <br />- <br />7 <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 AD L SUER pOLIGY NVMBER P LICY EFF POLICY EXP LIMITS <br />A GENERAL LIABILITY N N GL4014104273 4/1/2011 4/1/2014 EACH OCCURRENCE 2 000 000 <br /> X COMMERCIAL GENERAL LIABILITY DAMA TO RENTED XXXXXXX <br /> CLAIMS-MADE ? OCCUR MED EXP An one rson XXXXXXX <br /> X CONTRACTUAL LIAB. PERSONAL 8 ADV INJURY $ 2 OOO OOO <br /> X *TENANTS LEGAL LIAB GENERAL AGGREGATE $ 1 O 000 000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 3 000 000 <br /> PRO- <br />X <br /> P I $ <br />f{ AUTOMOBILE LU\BILITY ]v ]?J BUA40141042$7 4/1/2011 4/1/2014 OMBINED SINGLE LIMIT $ 2 OOO OOO <br /> X ANY <br />A <br />U <br />TO BODILY INJURY (Per person) $ XXXXXXX <br /> p <br />V <br />y <br />AUTOS NED EE <br />gUTOSULED BODILY INJURY (Per eceitlant $ J{J{X}{X}[X <br /> <br />HIRED AUTOS NON-OWNED <br />AUTOS PROPERTY DAMAGE $ XXXXXXX <br /> Cara ekee ers $ Included <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ XXXXXXX <br /> EXCESS LIAB CLAIMS-MADE NOT APPLICABLE AGGREGATE $ XXXXXXX <br /> <br /> DED RETENTION $ g <br />C <br /> <br />B WO <br />AND RKERS COMPENSATION <br />EMPLOYERS' LIABILITY <br />Y/N <br />N <br />WC40 1 4 1 0422 5<<RETRO)) <br />4/1/2011 <br />4/1/2012 WC STAT - OTH- <br />X <br /> <br />B ANY PROPRIETOR/PARTNER/E%ECUTIVE <br />OFFICER/MEMBER E%CLUDED4 ? <br />N/A WC4014104239(DEDUCTIBLE <br />WC4014104242 (CA) 4/1/2011 <br />4/]/201] 4/I /2012 <br />4/1/2U12 E.L. EACH ACCIDENT <br />$ 1000000 <br />g cMeaaaery la NHI N/A IN MONOPOLISTIC STAT S <br /> E.L- DISEASE - EA EMPLOYEE I OOO 000 <br /> DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT I OOO OOO <br /> <br />DESCRIPTION OF OPERATONS /LOCATIONS /VEHICLES /(Attach ACORD 101, Additional Ramarlcs Schedule, If more apace fs required) <br />•FIRE DAMAGE IS INCLUDED IN BROADER TENANT'S LEGAL LIABILITY FORM WITH LIMITS OF $1,000 000 PER OCCURRENCE. THE <br />CITY OF SANTA ANA, ITS OFFICERS AGENTS, REPRESENTATIVES, EMPLOYEES AND VOLUNTEERS Al'2E ADDITIONAL INSUREDS ON A <br />PRIMARY BASIS AS REQUIRED BY CzONTRACT AND SUBJECT TO POLICY TERMS AND CONDITIONS. RE: INSTALLATION, OPERATION 8c <br />MAINTENANCE OF TELECOMMUNICATIONS EQUIPMENT. <br />w <br />d??. <br />a Pc???- <br />? <br />;a - <br />r <br />255'1292 <br />_ { _2,_ <br />CITY OF SANTA ANA ; . ? St tt Sheed <br />ATTN: CARLA MACK-THOMPKIN S' <br />20 CIVIC CENTER PLAZA .... nttornev <br />SANTA ANA, CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />?CORDANCE WITH THE POLICY PROVISIONS. <br />TION. All rights reserved <br />The ACORD name antl logo are registered marks of ACORD