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acC7R0P CERTIFICATE OF LIABILITY INSURANCE �.�..-�" 5/1/2015 DATE(MMIDDIYYYV) 4/30/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER LDckton Companies Three City Place Drive, Suite 900 St. Louis MO 63141 -7081 (314) 432 -0500 CONTACT PHONE FAX o Ed l- AIC : No E-MAIL ADDRESS: LIMITS B X INSUREI AFFORDING COVERAGE NAIC# INSURER A: XL Insurance America Inc, 24554 5/l/2014 INSURED T- Mobile US, Inc. INSURER B: C1rRRnWiCh Insurance Company 22322 1366122 flea Metro PCS Communications, Inc. INSURER C: National Union Fire Ins Co Pittsburgh PA 19445 Its Subsidiaries and Affiliates 12920 SE 38th Street INSURERD; Bellevue WA 98006 INSURERE: INSURER F: $ 5,000 COVERAGES TMOBI CERTIFICATE NUMBER: 12900887 REVISION NUMBER: xxxxxxx — . 1. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR rypE OF INSURANCE ADEL SD SUBR WVD POLICY NUMBER POLICY SEE MWDDh`YYv` POLICY EXP MMIDDIYYYY LIMITS B X COMMERCIALGENERAL LIABILITY Y Y RGD500025903 5/l/2014 5/1/2015 EACH OCCURRENCE Is 1,000,000 PREM SES (Ea occurrence) $ 1,000,000 CLAIMS -MADE ]OCCUR 111 DIED ESP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000 000 GENE AGGREGATE LIMIT APPLIES PER', I T LX I LOC POLICY U I JECO GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $2000000 $ OTHER'. B B AUTOMOBILE LIABILITY ANY AUTO ALL OVVNEO SCHEDULED AUTOS AUTOS Y Y RAD500025703 AO$ RAD500025803 MA 5/1/2014 5/1/2014 5/1/2015 5/1/2015 (Ea accitlent) $ 2.000.000 X BODILY INJURY(Per person) $ XXXXXXX BODILY INJURY Per accident $ XXXXXXX PRO PERIe DAMAGE (Per to $XXXXXXX SWNED HIRED AUTOS AUTO $XXXXXXX C X UMBRELLA LIAR X OCCUR Y N 49131346 5/1/2014 5/1/2015 EACH OCCURRENCE $ 5 000 000 G C EXCESS LIAR CL41M5 -MADE SIR applies per policy terms & conditions AGGREGATE $ 5 000 000 DED I x I RETENTION 25,000 $ XXXXXXX • • WORKERS COMPENSATION ANDEMPLOVERS'LIgBILITY ANY PROPRIETORIPARTNERIEXECUTIVE Y OFFICER/MEMBER EXCLUDED? N NIA N RWD500030102 AD$ RWR500030202 WI 5/1/2014 5/1/2014 5/1/2015 5/1/2015 X STATUTE - ER E. L. EACH ACCIDENT $ 1000000 E. L. DISEASE -EA EMPLOYEE $ 1000000 (Mandatory In Ni If yes, describe under E, L. DISEASE - POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace Is required) THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S) REFERENCED. The Certificate Holder and other entities defined are additional insureds on a primary and non - contributory basis under general liability and are additional insured under automobile liability as required by written contract'. Waiver of Subrogation applies under general liability and automobile liability as required by written contract. * *See Attached Endorsements ** RE: SPECIAL EVENT, CINCO DE MAYO FESTIVAL IN SANTA ANA 5/3- 5/4/2014. SEPARATION OF INSUREDS ARE INCLUDED UNDER GENERAL LIABILITY. T 12900887 CITY OF SANTA ANA 20 CIVIC CENTER PLAZA SANTA ANA CA 92701 ACORD 25 (2014101) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE I C THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Is (f)Tr1 t� ACCORDANCE WITH THE POLICY PROVISIONS. r j5'<ar; , 7 � AUTHORI2E0 REPRESENTAT,/f�, � wry The ACORD name and logo are registered marks of ACORD reserved.