T-MOBILE U.S.A., INC. (2) - 2014

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CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 1 5/1/2015 9/9/2014 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 pollcy(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 LOcicton Companies CONTACT Three City Place Drive, Suite 900 PHONE AIC No St. Louis MO 63141-7081 E-MAIL (314) 432-0500 ADDRESS: INSURERS AFFORDING COVERAGE NAICP INSURER A: XL Insurance America Inc. 24554 INSURED ,f -Mobile US, Inc. INSURER B: 22322 1358772 Its Subsidiaries and Affiliates INSURER C: National Union Fire Ins Co Pittsburgh PA 19445 12920 SE 38th StreetINsu RERD: Bellevue WA 98006 INSURER E: INSURER F: COVERAGES TMOBI CERTIFICATE NUMBER: 13106742 REVISION NUMBER: XXXXXXX 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 ADDL INSD SUER MD POLICYNUMBER POLICY EFF MMIDWYYYY POLICY EXP MMIDDIYYYY LIMITS B X COMMERCIAL GENERAL LIABILITY Y N RGD500025903 $/1/2014 5/1/2015 EACH OCCURRENCE s 1,000000 PAMAGE TO RENTED REM SES Ea occurrence) $ 1,000,000 CLAIMS -MADE OCCUR MED EXP (Any one arson $ $ 00 PERSONAL &ADV INJURY $ 1,000,000 GEN 'L AGGREGATE LIMIT APPLIES PER: POLICY [:]JE� LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPIOP AGG s 2,000,000 $ OTHER: B B AUTOMOBILE LIABILITY x ANY AUTO Y N IZAD500025703 AOS RAD500025803 MA 5/1/2014 5/1/2014 $/1/201$COMBINED 5/1/2015 SINM $ (Ea accident) 2000000 BODILY INJURY (Per person) $ xxxxxxx ALL OSCHEDULED AUUTOSS AUTOS BODILY INJURY Peraccldent$ XXXXXXX PROPERTY DAMAGE $ XXXXXXX HIRED AUTOS NON -OWNED AUTOS $XXXXXXX C X UMBRELLA LIAB ]{ OCCUR N N 49131346 $/1/2014 5/1/2015 EACH OCCURRENCE $ $000000 C C EXCESS LIAB CLAIMS -MADE SIR applies per policy terms & conditions AGGREGATE $ 5,000,000 DEO I X I RETENTION$ 25,000 $ xxxxxxx A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE Y� OFFICERIMEMBER EXCLUDED? N N/A Y RWD500030102 AOS RWR500030202 W1 $/1/2014 5/t/2014 5/1/2015 5/1/201$ X STATUTE ER E. L. EACH ACCIDENT $ 1000000 E. L. DISEASE -EA EMPLOYEE $ 1,000,000 (Mandatory In NH) If yas, describe under L. E.DISEASE -POLICY LIMIT a 1'000000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) The Certificate Bolder and other entities defined are additional insureds on a primary and non-contributory basis under general liability and are additional insured under automobile Habil ity as required by written contract. Waiver of Subrogation applies under general liability and automobile liability as required by written contract. **See Attached Endorsements** F, @ �t 13106742\SP ° ctty NII, ChyOfSanta Ana PSI ACCORDANCE THEUEXPIRATONHDATEVHEREOFBNOTCEICISHOLD ANY OF TE ABOE DESCRIED WILLEBEN DELIVE ED DINE ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENPA? 411111, ©1988• CORD CORPORA1WN. All rights reserved. ACO RD 25 (2014/01) The ACORD name and logo are registered marks of ACORD