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SBACO -1 OP ID: NC
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />COVERAGES CERTIFICATE NUMBER: 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 />DATE 03/09 /2015 )
<br />03/0912015
<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 />Henderson Brothers, Inc.
<br />920 Ft Duquesne Blvd
<br />CONTACT Clem J. Wandrisco
<br />NAME:
<br />IAICNNo Exe.412- 261 -1842 jp /� No /; 412 - 261 -4149
<br />Pittsburgh, PA dr 15222
<br />Clem J. Wandrisco, III
<br />ADDRESS: cjwandrisco @hendersonbrothers.com
<br />- —
<br />INSURER(S)AFFORDINGCOVERAGE
<br />NAIC#
<br />INSURER A: Travelers Property Casualty CO
<br />i25674
<br />A
<br />_
<br />INSURED SBA Communications Corporation
<br />INSURERS: St Paul Fire & Marine Ins Co
<br />24767
<br />Thomas Hunt, Esquire
<br />5900 NW Broken Sound Parkway
<br />INSURERC:Illinois Union Insurance Compa
<br />DAMAGE
<br />SES Ea occurrence
<br />$ 900,000
<br />Boca Raton, FL 33487
<br />INSURER D:
<br />INSURER E:
<br />INSURER F t
<br />MED EXP (Anyone person)
<br />$ NIA
<br />COVERAGES CERTIFICATE NUMBER: 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
<br />LTR
<br />TYPE OF INSURgNCE
<br />DL
<br />IN R
<br />UBR
<br />WV
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDDIYYYY
<br />POLICY EXP
<br />MMIDDIYYYY
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 900,00
<br />A
<br />X COMMERCIAL GENER�A�L�LIABILITY
<br />X
<br />TJEXGL474M8138TIL15
<br />031151201510311512016
<br />DAMAGE
<br />SES Ea occurrence
<br />$ 900,000
<br />CLAIMS -MADE 17X OCCUR
<br />MED EXP (Anyone person)
<br />$ NIA
<br />PERSONAL &ADV INJURY
<br />$ 900,00
<br />X $100,000SIR
<br />GENERALAGGREGATE
<br />$ 2,000,00
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMPIOP AGG
<br />$ 2,000,00
<br />POLICY I X PE LOD
<br />!
<br />$
<br />AUTOMOBILE LIABILITY
<br />COMBINED SINGLE LIMIT
<br />1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />A
<br />ANY AUTO
<br />A]
<br />TC2JCAP474M814ATIL15
<br />0311512015
<br />03115/2016
<br />BODILY INJURY (Per accident)
<br />$
<br />OWNED SCHEDULED
<br />AUTOS AUTOS
<br />X AUTO AUTOS XDED-HCPD NON -OWNED
<br />AUTOS
<br />PROPERTY DAMAGE
<br />PERACCIDENT
<br />$
<br />! $
<br />X 100,000
<br />X
<br />UMBRELLA LAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 25,000,00
<br />AGGREGATE
<br />$ 25,000,000
<br />B
<br />EXCESS LAB
<br />C AIMS -MADE
<br />ZUPlSN3740616NF
<br />0311512015;
<br />03/15120116
<br />DED I X I RETENTION $ 10,000
<br />$
<br />1
<br />A
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y
<br />ANY PROPRIETOWPARTNERIE XECUTIVE®
<br />OFFICERIMEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />NIA
<br />TC2J U B47SM43781 5 (ADS)
<br />TRJUB476M438A15
<br />1 0311512015
<br />10311512015
<br />03/1612016
<br />03/1512016
<br />WC BTATU- IOTH-
<br />X TORV LIMITS �._J ER
<br />EA_ EACH ACCIDENT
<br />$ 1,000,00
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />Dyes, describe under
<br />DESCRIPTION under
<br />OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,00
<br />C
<br />PROFESSIONAL
<br />COOG24541800005
<br />0311512015
<br />03116/2016
<br />CLAIMIAGG 5,000,000
<br />POLLUTION
<br />SIR 100,00
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
<br />Site Number: CA45897 -A -0, Site Name: Adams Park, 2302 S Raitt, Santa Ana, CA
<br />CA46897 X
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana, EXBCU11ve THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />tY ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Director Parks, Rao and
<br />Community Services (M -23)
<br />AUTHORIZED REPRESENTATIVE
<br />26 Civic Center Plaza, M -76
<br />Santa Ana, CA 92701
<br />U 1988 -2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />
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