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CERTIFICATE OF LIABILITY INSURANCE Page 1 of 2FDATE <br />(28/2017) <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(les) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement <br />on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />Willis of Pennsylvania, Inc. <br />PHONE <br />FAX <br />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />c/o 25 Century Blvd. <br />ALC,NO,EXT)- <br />877-945-7378 (� NO). 888-467-2378 <br />P. 0. Sox 305191 <br />-MAIL <br />DDRESS <br />certificate59WilliS.Com <br />A <br />Nashville, TN 37230-5191 <br />COMMERCIAL GENERAL LIABILITY y <br />CLAIMS -MADE OCCUR <br />Y <br />7021-02-28 4/1/2017 <br />.4/1/2018 <br />EACH OCCURRENCE 'S 1 000_,_000 <br />F'♦itMlS'FES(Eacmurence) 'S_ 1,000,000 <br />INSURER(S)AFFORDINGCOVERAGE <br />NAIC# <br />INSURERA:Pederal <br />Insurance Company <br />MED EXP (Any one person) _ _ IS _ 51000 <br />20281-005 <br />INSURED <br />INSURER B; <br />Travelers Property Casualty Cc of Amer <br />p y y <br />25674-001 <br />Crown Castle International <br />CENT <br />ACGREGATE LIMIT APPLIES PER: <br />See Attached Named Insured List <br />INSURERC:Berkshire <br />Hathaway Specialty Insurance <br />Cc <br />22276-001 <br />1220 Augusta Dr. Suite 600 <br />i PRODUCTS-COMPlOPAGG $ 2 GOO 000 <br />Houston, TX 77057 <br />INSURER D: <br />$ <br />OTHER: <br />•� GK q <br />INSURER E: <br />B <br />-- <br />Y j Y <br />TC2JCAP-474X9749-17 <br />4/1/2017 <br />INSURER F: <br />$ 1,000,000 <br />X ANY AUTO <br />(10VFRAGF_S CF_RTIFICATF NIJMRFR-2S34nr'71 <br />RFVISInN NIIMRFR- <br />iBODILY INJURY(Perperson) <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 />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />TYPE OF INSURANCE ADDL <br />sUB <br />POLICY NUMBER <br />POLICY EFF -. POLICY EXPLTR <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY y <br />CLAIMS -MADE OCCUR <br />Y <br />7021-02-28 4/1/2017 <br />.4/1/2018 <br />EACH OCCURRENCE 'S 1 000_,_000 <br />F'♦itMlS'FES(Eacmurence) 'S_ 1,000,000 <br />I. <br />MED EXP (Any one person) _ _ IS _ 51000 <br />-PERSONAL &ADV INJURY �$ 11 000 000 <br />CENT <br />ACGREGATE LIMIT APPLIES PER: <br />GENERALAGOREGATE $ 2,000,000 <br />X <br />POLICY I'I PRO ' LOC <br />JECT <br />i PRODUCTS-COMPlOPAGG $ 2 GOO 000 <br />_ <br />$ <br />OTHER: <br />B <br />AUTOMOBILE LIABILITY <br />Y j Y <br />TC2JCAP-474X9749-17 <br />4/1/2017 <br />4/1/2016 COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ 1,000,000 <br />X ANY AUTO <br />iBODILY INJURY(Perperson) <br />$ <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />.__ <br />BODILY INJURY(Peraccident) <br />$ <br />_ <br />HIRED NON -OWNED <br />._._._ AUTOS ONLY ._ AUTOSONLY <br />PROPERTYDAMAGE <br />(Per accident) <br />$ <br />- <br />$ <br />I <br />C X <br />UMBRELLALIAS X <br />OCCUR <br />Y Y <br />47-UNO-303445-01 <br />4/1/2017 <br />4/1/2018 <br />EACH OCCURRENCE <br />$ 5,000,000 <br />AGGREGATE <br />EXCESS LIAB <br />CLAIMS -MADE <br />$ _ 5,-000, 000 <br />DED I X RETENTION$ 25,000 <br />$ <br />B WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />B ANY PROPRIETORIPARTNERIEXECUTIVE— <br />OFFICERIMEMBEREXCLUDED? <br />``Mandatory ,InNH) <br />yes,doscnbounder <br />DESCRIPTION OF OPERATIONS below <br />Y <br />N1Ai I <br />TC2JUB-474M9694-17 <br />TRKUB-474M9701-17 <br />4/l/2017 <br />4/1/2017 <br />4/1/2018 <br />4/1/2018 <br />X PER 0 - <br />STATUTE. ._ ER__ <br />E. L. EACH ACCIDENT <br />'i5 11000,000 <br />---- <br />E.L. DISEASE -EA EMPLOYEE '$ 1,000,000_ <br />F. L. DISFASF - POLICY LIMIT S 1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) <br />BU #628440 - TM3009 El Salvador Park <br />�a <br />See attached: <br />1 <br />r'_FRTIFICOTF I-IC11 r1FR <br />r..ANCFI I ATInN .!0� V a <br />Coll:5053466 Tpl:2134186 Cert:25340671 ©1988-2016ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) 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 />ACCORDANCE WITH THE POLICY PROVISIONS. <br />City of Santa Ana <br />AUTH IZEDREPRES ATIVE <br />Attn: Insurance Compliance <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />Coll:5053466 Tpl:2134186 Cert:25340671 ©1988-2016ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />