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AC"R6' CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDIYYYY) 1� 5/1/2018 L 5/4/2017 THIS CERTIFICATE IS ISSUED ASA 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 ACONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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 Lockbn Companies Three City Place Drive, Suite 900 St Louis MO 63141-7081 (314) 432-0500 CD TACT AIC No Ext : I A!C No): E-MAIL POLICY NUMBER INSURER A : XL Insut'ance America, Inc. 24554 INSURED T -Mobile US, Inc, 1359691 Its Subsidiaries and Affiliates 12920 SE 38th Sheet Bellevue WA 98006 INSURER B Greenwich Insi rance Company 22322 INs R c ; National Union Fire fns Co Pitts. PA 19445 X COMMERCIAL GENERAL LIABILITY INSURER E Y COVERAGES TMC)flf CERTIFICATE NUMIRER- 14677719 RFVISICIN NUMBER! XXX V'V'Vy 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 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS B X COMMERCIAL GENERAL LIABILITY Y Y RGD5000259-06 5/1/2017 5/U2018 EACH OCC RREN 1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED i OOO OOO MED E one y@I S 5,000 PERSONAL & ADV IWURY 5 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL A0GREQATE 2,000,000 POLICY❑ JE FX LOC PRODUCT - I G 2,000,050 $ OTHER: B AUTOMOBILE LIABILITY Y Y RAD5000257-06 5/1/2017 5/1/2018 COMBINED SINGLE LIMIT $ 21000,000 ANY AUTO BOUILY INJURY (Parperscn? $ AA TOS ONLY AUTOSULED I BODILY INJURY (Per'acciden)$ { HIRED IT OS ONLY AUTOS ONLYY PRfp�rOPERaucdTY DAMAGE $ $)CCxDCKxx C X UMBRELLA LIAR X OCCUR Y N 28189156 5/1/2017 5/1/201$ EACH OCCURRENCE $ 5,000,000 C C EXCESS LIAR CLAIMS -MAD SIR terms lees p itions policy terms && aondrtfons AGGREGATE $ 5,000,000 DED I X I RETENTION s25,000 $ 1 `, WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N RWD5000301-OS AOS $/1/20I7 5/1/201$ PO2 O R X STATUTE A YIN ANY PROPRIETORIPARTNERIEXECUTIVE 1❑r OFFICERlMEMBER EXCLUDED? N NIA RWR5000302-OS WI 5/1/ 01$ E.L. EACH ACCIDENT $ 1,000,000 El, DISEASE - EA EMPLOYEE 1,000,000 IM andatory In NH) �°Jr�l/2017 f� f % de.dbe under DESCRIPTION OF oprNAYIoNs b.Io [T. ��J! E.L. DISEAsE-PoLI¢Y LIMIT 1,000,000 ++ C7 ;,,:p DESCRIPTION OF OPERATIONS ILOCATIONS I VEHICLES (ACORD 101, Additional Remark attached if more space Isrequired) **SEE ATTACHED ENDORSEMENTS** TILE CITY OF SANTA ANA, IT R MPLOYEES, AGENTS, AND REPRESENTATIVE ARE NAMED AS ADDITIONAL INSUREDS ON A PRIMARY AND NON -C ASIS UNDER GENERAL LIABILITY AND ARE ADDITIONAL INSUREDS UNDER AUTOMOBILE LIABfLITY AS REQUIRED BY T CT. WAIVER OF SUBROGATION APPLIES UNDER GENERAL LIABILITY AND AUTOMOBILE LIABILITY AS REQU BY CMIMUCT, CANC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 14677732 AUTHORIZED REPRESENTATIVE CITY OF SANTA ANA ATTN: SILVIA CUEVAS 20 CIVIC CENTER PLAZA M-23 SANTA ANA CA 92701 -w ACORD 25 (2016103) 01988--244P[CORD C07MRAMON. All rights reserved The ACORD name and logo are registered marks of ACORD