Loading...
HomeMy WebLinkAboutOMNIPOINT COMMUNICATIONS, INC. (T-MOBILE) 2 - 2007A- 2007 -281 Site Name: TM010 Jerome Park Site ID #: LA03010A INSURANCE NOT ON FILE WORK MAY KI pROCETHE CITY o OF ANA AND OMNIPO NT COMMUNICATIONS INC. for CLERK OF COUNCIL (2 . Pa. ks , Re,-- . F C N ) Jerome Park DATE: 1-2 "10 -0�7 cur l0. rkvmfk�^s This First Amendment to Land Lease Agreement between the City of Santa Ana and Omni oint Communications, Inc. for Jerome Park (hereinafter "First Amendment ") is attached to and made part of the Land Lease Agreement Between The City of Santa Ana and Omniponu Communications, Inc. for Jerome Park (the "Lease ") dated as of December 5, 2005 by and between the City of Santa Ana, , a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California, ( "LESSOR ") and OMNIPOINT COMMUNICATIONS, INC., a subsidiary of T- Mobile USA, Inc., a Delaware corporation, with a place of business of 3 Imperial Promenade, Suite 1100, Santa Ana, CA 92707 ( "LESSEE "). RECITALS: WHEREAS, the property address 888 W. Santa Ana Blvd, Santa Ana CA, specified in Section 1 of the Lease., is incorrect and the Parties wish to correct the address to 2115 W. Mc Fadden Avenue., Santa Ana, CA 92704;and WHEREAS, LESSEE was to construct concrete bleachers under the Approved Plans but LESSEE and LESSOR now want to provide for portable bleachers instead; NOW THEREFORE, for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged; and WITHOUT limiting the terms of the Lease, LESSOR and LESSEE, intending to be legally bound, further agree to amend the Lease as follows: AMENDMENTS: 1) The address "888 W. Santa Ana Blvd, Santa Ana CA" appearing in Section 1 of the Lease is hereby deleted and replaced with the address "2115 W. Mc Fadden Avenue, Santa Ana, CA 92704 ". 2) The Approved Plans included in the Lease and titled "Exhibit B" are hereby deleted in their entirety and replaced with the Approved Plans embodied in "Exhibit B -I" attached hereto. All reference in the Lease to Exhibit B shall mean the new Exhibit B -1. LESSEE shall contract and pay to All Purpose Manufacturing, Inc., the sum not to exceed Thirty Thousand Dollars ($30,000.00) for the purchase and installation of portable bleachers as described in the attached Exhibit B -1. The portable bleachers shall not be part of the Premises or LESSEE's Facilities. LESSOR assumes all title and ownership interest in, all maintenance responsibility and liability for the portable bleachers. LESSEE shall have no obligation under the Lease to provide concrete bleachers or any other bleachers once the sum is paid to All Purpose Manufacturing, Inc., as provided herein. HEADINGS: Any and all headings in the original Lease and any Amendment thereto, are for reference and/or clarification purposes only and shall not be deemed to define or limit the scope or intent of any of the terms, covenants, conditions or agreements contained therein. IN THE EVENT of a conflict between the original Lease, and this First Amendment, this First Amendment )hall control. All terms and conditions in the Lease and Exhibits thereto which are not inconsistent herewith remain in full force and effect. (signature page followsl Site Name: TMO10 Jerome Park Site ID #: LA03010A IN WITNESS WHEREOF, LESSOR and LESSEE have caused this First Amendment to be duly executed as of the date below. ATTEST: TRiCIA E. HEALY lJ Clerk of the Councii APPROVED AS TO FORM: JOSEPH W.FLETCHER City Attorney By: i �H . LAURA SHEEDY (/ Assistant City Attorney CITY OF SANTA ANA DAVID N. REAM City Manager LESSEE: OMNIPOINT COMMUNICATIONS INC., a subsidiary of T- Mobile USA, Incy By: Printed Name: _ Jon Zu"Ie Its: #eHt£a AreaPirecior- Date: T- Mobile Legal Approval By: Site Name: TMO10 Jerome Park Site IM: LA030IOA EXHIBIT B -1 -�+tn rcnnromrnw nr mvr R aro -+�- ai[ SITE PLANS/ DESCRIPTIVE RENDERINGS However, it is expressly agreed and understood by and between the LESSOR and LESSEE that the exact and precise location of the LESSEE's Facilities are subject to review and approval by the planning and /or zoning Boards having jurisdiction over the "Premises ". Therefore, it is expressly agreed and understood by and between LESSOR and LESSEE that the precise location of the Premises as shown on Exhibit `B -l" may be modified by the LESSEE in order to comply with and obtain necessary planning and/or zoning approvals, and any and all other approvals necessary for LESSEE's intended use of the property. The Premises as described herein may therefore be modified by the LESSEE to reflect the final engineering design. An amended Exhibit "B -I" (if necessary) will be provided by the LESSEE and attached to the lease in place of the existing Exhibit `B -I ", a copy of which will be provided to the LESSOR for review prior to being incorporated into the Agreement. See the attached drawings dated 08/21/2007, identified as Site Name Jerome Park, Site Number LA03010A, Sheets T -1, T -2, T -3, C -1, C -2, A -1, A -2, A -3, A -4, ANT -1, S -1, S -2, S -3, L -1, E -1, E -2, E -3, E -4, E -5, E -6, E -7, M -I, M- 2, and M -3 along with Site Surveys: LS -I and LS -2 dated 09/19/2005. LESSOR INITIALS:_ LESSEE INITIALS: — Z Hif hill v V, ILI Im kv Fill I ly is li 0 Ill IN It i ca 41: ILL] ly I aRpn° d$� ;wp a 4 aK- i � �V IYgg3n ��S LvI S Rolh a ^ it 196�� x X88 = °Y nR�4 a 6 NNpSeeX FFr +a qq 0 1 a W $ o qu 4. Of F �6 ggg° §o $gip fROB CA[ ryY a p ° 49 c' �� parr qj p ysa gtl i� °g o 6 w § �a hr � Ws ; Y i F p n w» �d �o W p ? v II F a ?F yy i F ggpp� r fi y r+ Y «I r 1 pyy ! 1 1 gg f r S i 'LLI it I , rl i tt / I� pp IF Ie 1 i it a h t #i ii iilt lr II qj r k� f it 1� f + r t ! 4' v II F a ?F yy i F ggpp� r fi y r+ Y «I r pyy ! 1 1 gg f i it I , rl i tt / I� pp IF ° 6i iill tEi �t ftlr I! l�ijlt ` S it a h t #i ii iilt lr II qj k� f it 1� f , f i ° S h f ! 4' F4 llX . 511 . rF S; k� STB T (ABAND ST Os^ r- I Pali .qoW. ffi IZ i 2 m-• •Mobile t. F 4:1 � E�7� 3K:+�37,. TZI lo $7a V�h �s- .k �z -I. ..-1 1. -7 0:7 -1r ON =1 ON �Ia7J 4DN po _NN: -Nr 0. hvW ML c 60E0 `5114 s¢i 3iMM acs +a.rm tw3y f °" f�w- a".�a°o at. i�non •v Y3Bw .. :GnvYOCVG. nRG -aG - .lAa.mi lgi P.T av NCG.v 3X1v4 W �aR Waofv 9n 6• FYa� .iC e -� 3A5 MTA �r n �l f .mx r - tvr..a.m..amGa�w Kod3d.�Y � __ g. aumacs -nasty r �•� �'.w ,tr vrra.re y' YJ 3lGT +hCYLYJ n .]9Ml G ': Jina73l 3n 'JiIPJ 3Y.LL W'J A .a ss.wan <cwa —n GaGR3e0 G ♦rC( HN 3° N4� 3 /ti U. �: ry^K ti vBW ib7.73.d � wv YiY1Y 3w J3vOJ 1 1. vM9a G. aBiM1 �v'44 R. YL.G WN° RnWA Gr.Nii 3l4 e3lM1Y.f XYU.'e0i 9nuGG' ?i G•Jiry3,i' 3u L y O. ]GN: 3f\ Y. CMV t33G 3n. a' t(' 3n at4YV 9G[Ot �y rar.� e.�t. / c.w� �>^. aGa7i ..w » ao�i{ an9roa YaG •*a.i a •aaw 3^.w -, Y �mw - aGm,,._. .. a.0 c c �� a.. oi. a.e° Gr. F_N j PaB. a __ G3S ON. °. ♦.4. �.e 3y.(f vNa3Y.v V �YI � a.. rcuxayo,.,.�,a.oua3 ,�ma i cc.�.0 acJ35:�, aotm ®�muA.a 3t ^43cD:.: >9' 3� ^G3r1GS 3GGG .aG':GG XCG7 k 4h! FYa� .iC e -� 3A5 MTA �r n �l f .mx r • a.. vac - '. Kod3d.�Y � __ g. q iurvfnl r �•� �'.w ,tr vrra.re y' YJ 3lGT +hCYLYJ n .]9Ml G ': Jina73l 3n 'JiIPJ 3Y.LL W'J A .a ss.wan <cwa —n GaGR3e0 G ♦rC( HN 3° N4� 3 /ti U. �: ry^K ti vBW ib7.73.d � wv YiY1Y 3w J3vOJ 1 1. vM9a G. aBiM1 FYa� .iC e -� 3A5 MTA �r n �l f m • a.. vac - '. Kod3d.�Y � �• nPo00: L. Cm a3M 3' _ Cz,T+irO]316: 5e0 � 3+: aL O. n � � u arG.x'a n:3 M 6v }v. P+IVM9A' in G_ iY Av 4 Y y�.�\ y' YJ 3lGT +hCYLYJ n .]9Ml G ': Jina73l 3n 'JiIPJ 3Y.LL W'J A 3YT- C�'M1'YG GaGR3e0 G ♦rC( HN 3° N4� 3 /ti U. �: ry^K ti vBW ib7.73.d � wv YiY1Y 3w J3vOJ 1 1. vM9a G. aBiM1 �v'44 R. YL.G WN° RnWA Gr.Nii 3l4 e3lM1Y.f XYU.'e0i 9nuGG' ?i G•Jiry3,i' 3u L y O. ]GN: 3f\ Y. CMV t33G 3n. a' t(' 3n at4YV 9G[Ot �y rar.� e.�t. / c.w� �>^. aGa7i ..w » ao�i{ an9roa YaG •*a.i a •aaw 3^.w -, Y �mw - aGm,,._. .. a.0 c c �� a.. oi. a.e° Gr. F_N j - __ G3S ON. °. FYa� .iC e -� 3A5 MTA �r n �l f Yd TY. vM31M �ay TYG11N 3n T ?nom ^n aoa c°Yw� -ML. w'�a h0 .b'.N3;aC rhN31N" �ay %b '_ t- -ML. �: ry^K ti e..c its �y (�a - .Y GENERAL-NOTES M't:E�a MSn . uC 3f 'TYtR F.a[ !v'A.nw ♦ "S TMp Pl MGRJ f dMn.S ''m d' WAA I: >mY..WMY i!YPM1C iAX "HZ?.[ M.RJ ICj .Z fuTF M 9HC'n HT lv�1aM a W6 T� .RRN4 ^��reSnN Sl! -CV+rt .. �pyx py ZFK E,FM,P Y., .(.;Yi'.� ?OF,vv WP H EwL' .nYHV iJ M ZTht(Nk !SAFl•L- :6LiP a'O w" 49(F i34(JI' HaE P.1^ ,re .(OafA fr➢IPR z.Yl x'-V9E o ,M•m.RaG caE �[_ axY'En .,O cW4.CR J'RP'xn RG4 Ai�SEf w ➢KK•imMm'. ;9.xl4ivyy�- Hi^nbC3AD vrcN ®i5i Hrrr. aws - . x,.. FX;a w - ..owro. -, ..x rmm�uw m rc*E: +e. x..r. REINFORCMO STEEL R"s' nHE v+.,., J.,-,,.e „1.J,tx rvb s.X_ ud. s ^v yr;. wa xJ o w rr. STRUCTURAL STEEL uw..o .w.a • .. ucsn .._ rt i- M1,LLaW YVMi1t`n ry - YMI x .. ✓[ W'naE. P v) H u- n .._ ,tviGi'll3 !X.UCY.E 2 VPL]>LO ,SKNC aSF>? c'1`RCTn�FI(nrw WY'.p.SW.xT Y.YIENY Mt]ri. ti uFN"6 T •v'� . rtlllG'rMtY F!64rci1 R) Rx n !Ott iM, S R,E.O(➢ W Y rbgA,s /'XL'A .'o va..vP A'4 Pviry Y ROID M w5 • ! X d.TS eWPCR? Rmu"aEV e x aE; m wrr•.w CONCRETE ti i0.4D -w -N.R 'JMFl( iwa 'uh a,wv rf ui iy iRD!4(+6 31V N. ., i � UlxTi ¢O Ravi M,0 'SYJ,1 P [ME a RW RPFJ TO]I R4,Y _ --. .. rvawcar. a•.s' was nz zus � .s K aac a au- smsw�% �J'F°m[rzn c+ni Po`� +.„!K w rte. n,.te w�+es yr .e:.rzs ,!✓ava�iaitfl � s Zxwen 3 - r �, e[. �- -.r commAICTION MATERIALS_SPE�CATIONS. gONCIIETEBLOCK MARY e.4m uMS, ''fit 'ems Spx JKEW � kv s w �ws iv .ib w .n ry -a. Ltll '� •I Bld Rlav uwF� �_ xtttL }:SAM KS ,ICY9 �6,rt. i TilfEx B6= v6 R,[M P .. Of :.7N[rtn E S Iti MY.�. x ti,TR,wxF'Jn wu.m 'N . w..sn •n +VR w141S, IECt rvM � .a P2^ iWT[nt ^x yl.• `= 1i REINF. BENDING DETAIL CONC BLOCK DETAIL FRAMING LSI fLE.R -¢c— - ' - Srnx YN FV. grvpS nCx A Y;a MXUVry rA� 9Nf. rH. k t[ rxwX ♦,Fla.. .. R:._ r. dM YFa a w) wa c '•' � 91M1CPM W WS .9w ftw0.v 7 3 s. WYW ?a [N `IW HWLRwTiSm _ D !u. 3WLL EITCSIR Ff!RT A,41 rni .,cr TFIPR M� � wig Y n 0.YS M:[J[4E0 x. ” O�F }Iai`nLaAi fwu 3.M � 3^wvcT'0. xN EES CT� EE rJ'fJ n IPVKS mm ;J sus. _,. _u ;z we. - e-_ x,•aa --; s. 'l3 n ix'EeSECr�'nS "iT�wk ,� .'e CEr1C l]RR it owi� PMEFS [C[ . an * -m XE.aws t,emsrc � .,�� n.(q•Z[ aEai� uvF[�[rJ�. ?M[�J s : +s .con wvw. wnc Xwo nwmo ns+..s .FSF •. ma'.+a v,a aw°an � l sa +;.s•!x xwac awf�swf �"s�'n.'a tyro mwi o- .- '+a•� -. Fx'r T X -Mobile rt� -ERd -'E °oRK _> mDOiO -c .on,esE a CA n �7 NEB-:_ *�O'ES a�ESEize x.a_ „r ^. CONC BLOCK DETAIL FRAMING LSI fLE.R -¢c— - ' - Srnx YN FV. grvpS nCx A Y;a MXUVry rA� 9Nf. rH. k t[ rxwX ♦,Fla.. .. R:._ r. dM YFa a w) wa c '•' � 91M1CPM W WS .9w ftw0.v 7 3 s. WYW ?a [N `IW HWLRwTiSm _ D !u. 3WLL EITCSIR Ff!RT A,41 rni .,cr TFIPR M� � wig Y n 0.YS M:[J[4E0 x. ” O�F }Iai`nLaAi fwu 3.M � 3^wvcT'0. xN EES CT� EE rJ'fJ n IPVKS mm ;J sus. _,. _u ;z we. - e-_ x,•aa --; s. 'l3 n ix'EeSECr�'nS "iT�wk ,� .'e CEr1C l]RR it owi� PMEFS [C[ . an * -m XE.aws t,emsrc � .,�� n.(q•Z[ aEai� uvF[�[rJ�. ?M[�J s : +s .con wvw. wnc Xwo nwmo ns+..s .FSF •. ma'.+a v,a aw°an � l sa +;.s•!x xwac awf�swf �"s�'n.'a tyro mwi o- .- '+a•� -. Fx'r T X -Mobile rt� -ERd -'E °oRK _> mDOiO -c .on,esE a CA n �7 NEB-:_ *�O'ES _VSK . of[ .qoW.. ffi R .qo ON. I $$ u EI d & q i a V i yyy 4 I\ r, v ul n. djs u �a a r .� s i g ul rni It J,, . .�3 •uv w w U ar ''Egg, §o�aayx 9�WW WO'y� bg3�yg wWu��S� yY� �'3 qR d .M \t jh � 4tl ���i0 W � h� 4i •� iy(fd Midi Q �'ri3Y'�1�4 "� � )� ]�r �� 3�Y� � -. Q r; r>t5' W. la :JSs 1 HW ell"[�1 y^ Sgqj� n I 17P �neN3 r; r>t5' W. la :JSs 1 1 41 i, 11 '.I "I �L , 1 t I �pf I11' . t u�Q iiu Y �+ is 1'� � d 8• QH4 . 1.S HW ell"[�1 y^ Sgqj� 1 41 i, 11 '.I "I �L , 1 t I �pf I11' . t u�Q iiu Y �+ is 1'� � d 8• QH4 . 1.S HW I 17P �neN3 1 41 i, 11 '.I "I �L , 1 t I �pf I11' . t u�Q iiu Y �+ is 1'� � d 8• QH4 . 1.S HW 1 41 i, 11 '.I "I �L , 1 t I �pf I11' . t u�Q iiu Y �+ is 1'� � d 8• QH4 . 1.S ,1 It w W a:�a t �•`f��` a � w, y , u wl ;v S��W� Y�� #�n Y nC. • c C1 y Ull F u , Y pTJ Ul . 1 �,n � 6 �• i �., � its # � s�@ �. � + _ �I u; CC M? <.d a wY3: p- 91 ; YEd�g � Pa ,�6 1 > k 11 �_ Sao nk y Oj Jj O Y w W,MR�M1 3 ° 1 3Witf m rn (1111 Jj Y w W,MR�M1 3 pp qq O p s tip 9 ;, p4 fw £ v m a f IV f lid 2 pit Z x+99: SRS U W r I'M xJ d �4� a it ti I � � e 1 m rn (1111 qq O p s tip 9 ;, p4 fw £ v m a f IV f lid 2 pit Z x+99: SRS U W r I'M xJ d �4� a it ti I � � e � � iq °; i) �, a �g� ➢y& � �° �A ��a � z; �'3 0,4 ° Ea � d o` o sy �. k od' gg eo k gg �p pp aCo pig q m n O d O� w� N 41 IR'1 1 ui N %��Y f - i tltltltltltl }� � � i s T I �1 �a � 'VY �•9�0. � -1 I III} � q qq I 1 _ m n O d O� w� N 41 IR'1 1 ui N F zv tt f! v sU1 gg III fns. f PIA �i. .:� rapaF aa- Fa^6� ���� ZI gg44 0`I 0 ,I I.l v$ 4 ( n moo.. u' uj Q It 194 MA9� ,� v al ul 1 1 1_ Ti n n Vii e 3 F3 ul � 9� `i ° 9�$ _8 �o E � ' i °c d^ Diu "�.�dt R�• 6 $� U, � H � !�8 82 pC GS �o � � �� Vvd@ 8k :6$s�F'�o oW� ,G� E�r4a �~ ♦�e� � c z < d o � ..� k of o$ 4 ` 0 v a d 1, a i i w n n WI l9i U. a�_ LLI u i ,1 ICI; u: i i t P I i i �a �g �5 y� a P-3 `! w n 6 w ,pp i _ ,I �T U I l 5srW4r d etpy u '^Cd 3 rSU Piµµ �9 pA1 ay nl� n. UPI r ' n; P-3 `! w n 6 w ,pp i _ ,I I a' l r j �T U I a' l r j ra; fF P H�ic � b nP 6 i n' �2 2W W n V ¢1 Vi 12 ✓ Sol �n aw Haig o m mi w w cj S y p cz5 "S2 �R _ q DcF swig ?� °F `y 37 rc oo a Sg �pNr ix °tiu° uo G Wn < a°n� m v_+ �� �¢'U c� 1; $K °vwi SNw g O 1 m w i> a o r U zd Win�o InO<i yrc� �" ' ys� �o t€ ¢ I^S "p<'�°+ alv'.I8. Zn NN Z¢o <N2 ��n 2 6''ji SZ 2_ al i N w$i o1,6 & .iJJ �Fq vl �z zB 6z3 �w ?�J� 1 °z mV zp$ op w °w w u a p qG o LL w4ia p� \m zrc 'vl iii z_ o° z p�GjK V U �w Uw �O �I� 5~ � �0 `C rn yVj O Iri S GG�Tif aK ¢K gC ¢4 �'p OV IJ OU �2 �ii � �6 •� �Z� N N N N N U �n o o owl za a° wCi� o zZ ao�k¢" e$aQ3 :51a �nqm zeo n9 ma °w° o $ $ a g H��y (o��mWNI 3o� (rye °op iav VP MH Aa [CCn 5,% JJQ O Oy pF�jr * °O°F�U 2m yy6°ZNZ�I Z Zp w 2e OoOp yZjL r mz p ~ °JZ`in ? o° mc°i _� g23p �-i ° oi{ .zm Wo¢ ma oc�i v iii o �°.y�o u_ Inwk a i>a °wr,+ y7 �wrcZN iFp mqp z'mw^� asp ze°v°i wo �mm ¢ �z solwil zjE zg�o .. � Z ui�Wzd° 3 25 Ji w 3w o Wz w q, �KwK�<}pa,� .f'iy�Il/n�F io UOV3p in $Y nu Z°Z ZO= Y DU'Z �y Y �+ NWO 22J w� Y I°ya W A, wo ZK pQ p pp>>� nn,Nl >WI>JJU Ny�1m2U_2 � �Cn }fin CC� 7 zQ GjOp������ F� OF Oy�O Gi23o N� �� NG 3„=,�w ego Rapi °��''oln?rc °G cwi Qzdw'S 8 =� k''" n�4g d3 ? °-'zy za �5 Ocwig °H z j N F� _0 D QER W 6 4 1 E -H aln7�'TdoaoSp tpa z5 i� &N dvni N M V of b h m m • p�` ��3� €a Vii; �I�� ^�f'E�� i " Z4 �o a �`o n OOV W O�� a G °wz 4 a z �z 00 v p a w S w rail j Z B¢O a c m z G ZO JO O j V O40 L.1 �" > a J o u z U J z Z J 2 p�Z+z w ¢ a < x Q al A aWw bwi lid � z 3 'w` z � 3 0 FO ~ b6J mQ W S Ti-i Z N0 O, M Z =m O O 0 I d C G O K � p 7 z W�rr11 a a Li _ W I — - �I9IIn y1 9 1a elfgN vi CV a Q w P a C,e o dS c - II � x � s NO J n J z I O z O 0O¢¢ O O —1 O W W x O K 0 4 O CK a z F 7 ti O� U W LL q V z Z N O 4 b O oil O UG 1 � Y6 F O n a• W V z 0(J i z o 4 0c> v 0 � o �� a ¢ z �w O K z O F V �z 'oQ r + > O Q> w YCK O� G G R a 1 z z j I-. F-W Uz W a' a' JK p 4- a a' 2 x Wz L- U UO WU Zqq 6' J Q 3 W F IW-LL zO I 0 p 1- a o o mz 3 3 z o i b uF-i z Q`J` x? x0 0 o z 3 u K p ON J b0 N U O pW NO 0O 30 O O O Xn xb� NN p p O ED .... .� � � J!� � m s , y «t® §2! #\§ || ||| W211 )■ §�§|| § \Se S@@ �®. i k � J }� ea ƒ / e �) @ �® t # ; / \\ �\ \ \ / @] 8/ � - -- @ . ! y «t® §2! #\§ || ||| W211 )■ §�§|| § \Se S@@ �®. i k � J }� ea ƒ / e �) @ �® t # ; / \\ �\ \ \ / @] 8/ RLL' -�30 -2006 16:01 �ca^zisk sarvices,Inc of washington 1420 Fifth Avenue Suite 1200 seattla wA 98101 -4030 USA aR1nIW T- Mobile USA, Inc. its subsidiaries and Affiliates 3211 o SE 38th Street Be] i eVUe WA 98006 USA Va tm VM*rPeKm.VCIL A�mY '^ f ^NrMSPN,O@78RALLU93lrr 'a.tlLD WDe ® CCL17R URtra[ ) Ll"ilitY =+K1. GOWLAWROrAMLAUTANIMIeR MLTV ❑ � ❑ Lac A ANYAM A OWMAVTGI ICISOl3E0AU'rW UM A" NONOWNWAUM ANY AUTO ralpKThKB 525.000 �- '+olO6aRCdOl1MATRW I Flo 8 OOLOYOP IAAaTHTY ANYM00KW=1rARTK1a!BXhC p aorleLSNNMZWUX Wf VYe,aw,b. �i IrBC1A1RCVlODNa Le.. CTOLR #t City of Santa Ana ZE6 W. Santa Ana Ave. Santa Ana CA 92707 USA P. 02/03 I 1169 CERTIFICATE IS MWED AS A MATTER OF INFORMATION ONLY os/WOG AND CONKERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS raRTONALaADVeWRY CBRTTFICATE DOES NOT ANEW EXTEND OR ALTER THE i COVERAGE AFFORDED BY THE PW,ICIES BELOW. d .n BL„DHr- ARe-ILA awrTav� . 73 INSURERS AFFORDING COVERAGE NAIC0 wRquaA: GraenNich insurance Comoahy 22322 Dames: Travelers Property Ca$ Co of America 25674. �• IMaURkRn National Union Fire Ins Co of Pittsburgh '19445 " MsURM o: ne Park Site Address., 2135 W. n Ave., Santa Ana/APN 109- 050 -30. The for nsured General Liability Solely as respect to operations of the Named 6 Balms, Os /01/07 891'1 ABUBD TO TM DMURBD NAMED ANOVE FM TIE !OBEY rEWD 1N0M.ATED. NOTWrrH3TANWNQ 3NTRACT OR=aDocxmwT WITH REWM -r TO WHICH TIM CBRTH ICATE MAY BE ISSIAD OR MAV ES DFSCRtWO JWAWN 15 SUBIEC'r TO ALL THE TERM& EXCLUSIONS AND CLWDMWS OF BUCK MICUIS. :9DBYPAIDCL.LIMS. .'Otx -r rlUMaol Iwt[DMDO�m1- �+sa�MloNm7 _L1_H_ ''_s _ OOug<— OS /0 OS /01/07 Tuea oetvRRr NeR I S1,000,i AUTOCN.Y• OA AOdOTDtT GTtMRTKAN RAAOC .. AUMOIR.Y: AGO 3AOTOCCU TCr. 041916OS606 os/WOG DS/01/07 raRTONALaADVeWRY S1,D0p, i 10A• OR, W1 BL„DHr- ARe-ILA awrTav� GRNALLADOIOGAIR s2.a0o.000 ILI..012W&a01.TL.YTIIDT I- ,N S "WOUCTS -00MM rAOG (2,000. DNS AODao EV OWDRiOO+1APYQAL rROVOICHS ne Park Site Address., 2135 W. n Ave., Santa Ana/APN 109- 050 -30. The for nsured General Liability Solely as respect to operations of the Named 6 0S /01/06 Os /01/07 DAT9 nlm moo.TI® WDIMO DOURER WILL Da" onto MAO. w DAVRWRIITONNMI®TOTMCUTMCA"KVL RlNA1®TDVNELWr, OTKaNUICMT ImEN00q iT1oN6C7RffiLLTW¢BTXLLTWQM,�tr]S(• . . (e. saki 91.000.000 .��. 5000067 05/01/06 05/03/07 aCOaY TNlURY f k Aned 6 a000.Y M1lRY lM�l (}$�� 1 AUTOCN.Y• OA AOdOTDtT GTtMRTKAN RAAOC .. AUMOIR.Y: AGO 3AOTOCCU TCr. 041916OS606 os/WOG DS/01/07 RL- aA ®wT1L70H+r BL,ew, am 10A• OR, W1 BL„DHr- ARe-ILA awrTav� 51,000, ILI..012W&a01.TL.YTIIDT I- DNS AODao EV OWDRiOO+1APYQAL rROVOICHS ne Park Site Address., 2135 W. n Ave., Santa Ana/APN 109- 050 -30. The for nsured General Liability Solely as respect to operations of the Named iced by contract. SHOULD ANY OPI'ae ABOnDISCLIBED MUCUM RL CATR8LLID 1170RIL TH3 B7VI ATM DAT9 nlm moo.TI® WDIMO DOURER WILL Da" onto MAO. w DAVRWRIITONNMI®TOTMCUTMCA"KVL RlNA1®TDVNELWr, OTKaNUICMT ImEN00q iT1oN6C7RffiLLTW¢BTXLLTWQM,�tr]S(• . . AVrNCRRBDRHpMM TAnVz r� ' .+ J aG u 4J- Va P.02 ENDORSEMENT # 008 W207 (7M) This endorsement, efftciive 12:01 a.m.,0510 V2006, forms a part of Policy No. RGD5000004 issued to T4AOW E USA. INC. by Greenwich insurance Company ADDITIONAL INSURED —WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies Insurance provided under all coverage parts_ Section l INSURED Insured ocganiwn for whom you have reed under wri(ten contract or agreement to za g provide insurance. However, the insurance provided shall not exceed the scope of coverage andfor limits of this urance this Scope d regr+e by said contract ara7eemenf. p e exceed Mother terms and conditions of ff" policy remain unchanged. ,�.�.�. Authorized RepKsentailve ACORD,. CERTIFICATE OF LIABILITY INSURANCE,. =- DATE 01/255 °/22008Y� PRODUCER non Risk Insurance Services west, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY fka Aon Risk Services, Inc- of WA AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 1420 Fifth Avenue Suite 1200 Seattle WA 98201 -4030 USA CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC q PHONF. 206 749 -4800 -x-(206) 749 -4860 INSURED INSURER A. Greenwich insurance Company 22322 T- Mobile USA, Inc. its Subsidiaries and Affiliates INSURER National union Fire Ins Co of Pittsburgh 19445 12920 SE 38th street Bellevue wA 98006 USA ,C() % A {/N O�? '� Q 1 U INSURER C. XL specialty insurance Co 37885 INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED HFLOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR 111E POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT IO 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD' INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATT{MMV)D\YY) POLICY EXPIRATION DATE(MM\DD \YY) LIMITS A LIAB ILITY RGD5000064 01 05/01/07 05/01/08 EACH OCCURRENCE 51,000,000 COMMERCIALGENERALLIABILITY DAMAGE TO RENTED 51,0001000 PERAL CLAIMS MADE ® OCCUR Contractual Liability Incl. PERSONAL k ADV INJURY 51,000,000 GENERAL AGGREGATE 62,000,000 GENT. AGGREGATE LIMIT APPLI ES PER. PRODUCTS - COMP)OPAGO S2,OD0,000 ❑X POLICY ❑ PRO- JECT LOC A A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED ALTOS RAD 5000066 01 ADS RAD 5000067 01 M,y 05/01/07 05/01/07 05/01/08 05/01/08 COMBINED SINGLE LIMIT (� ) $1,000,000 BODILY INJURY SCHEDULED AUTOS (Perpm n) HIRED AUTOS BODILY INJURY NON OWNED AUTOS (Per auident) PROPERTY DAMAGE (Pct accidcot) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT 1H ANY AUTO OTHEN THAN EA ACC AUTO ONLY: ACG B EXCESS /UMBRELLA LIABILITY 9834866 05701/07 OS EACH OCCURRENCE OOCCUR ❑ CLAIMS MADE AGGREGATE 55,000,000 HDEDUCTIBLE RETENTION $25,000 C c WORI(ERS COMPENSATION AND F.MPLOYERS' LIABILITY ANY PROPRIETOR) PARTNER I EXECU I I VF OFFICEWMEMBER EXCLUDED? If yes. deccribc urMtt SPECIAL PROVISIONS lx - A05 RWR5000124 w 1: 05/01/07 05/01/08 X ( 3TATU- OTH- umrrl ER E.L. EACH ACCIDENT $1,000,000 c E.L. DISEASE -EA EMPLOYEE $1,000, 000 b E.L. DISEASE POLICY LIMIT $1,0001000 OTHER - i DESCRIPTION OF UPERAI ION& 'LOCATIONS /v EHICLES)EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Site # LA03010A, site Location: TMO10 Jerome Park, 2115 w. McFadden Ave., Santa Ana /APN 109- 050 -30. The Q Certificate Holder is an Additional Insured for General Liability solely as respect to operations of the Named C insured at the above location if required by Contract. City of Santa Ana 888 w. Santa Ana Ave Santa Ana CA 92707 USA SHOUT n ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION s DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL Y 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, a� BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY B7 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. 1UTH01I >F l DREPRESF.NTATIVr Jam/ i/i ACORD ACORD,CORPORATION . ■ ENDORSEMENT #005 This endorsement, effective 12:01 a.m., 05/01/2007, forms a part of Policy No. RGD500006401 issued to T- MOBILE USA, INC. by Greenwich Insurance Company THHIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under all coverage parts. COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM RAILROAD PROTECTIVE LIABILITY COVERAGE FORM Section II — WHO IS AN INSURED is amended to include as an Insured any person or organization for whom you have agreed under written contract or agreement to provide insurance. However, the insurance provided shall not exceed the scope of coverage and /or limits of this policy. Notwithstanding the foregoing sentence, in no event shall the insurance provided exceed the scope of coverage and /or limits required by said contract or agreement. All other terms and conditions of this policy remain unchanged. Authorized Representative GU207 (7/99) T— Mobile USA, Inc. Policy #RGD 5000064 Effective May 1, 2006 b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured; but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the ap- plicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claim- ant's legal representative. 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Cover- ages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when b. below applies. If this insurance is primary, our obliga- tions are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method de- scribed in c. below. b. Excess Insurance This insurance is excess over: (1) Any of the other insurance, whether pri- mary, excess, contingent or on any, other basis: (a) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work'; (b) That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner, (c) That is insurance purchased by you to cover your liability as a tenant for "prop- arty damage" to premises rented to you or temporarily occupied by you with permission of the owner, or (d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section I — Coverage A — Bodily Injury And Property Damage Liability. When this insurance is excess, we will have no duty under Coverages A or B to defend the in- sured against any "suit" if any other insurer has a duty to defend the insured against that "suit ". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other in- surance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of (1) The total amount that all such other insur- ance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self - insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution -by equal shares, we will follow this method also. Under this approach each insurer contrib- utes equal amounts until it has paid its applica- ble limit of insurance or none of the loss re- mains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's " share is based on the ratio of its applicable limit of insurance to the total applicable limits of in- surance of all insurers. S. Premium Audit a. We will compute all premiums for this Cover- age Part in accordance with our rules and rates. b. (2) Any other primary insurance available to you covering liability for damages arising out of the premises or operations, or the products and completed operations, for which you have been added as an addi- tional insured by attachment of an en- C. dorsement. Premium shown in this Coverage Part as ad- vance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. The first Named Insured must keep records of the information we need for premium computa- tion, and send us copies at such times as we may request. CG 00 01 12 04 © ISO Properties, Inc., 2003 Page 11 of 15 ❑ r'1- X07- D 8 i A- aoo�- -cZ7 ACORD.. C R T1I1CATJ90 iLMLM- �i�f'lki �.. .:. �� ... _ 06/25/2008 . �y �i DATE 06/25 /2008 PRODUCER AGO Risk Insurance Services West, Inc. fka AGO Risk Services, Inc. of WA THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONI A AND CONFERS NO RIGHTS UPON THE CERITFICATE HOLDER. THIS 1420 Fifth Avenue CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE Suite 1200 COVERAGE AFFORDED BY THE POLICIES BELOW. Seattle WA 98101 -4030 USA INSURERS AFFORDING COVERAGE NAICIt PHONE -(206) 749 -4800 FAX -(206) 749 -4860 INSURED INSURERA Greenwich Insurance Company 22322 .. w INSURERS XL Specialty Insurance Co 37885 T- Mobile USA, Inc. its subsidiaries and Affiliates - - INSURER C. National union Fire ins Co of Pittsburgh 19445 12920 SE 38th street Bellevue WA 98006 USA s` INSURER D w a_ INSURER 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS SHOWN ARE AS REQUESTED INS R LINK ADD' 195R TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE(MMWMYV) POLICY EXPIRATION DATE(MMIDD\YY) LIMITS A LIABILITY RGD500006402 05/01/08 05/01/09 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED $1,000,000 COMMERCIALGENERALLLABILITY NENFILkI, CLOMS M1I.4DE ® OCCLR contractual Liability Incl. rN N —.7 Am one Oer�A PERSONAL &ADV INJURY $1,000,000 ElGENERAL AGGREGATE §2,000,000 GF,N'L AGGREGATE LMT APPLIES PER'. ❑X POLICY ❑ PRO ❑ LOU NO E` PRODUCTS - COMPIOP.4GG §2,000,000 A A ALTOMOBILF X LIABILITY ANY AUTO RAD500006602 ADS RADS00006702 05/01/08 05/01/08 05/01/09 05/01/09 COMBINED SINGLE LIMIT (Ee azedem) $1,000,000 Z BODILYINIURY ALL OWNED AUTOS MA A SCHEDULED AUTOS ( Per person) L HIRED AUTOS ' (, BODILY INJURY NON OWNED AUTOS `,. e ( *. _� \,i 3'. �5. (Perwrrdeml PROPERTY DAMAGE (Per eccrdam) GARAGE LIABILITY _ AUTO ONLY - EA ACCIDENT ANY ALTO .... U V' ..r. OTHER THAN EA.ACC e AUTO ONLY AGO C EXCESS /UMBRELLA LIABILITY 5443136 05/01/08 05/01769 EACHOCCURRENCE OCCUR ❑ CLAIMS MADE AGGREGATE §5,000,000 ®DEDUCTIBLE RETENUON $25,000 B RWD X 0C STATU- 10111- WORKERS COMPENSATION AND AOS Y LIMITS E B EMPLOYERS LIABILITY RWR500012401 05/01/08 05/01/09 EL EACH ACCIDENT $1,000,000 ANYPROPRIFTOR: PARTNER/EXECUTIVE WI OFFICEKNWMBFRFXCLUDED" EL. DISEASE -EA EMPLOYEE $1,000,000 If,., describe wde, SPECIAL PROVISIONS E. L. DISEASE - POLICY LIMIT $1,000,000 Mbw OTHER DFSCRIPTION OF OPERATIONSIOC:ATIONS'V FI)ICLES %EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Site Number: LA028990D, Site Name: Fire Station. city Of Santa Ana is an Additional insured for General Liability solely as respect to operations of the Named insured at the above location if required by contract. The policies certified hereon are Primary to other insurance available to the certificate Holder, but only to the NO City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Attn: Sandi Gottlieb, community Dev. DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 2D Civic center Plaza M -25 BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY Santa Ana CA 92701 USA OF ANY KIN D UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES. �1 AUTHORIZED REPRESENTATIVE. ... lW liWi�41._ r ', .. <,. ,.. "'�'. S'... _. .: {P'VSRV£»t,".....- hC.yt.�yi�YyK�4}M8gt� Attachment to ACORD Certificate for T- Mobile USA, Inc. The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage afforded by the insurcrlsl. This attachment does not contain all terms, conditions, coverages or exclusions contained in the policy INSLRFO T- Mobile USA, Inc. its subsidiaries and Affiliates 12920 SE 38th street Bellevue WA 98006 USA ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. rVSR LTR AWYL INSRD TYPE OF INSURANCE ANCE POLICY NUMBER POLICY DESCRIPTION POLICY FFECTIVE DATE POLICY EXPIRATION DATE LIMITS 3SCRIPTION OF OPERATIONS /LOC kTIONS NTMCLES.IESCLOSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS extent required by written contract with the insured, and always subject to the policy terms, conditions and exclusions. Certificate No : 570029239871 El ENDORSEMENT p 006 GU207 (7/99) This endorsement, effective 12:01 a.m.,05101/2006, forms a part of Policy No. RGD5000D64 issued to T- MOBILE USA, INC. by Greenwich Insurance Company ADDITIONAL INSURED —WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under all coverage parts. COMMERCIAL GENERAL LIABILITY COVERAGE Section 11 — WHO IS AN INSURED is amended to include as an Insured any person or organization for whom you have agreed under written contract or agreement to provide Insurance. However, the insurance provided shall not exceed the scope of coverage andlor limits of this policy. Notwithstanding the foregoing sentence, In no event shall the insurance provided exceed the scope of coverage and /or limits required by said contract or agreement All other terms and conditions of this policy remain unchanged. Authorized Rep sentativer CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DDNYYY) 06/14/2012 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(ies) 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 Aon Risk Insurance Services West, Inc. Seattle WA Office CONTACT NAME: PHONE (206) 749 -4800 FAX (206) 749 -4860 (A/C. No. Ext): A/C. No.): E-MAIL ADDRESS: 1420 Fifth Avenue Suite 1200 Santa Ana CA 92707 USA Seattle WA 98101 -4030 USA F 'X' XM ylfitliw X "XI INSURER(S) AFFORDING COVERAGE NAIC 1t INSURED INSURER A: XL Specialty Insurance CO 37885 T- Mobile USA, Inc its Subsidiaries and Affiliates INSURER B: Greenwich Insurance Company 22322 INSURER C: National Union Fire Ins Co of Pittsburgh 19445 12920 SE 38th Street Bellevue WA 98006 USA INSURER D: S5,000 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: b /UU4bb4b913 REVISION NUMBER, 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. Limits shown are as requested LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM /DD MMIDD LIMITS B GENERAL LIABILITY Santa Ana CA 92707 USA RGD F 'X' XM ylfitliw X "XI EACH OCCURRENCE $1, 000, 000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR PR DAMAGE ES Ea occurrence) $1,000,000 MED EXP (Any one person) S5,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 POLICY PRO X LOC IECT B AUTOMOBILE LIABILITY RAD 500025701 AOS 05/01/2512 05/01/2013 COMBINED SINGLE LIMIT Ea accident $2,000,000 BODILY INJURY ( Per person) B X ANY AUTO RAD 500025801 05/01/2012 05/01/2013 ALL OWNED r SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS MA BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident C X UMBRELLA LIAB X OCCUR 13273159 05/01/2012 05/01/2013 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS -MADE SIR applies per policy terns & conditions AGGREGATE S5,000,000 DED I X RETENTION A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANV PROPRIETOR I PARTNER / EXECUTIVE OFFICER/MEMBEREXCLUDED? N/A RWD5000301 AOS RWR5000302 05/01/2012 05/01/2012 05/01/2013 05/01/2013 X I WC STATU- I OTH- TORY LIMITS ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 (Mandatory in NH) wi If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is required) The Certificate Holder and other entities as defined if required by written contract" are Additional Insured for General Liability and Automobile Liability solely as respect to operations of the Named Insured at the above location if required by contract. A waiver of Subrogation is granted in favor of Certificate Holder as required by written contract but limited to the operations of the Insured under said contract, with respect to the General Liability and Automobile Liability policy. General Liability and Automobile Liability evidenced herein is Primary and Non- Contributory to other insurance available to the Certificate Holder, but only to the extent required by written contract with the insured. Per Cancellation Notification to others Endorsement - In the event coverage is cancelled for any statutorily permitted reason, other than nonpayment of premium, CERTIFICATE HOLDER CANCELLATION .,! / J SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa And ' -� - , , , . _ AUTHORIZED REPRESENTATIVE Santa Ana City Fire Department. - Santa Ana CA 92707 USA F 'X' XM ylfitliw X "XI ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD v M J m :r c m 'O m 9 O 2 rh n T U) O LO rr) O Z dt V li. 1: m 0 AGENCY CUSTOMER ID: 10616550 LOC #: A� ° ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Aon Risk Insurance services West, Inc. T- Mobile USA, Inc POLICY NUMBER see certificate Number: 570046545973 CARRIER NAIC CODE see certificate Number: 570046545973 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, I FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Additional Description of Operations / Locations / Vehicles: advanced written notice will be mailed or delivered to person(s) or entity(ies) according to "Blanket per List on file" - 30 Days Notification. All other terms and conditions of the Policy remain unchanged, with regard to the General Liability and Automobile Liability policy. See Attached Addendum for Site Information. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD INSURED T- Mobile USA, Inc its subsidiaries and Affiliates 12920 SE 38th Street Bellevue wA 98006 USA site List LA02024A - 1405 North French St., Santa Ana, CA 92701 LA02899D - 120 W. walnut, Santa Ana, CA 92701 �svrc AA02901A - 1528 South Standard Avenue, Santa Ana, CA 92707 XA03009C - 1825 3/4 Civic Center Drive west, Santa Ana, CA 92703 ✓LA03010A - 888 w. Santa Ana Blvd., Santa Ana, CA 92707 LA13160A - 1801 w. Segerstrom Ave., Santa Ana, CA 92704 ,ZA33321C - 4622 3/4 west Hazard Avenue, Santa Ana, CA 92703 veA33807B - 1817 w. 21st Street, Santa Ana, CA 92706 1 LA338076 1817 W. 21st street, Santa Ana, CA 92706 a , LA33835A 2302 S Raitt Street, Santa Ana, CA 92704 r LA33836B 730 E warner Ave, Santa Ana, CA 92707 r Certificate No : 570046545973 ENDORSEMENT # This endorsement, effective 12:01 a.m., May 1, 2012 forms a part of Policy No.RGD500025901 issued to T- MOBILE USA, INC. by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED — WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under all coverage parts. COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM RAILROAD PROTECTIVE LIABILITY COVERAGE FORM Section II — WHO IS AN INSURED is amended to include as an Insured any person or organization for whom you have agreed under written contract or agreement to provide insurance. However, the insurance provided shall not exceed the scope of coverage and /or limits of this policy. Notwithstanding the foregoing sentence, in no event shall the insurance provided exceed the scope of coverage and /or limits required by said contract or agreement. All other terms and conditions remain the same. (Authorized Representative) MANUS © 2011 X.L. America, Inc. All Rights Reserved. May not be copied without permission. ENDORSEMENT # This endorsement, effective on May 1, 2012 at 12:01 A.M. standard time, forms a part of Policy No.RAD500025701 of Greenwich Insurance Company issued to T- MOBILE USA, INC. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SECTION II A.1. WHO IS AN INSURED is amended to include as an insured any person or organization for whom you have agreed under contract or agreement to provide insurance. However, the Insurance provided shall not exceed the scope of coverage and /or limits of this policy. Notwithstanding the foregoing sentence, in no event shall the insurance provided exceed the scope of coverage and /or limits required by said contract or agreement. All other terms and conditions remain unchanged. (Authorized Representative) MANUS ©2011 X. L. America, Inc. All Rights Reserved. May not be copied without permission. POLICY NUMBER: RGD500025901 COMMERCIAL GENERAL LIABILITY CG 24040509 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Where required by written contract or agreement executed prior to loss (except where not permitted by law). Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 POLICY NUMBER: RAD500025701 XIC 404 1007 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. Changes In Conditions The Transfer Of Rights Of Recovery Against Others To Us Condition is changed by adding the following: We waive any right of recovery we may have against the person or organization shown in the Schedule below because of payments we make for "bodily injury" or "property damage" arising out of your ongoing operations or work you performed under a contract with that person or organization. This waiver applies only to the person or organization shown in the Schedule below: SCHEDULE Name of Person(s) or Organization (s): Any person or organization for whom you are required to waive your right of recovery under the terms of a written contract. All other terms and conditions remain the same. (Authorized Representative) XIC 404 1007 © 2007, XL America, Inc. Page 1 of 1 Includes copyrighted material of Insurance Office, Inc., with its permission. POLICY NUMBER: RAD500025701 COMMERCIAL AUTO CA 04 44 03 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: T- MOBILE USA, INC. Endorsement Effective Date: May 1, 2012 SCHEDULE Name(s) Of Person(s) Or Organization(s): Where required by written contract or agreement executed prior to loss (except where not permitted by law). Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Oth- ers To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "ac- cident' or the 'loss" under a contract with that person or organization. CA 04 44 03 10 © Insurance Services Office, Inc., 2009 Page 1 of 1 13 ENDORSEMENT # This endorsement, effective 12:01 a.m., May 1, 2012 , forms a part of Policy No.RGD500025901 issued to T- MOBILE USA, INC. by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE CLAUSE ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS COVERAGE PART It is agreed that to the extent that insurance is afforded to any Additional Insured under this policy, this insurance shall apply as primary and not contributing with any insurance carried by such Additional Insured, as required by written contract. All other terms and conditions of this policy remain unchanged. (Authorized Representative) XIL 424 0605 ©, 2005, XL America, Inc. ENDORSEMENT # This endorsement, effective 12:01 a.m., May 1, 2012 forms a part of Policy No.RGD500025901 issued to T- MOBILE USA, INC. by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT In the event coverage is cancelled for any statutorily permitted reason, other than nonpayment of premium, advanced written notice will be mailed or delivered to person(s) or entity(ies) according to the notification schedule shown below: Name of Person(s) or Entity(ies) Mailing Address: Number of Days Advanced Notice of Cancellation: "Blanket per list on file ". "Blanket per List on file" 30 All other terms and conditions of the Policy remain unchanged. (Authorized Representative) IXI 405 0910 © 2010 X.L. America, Inc. All Rights Reserved. May not be copied without permission. ENDORSEMENT # This endorsement, effective 12:01 a.m., May 1, 2012 forms a part of Policy No.RAD500025701 issued to T- MOBILE USA, INC. by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT In the event coverage is cancelled for any statutorily permitted reason, other than nonpayment of premium, advanced written notice will be mailed or delivered to person(s) or entity(ies) according to the notification schedule shown below: Name of Person(s) or Entity(ies) Mailing Address: Number of Days Advanced Notice of Cancellation: "Blanket per list on file ". "Blanket per List on file" 30 All other terms and conditions of the Policy remain unchanged. (Authorized Representative) IXI 405 0910 © 2010 X.L. America, Inc. All Rights Reserved. May not be copied without permission. UCROWN ..0 CASTLE January 30, 2015 City of Santa Ana PO Box 1988 M -23 Santa Ana, CA 92702 Crown Castle 38 Technology Drive, Suite 250 Irvine, CA 92618 Via: Certified Mail and Email RE: BU# 828436; TMo10 Jerome Park RL Telecommunications Facility Modification �(� —2W i - 2--3 1) Dear Landlord: In order to better serve the public and minimize the amount of towers in an area where a Lease is located, Lessee plans to modify the equipment at the telecommunication facility for T- Mobile. The modification will not alter the character or use of the site nor will it change the nature of Lessee's occupancy of the site. In order to submit for the appropriate building permit approvals, the City of Santa Ana requires a property owner signature. Therefore, I respectfully request your signature where indicated and have notarized on the enclosed Letter of Authorization documents and return the originals to me. I have enclosed a return FedEx label for your convenience. If you should have any questions, please feel free to contact me at (949) 930 -7450 or via email at lisa. goldner . contractor Perowncastle.com should you have any questions. Sincerely, I &;j Lisa Goldner Real Estate Specialist (contractor) The Foundation for a Wireless World. CrownCastle.com CROWN CASTLE January 30, 2015 City of Santa Ana PO Box 1988 M -23 Santa Ana, CA 92702 Crown Castle 38 Technology Drive, Suite 250 Irvine, CA 92618 VIA: Certified Mail and Email Re: BU# 828436; TMoto Jerome Park RL First Amendment to Land Lease Agreement between the City of Santa Ana and Omnipoint Communications Inc. for Jerome Park; Land Lease Agreement between the City of Santa Ana and Omnipoint Communications Inc. for Jerome Park "Lease" Consent for Modification Dear Landlord, As you are aware, CCTM1 LLC ( "Lessee ") is the lessee under the Lease. Lessee is a Crown Castle company. Lessee and its affiliates and subsidiaries own and operate shared wireless communication facilities. In order to better serve the public and minimize the amount of towers in an area where this property is located, Lessee plans to modify T- Mobile equipment at the wireless communication facility. Pursuant to Paragraph to of the Lease, Lessee is required to obtain your consent, which consent cannot be unreasonably withheld, conditioned or delayed. Therefore, Lessee respectfully requests your consent to this modification. Please indicate your consent by executing this letter where indicated below and return one original of same to the address indicated above. A prepaid envelope is included for your convenience. Thank you for your continued cooperation with Crown Castle. If you have any questions concerning this issue, please contact Lisa Goldner at (949)930-7450 or lisa.goldner .contractor @crowncastle.com. Sin erely, Agreed and accepted this day of 1120 Lisa Goldner (Lessor's signature) Real Estate Specialist The Foundation for a Wireless World. CrownCastle.com Uv.,�CROWN CASTLE January 30, 2015 City of Santa Ana, CA 20 Civic Center Plaza (M -19) PO Box 1988 Santa Ana, CA 92702 Re: Zoning/ Permit — Plan / Design Review Process Crown Castle 38 Technology Drive, Suite 250 Irvine, CA 92616 I hereby represent that I am the legal owner of the property referenced below, and I hereby give my authorization to T- Mobile and /or its Agent(s), to act as our Agent(s) in the processing and obtaining approval for Building and /or Zoning permits through the City of Santa Ana for the modification of the facility that would be located at the existing wireless communications site described as: Crown site ID: 828436 T- Mobile site ID: LAo3o1oA Site Address: 2115 3/4 W. McFadden Avenue, Santa Ana, CA 92704 APN: 109 - 050 -30 Property Owner: City of Santa Ana, California R Date: / 2 1 The Foundation for a Wireless World. CrownCastle.com CALIFORNIA ALL - PURPOSE ACKNOWLEDGEMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California) County of Orange) On March 12. 2015 before me, Maria D. Huizar, Notary Public personally appeared David Cavazos, City Manager , who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. g;;.. MARIA O. HUIZAR Commission * 1974202 a °sr Notary Public - California i Orange County M Comm. E fires A r 5, 2016 CAPACITY CLAIMED BY SIGNER: ❑ Individual(s) _ ❑ Corporate _ ❑ Officers Titles) ❑ Partner(s) ❑ General Partner of a Limited ❑ Partnership ❑ Attorney -in -Fact ❑ Trustee (s) ❑ Subscribing Witness ❑ Guardian /Conservator ❑ Other: WITNESS my hand and official seal. Signature (Seal) SIGNER IS REPRESENTING: THIS CERTIFICATE MUST BE ATTACHED TO THE DOCUMENT DESCRIBED TO THE BELOW: ZONING/ PERMIT— PLAN/ DESIGN REVIEW PROCESS NUMBER OF PAGES: DATE OF DOCUMENT: SIGNER (S) OTHER THAN NAMED ABOVE: J Ys� W i5 w L m f- of. F f 0 F 4 lH V LL W r Z s €gj a�€ N (n ® °s � co 3 U VS U � RsO w Y J � ZT_ ali W G ® M r g 5 m W W W 'o A s a a3g9 „ i ° „ W W W gg„ :�q- ^assn p = &3 gM' $ . W ZW a as O N �9 u iD 5 & z J U' p N Ta p3 UU �� eg e�aw > ig Y6 �°-� e a N ood4S3g "o 2 W z5 Oa O a�g O W Nap N L1 r W rl Who 3£so o g Po IFFS ¢YG k�o�e�oo is R. %$o ° == Y g° �3I_io b °�o o? ° qq 3 8 0 19H S vod50 N A", '� do "_� `° c €Y�6 3 -FC 0 Z °k�a� ° $ ��R gflP =° m poi C'ffio S6 -6 s 33 P'�o �o �d° WWK £ES f 5 m �z ZO 5 4 =S € kLq € - ;° °� ���� "g ".n �a 53 SO Gtl o dtlk "='Z Pw� s . e€ _ Via_=y Fig= "_ g3°g K I� Z 5wgpq k ;'e_Sa�.� „88k'_ k wFE' .off 336� £ w °dam °E§ =g oRk� 5$z� ky£ § € €_ & o 3E ddo § g¢S S Gg>� E�F� and° B6$° # 8 E° 4d°'� fi,; 4�C ex!N €d� Y w: -= .miG a RE 9 e§h�3= ao 04 ga3k� °o: ia9 p�55 "5wo eY NSwde SE JJa HE 'e z#� e €a N. " �SWd n o °�z b €2 €$� A. - ° e sw &�l33�g �66° ¢Yg M K W d�3o „z�k cFS �ezSs3� offwoe u G � of 16 1 "N En HE =t� =�zk p°.. °.� °- = = >sa °dg k o w o a w t o N all- w e' o ��E �?s4 §oss iis� c c o 5 o _- s =� = ° °asaaada° W€ N A J s e ii .�„sss ssss., z°° °G °a'aaa °� II 04 ` N R i�8 i3o J0`9�G8 H spy �� [y kG <ifa iFFn <i £ 'F<zuG3e::a ,Wi, n a a How IP3` Z m w a oso3=s =gad o IM - z p o o v g .00sc'ww��S� =LLLL ° °�. �D,ee °„w W o NI o o}o, �wrudwWwwai zsvuuuL'.<:°. rru yu3uyf Irn t p .'r .� 0 Sb A '.V J3' 41 W2 a H= p o vf w f a 6 w2ow- n:r '�aea.a,'�maavmma553�d .§ om e ° °�� °d6 °8 w i a s a. tl e �I 2 G m W l7 W ~ ss.mam- 5 .a2:mmmaccas 2 } y I } \ 2 / , .- - - - - -^ � \A \ \§ 0n! , §/\ uu uu .R;=% // `! ƒ \\ ! ! w , 2 } y I } \ 2 / , .- - - - - -^ � {} y � \ � \A �T )1 , F, � 2 k a . , ».� � - - �) ) ong ) )m § zw L 2 l g5 DUI r, LiV 3�'gg WYb� K � M O p �'aF� a'20� yy%W� \ ; 5eG . zo WH:u 5 &= � pO wzo �'0 g U �w a,x "M e rt" - -- 5 IQ4 on � i , aa „I Z ��� a W 0 =1 P :.w W H Z N th a``w r HQ- r iicE S t g_ - v 4 g�s�� IT- { C O H rL _ �a 2 z �g Faye Fed �: OW 2 w �C X� O figd €�9 LL U t5'e5k° z ay'S §( a z Z odi c gi. 4 - tE 2 W z a X W W «..a 2 zW as J af $3 OVI Of zo :Yi j'1 UU ig S a£'m n� 3 �; w$ s W o .� z" ��; E1 m � a6 a � LLI M �yw Yyh7�A I1 -I1TD �' 31e q° 6 C YY Hr r °& 7. K a e W X633 3s l �Ij N W Pry 1 iglu. 5 JJFe `� n a .rte :d L � gl y� W =I £9 €aa 1s F 1 -- Jy IY !IY N d Ea �a O V ,iso J u Y..TS .. J LL LL a a zw �F— 5 Q 4m 3 YS 0 K y B gn co o UU5 M ° a ss z o az Q o QQ H viii I £££� � LU �� IS S� rlxl �e % y Y Ve oofoo 550000 pNaoo o>so N y W AI .g B .�� as � u�u ooao�mc 141MMMI � 85c ou[aon � NN Nmr+ o. N � e - ■ ■ � Re N Q. O` 7F z n S � N 5a� 'id ire ¢1 :2 �s� F� w Kok H! V�P< z z z a _ k b% Q ® �z -0 yy 6^ �wp g z ~ a. �� 6 MO o z s UUa', Fnw o V ood9S 2 Lu C'y� T W b I� H3 �8 i sl el w a � J 2 e °_ U ' — — vaur srvswaicoa orvusxs W E !d LL U O BI s' 3q. silo E @ B i � �_. g fQ 00 eg ©w 7-- 2 U I ----------------------- � LS = W RN Co N N 2. 2 z O E c �xc ti Y =23e §§ U SIGNATURE PAGE LEASE AGREEMENT AT: Jerome Park CONSENT TO MODIFICATION ATTEST: Maria D. Huizar Clerk of the Council APPROVED AS TO FORM: Sonia R. Carvalho City Attorney Lisa Storck Assistant City Attorney CITY OF SANTA ANA David Cavazos City Manager APPROVED AS TO CONTENT: erardo Monet Executive Director —Perks, Recreation & Community Services CONSENT CALENDAR 25.CC. AGMT NO. 2007-279 - VIDEO PRODUCTION AND CABLE EQUIPMENT SERVICES WITH VIDEO ENGINEERING SERVICES- Execute an amendment with Video Engineering Services extending the term of the agreement for one year in an amount not to exceed $99,660 — Parks, Recreation & Community Services Agency Motion: Direct the City Attorney to prepare and authorize the City Manager and Clerk of the Council to execute an agreement. MOTION: Martinez SECOND: Sarmiento VOTE: AYES: Alvarez, Benavides, Bustamante, Martinez, Sarmiento, Tinajero, Pulido (7) NOES: None (0) ABSTAIN: None (0) ABSENT: None (0) 25.131). AGMT NO. 2007 -280 — OFFICE SPACE AT THE SANTA ANA REGIONAL TRANSPORTATION CENTER — Execute the second amendment to the lease agreement with the County of Orange - Community Development Agency 25.EE. AGMT - NO. 2007 -281 - CELLULAR ANTENNA AT JEROME PARK — Execute an amendment with Omnipoint Communications Inc. (T- Mobile) — Parks, Recreation & Community Services Agency 251F. AGMT NO. 2007 -282 — LEGAL SERVICES — Execute an amendment with the law firm of McCune and Harber increasing the hourly rate from $155 to $175 — City Attorney's Office 25.GG. SANTA ANA TRANSIT VISION AND GO LOCAL PROJECT CONCEPT STUDY PROJECT - 06 -2502 Jackie Deter raised concerns that the money designated for this agreement should be used to fix the local streets instead. COUNCIL MINUTES 391 DECEMBER 3, 2007 COTC PROCESSING FORM Agreements / Amendments / DeedgM MAR _1,1 P1 8� E)3 CITY ��° OF Sa�� TI, tM1J61\ CLERK OF TO: CLERK OF THE COUNCIL OFFICE FROM: DEPT.: Parks, Recreation and Community Services Agency MAIL STOP: PROJECT MANAGER: Silvia Cuevas M -23 EXT.: 5254 AGREEMENT NUMBER (if amendment): A / N AMENDMENT NUMBER (if applicable): ❑ 1ST E] 2ND F-] 3RD ❑ NAME OF CONSULTANT I PARTY: Crown Castle (Omnipoint Communications Inc) AMOUNT: ❑ * OVER $25,000 —(A) 71 *UP TO $25,000 - (N) Note: If your agreement with a vendor exceeds $25,000 within a Fiscal Year, then you will need to obtain Council Approval. [Z] 1) NOT approved by council. ❑ 2) Approved by council. COUNCIL APPROVAL DATE: N/A TERM OF AGREEMENT- EFFECTIVE DATE: 1/30/15 ITEM #: TERMINATION DATE: SIGNATURES REQUIRED: m VENDOR ® AGENCY 7 CITYATTORNEY n,/ OTHER N/A (INSURANCE APPROVAL REQUIRED BY CAD PRIOR TO SUBMITTING TO COTC) INSURANCE REQUIRED: ❑ YES 0 NO (Provide City Attorney Office approval) ❑ AUTO ❑ CGL (Commercial General Liability) ❑ PROFESSIONAL LIABILITY ❑ WORKERS COMPENSATION COMMENTS: Please notarize Vendor is reauestino to make equipment chances only. There is no visible impact to the site of tower. "This is related to aareement A- 2007 -281 with Omnipoint Communications Inc. Site #LA03010A FOR CLERK OFFICE USE ONLY: ❑ PROCESS ❑ DO NOT PROCESS ❑ Needs Council Approval (}^ ❑ Missing Signatures ❑ Other ADDITIONAL REMARKS: C Ga 7 * Charter amendment effective December 21, 2006 for City Manager contract authority increase; NS -2717 I: IAgreements\Form - AGREEMENT PROCESSING FORM_canary.doc Revised: 1/17/2012 A CERTIFICATE OF LIABILITY IN''SURANCE page 1 of 2 =A1 2015' 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 INSU'RA'NCE 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(ies)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). Willis of Pennsylvania, Inc. c/o 26 Century Blvd. P. 0. Sox 305191 Nashville, TN 37234 -5191 Crown Castle International See Attached Named Insured list 1220 Augusta Dr. Suite 540 Houston, TX 77057 r`..hVIPPAn=:C r'F'R'TIFI('ATF NI RFVI'!BI(')N NIIMRFR- 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I ADDL SUIIR POLICYEFF POLICYEXP INSR T'YP'E OP INSURANCE POLICY NUMBER LIMITS A X GENERAL, LIABILITY y y 7021- 02 -2..8 4/1/2015 4./1/2016 EACHOCCURRENCE S .....11000.,.000 CLAIMS -MADE X .00CUR II7ftAMAg<F WpRIENTED f'FZEMISEgLaeccurenceg S 1, 000.,.000 MED EXP (Any one person) $ 5,000 PERSONAL &.ADVINJURY S 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE .....2,000.,.000 X POLICY PRO- LOG .. JECT ..._ PRODUCTS- COMPIOPAGG $ 2,000,,_000 _.. OTHER: S A AUTOMOBILE LIABILITY y Y 7021.- 02 -29 4/1/2015 4/l/2016. _ COMBiNEDSVNGLELIM7 (Eaaccidenl ) S 1,000,000 X ANYAUTO 80DILYINYU'RY(Perperson) S ALL OWNED SCHEDULED _ BODILY INJURY(Peraccidenl) S AUTOS AUTOS _._ HIR'.EDAUTOS _... NON -OWNED AUTOS PROPERTY DAMAGE .. (Peraooident) S S B X UMBREL.LALIAB X OCCUR y Y '.UM$ 2000165 -01 4/1,/2015 .4/1/2016 EACH OCCURRENCE. .$ ._..5,000.,..000 EXCESS LIAR CLAIMS -MADE '.. AGGREGATE S __.5, 000.,..000 DED X RETENTIONS 25,000:: '.. -S A WORKERS COMPENSATION T 7171-06 -98 4/1/2015 4/1/2016 X PER H- STATUTE ER AND EMPLOYERS' LIABILITY .... ANY PROPRIETOR'IPARTNERIEXECUTIVE NIA E1 EACHACCIDENT $ 1,000,000 .... OFFICERIMEMBER EXCLUDED? IMandatory inNHI _ EL.DISEASE. - BAEMPLOYEE $ 1,000. %.000 -- .... f yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT '..$ 1,000,000 DESCRIPTION OF OPERATION$! LOCATIONS VEHICLES (ACORD 101, Additonal Remarks Schedule, may he attached If more space is required) Business Unit #828436 - °Trii010 Jerome Park RL, 2115 3/4 W. McFadden Ave. Santa Ana, ,0C 4t+ ed `'...� See attached: ► _ ,NNy+I(r . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS City of Santa Ana Attn: Insurance Compliance 20 Civic. Center Plaza Santa Ana, CA 92702 Co11s4651822 Tplt1933413 Cert »22938339 Q 1988- 2014ACORDCORPORATION. All rights reserved. ACORD 25 (2014!01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 713115 LOCM ACC>R" ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Crown Castle International Willis of Pennsylvania, Inc. See Attached Named Insured List POLICY NUMBER 1220 Augusta Dr. Suite 500 Houston, TX 77057 See First Page CARRIER NAIL CODE See First Page EFFECTIVEDATE: See First Page ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Certificate Holder is included as an Additional Insured under the General, Automobile and Umbrella policies as required by written agreement and only with respect to the liability arising out of the operations performed by or on behalf of the Named insured. General, Automobile, Umbrella Liability and Workers' Compensation include a waiver of Subrogation in favor of the Additional Insureds when required by written contract but always subject to the policy terms, conditions, exclusions and as permitted by law. Additional Insureds: City of Santa Ana, its officers, agents, representatives, employees and volunteers General Liability and Auto Liability policies shall be Primary and Non-contributory with any other insurance in force for or which may be purchased by Jkdditional Insureds. ACORD 101 (2008101) Coll:4651822 Tpl:1933413 Cert:22938339 @ 2008 ACORD CORPORATION. All rights reserved. The ACORD name andl logo are registered marks of ACORD MFITFMMM�= Atanfic Coast Communications LLC Bq Top Ventures, LLC eff 112115114 Bvick House Really, LLC eff 12/15114 Bronze Property Ventures, LLC eff 12)15/14 CA - CLEC LLC CC Castle International LLC 'C Finance Li CC Holdings GS V LLC, CC &te Acquisitions 11 LLC CC TIM PA LLC (eff 1013'1V'213'12) CC Towers, Guarantor Li rX Towers Holding LLC COAT, T Holdings LLC CCATT LLC CCATT i LLC COGS Hi Corp. COPE Acquisftions LLC CCPR VI LLC CGS & E LLC Feb 10, 2014 CCT2 Holdings LLC June 27, 2014 COW HoPdings LLC (eff 100112012), CCTM 1 LLC (eff 1`1)311112) CCTM2 LLC (effective I V30112) CCTM0 LLC (eff 10131)2012) COTTA Pty Limited (eff 8/13I08) Chesapeake Fiber, LLC (off 10131)2014) Chimera Holdings, Li eff 121154I4 Coastal Antennas i Cornsite Venture, Inc. Coverage Plus Antenna Systems, LLC CPS Holi LLC eff 17115114 Crown Atlantic Company LLC Crown Castle Administration Pty Ltd Crown Caste AS LLC (eff 4/2911 J) Crown Caste Atlantic LLC Crown Castle Augusta LLC Crown Castle Australia Holdings Pty Ltd Crown Castle Australia Ply Ltd Grown Caste BP ATT i Crown Castier CA Corp Crown Castle Investment 11 Corp Crown Castle VM Holding Corp Crown Castle NfPJ Holding LLC Crown Castle MU LLG Crown Castle MUPA LLC Crown Castle SIG Atlantic, LLC (eff 514112( fka NextG Nehnoft,kfiantic Inc. Crc,wn Castle NG Central LLC (eff 5012) fka NertG Netwirks of Mir i5 drc Crown Castle NG East. LC (eff 53112) fka NextG Networks of NY Inc Crown Castle NG i Inc. (eff 513112) the NextG Networks fnc Crown Castle NG "Jest LLC (eff 5012) fka NextG Networks of Cai Inc Crown Castle Operating Company Crown Castle Operafing LLC Crown castle aflarpdo Corp Crown Castle PR LLC Crown Castle PiRSoluthurs; LLC (eff MOM) Crrown Castle' PT fric Crown Castle Ii Ricca Corp Grown Castle REIT lac %fary 27, 2014 Crown Castle Servces 11C (eff 6r241201 1) Crown Castle Sprites Ply Ltd- July 8, 2014 Crown Castle Solutons Comp. Crown Castle South LLC; Crown Castle TLA LIC Crown Castle Tower's D5 LLC Grown Castle Towers 06-2 LLC Grown Castle Towers 03 LLC Crown Castle Towem LLC Crown Castle Towers Pty Ltd June 5,'2014 Crown Castle USA Inc. Crown Commuricat(m LLC Crown Commumcatron LLC (fwmerly Crown Communication inc. eff III Ili 1) Crown Communication New'Yiork Inc Crown Mobile Systems, no X xj j Crystal Properties, LLC eff 12115114 Cyan Properties, LLC. eff 12115114 DO - CLEC LLC LET Holdings, LLC eff 12115114 Deke Land Enterprises, LLC eff 12115/14 Delta Real Estate Enterpnses, L1C eff 121151t4 Diamond Five, LLC, eff 12115114 2417 Chesapeake HoMing5, i (eff 10131120I4) Crown Castle GS III Corp 240 Mid-Atlantic Network of Virginia, LLC (eff 1013112014) Crown Castle GT Company LLC 24f7 Mid - Atlantic Network, LLC (eff 1013112014) Crown Castle GT Corp, AeComm of Avon, L.L C, Crown Castle GT HrAding Sub LLC AMA Group, LLC eff 12115114 Crown castle intemati3nal Corp, A1pha Centauri Group, Li eff 12115/14 Crown Castle international Corp. de Puerto Rico AMO River Enterprises, Li eff 12115)14 Grown Castle Irternational Ll-C, Arcturus Land Enterprises, LLC eft 12115114 Crown Castle Investment Corp Atanfic Coast Communications LLC Bq Top Ventures, LLC eff 112115114 Bvick House Really, LLC eff 12/15114 Bronze Property Ventures, LLC eff 12)15/14 CA - CLEC LLC CC Castle International LLC 'C Finance Li CC Holdings GS V LLC, CC &te Acquisitions 11 LLC CC TIM PA LLC (eff 1013'1V'213'12) CC Towers, Guarantor Li rX Towers Holding LLC COAT, T Holdings LLC CCATT LLC CCATT i LLC COGS Hi Corp. COPE Acquisftions LLC CCPR VI LLC CGS & E LLC Feb 10, 2014 CCT2 Holdings LLC June 27, 2014 COW HoPdings LLC (eff 100112012), CCTM 1 LLC (eff 1`1)311112) CCTM2 LLC (effective I V30112) CCTM0 LLC (eff 10131)2012) COTTA Pty Limited (eff 8/13I08) Chesapeake Fiber, LLC (off 10131)2014) Chimera Holdings, Li eff 121154I4 Coastal Antennas i Cornsite Venture, Inc. Coverage Plus Antenna Systems, LLC CPS Holi LLC eff 17115114 Crown Atlantic Company LLC Crown Castle Administration Pty Ltd Crown Caste AS LLC (eff 4/2911 J) Crown Caste Atlantic LLC Crown Castle Augusta LLC Crown Castle Australia Holdings Pty Ltd Crown Castle Australia Ply Ltd Grown Caste BP ATT i Crown Castier CA Corp Crown Castle Investment 11 Corp Crown Castle VM Holding Corp Crown Castle NfPJ Holding LLC Crown Castle MU LLG Crown Castle MUPA LLC Crown Castle SIG Atlantic, LLC (eff 514112( fka NextG Nehnoft,kfiantic Inc. Crc,wn Castle NG Central LLC (eff 5012) fka NertG Netwirks of Mir i5 drc Crown Castle NG East. LC (eff 53112) fka NextG Networks of NY Inc Crown Castle NG i Inc. (eff 513112) the NextG Networks fnc Crown Castle NG "Jest LLC (eff 5012) fka NextG Networks of Cai Inc Crown Castle Operating Company Crown Castle Operafing LLC Crown castle aflarpdo Corp Crown Castle PR LLC Crown Castle PiRSoluthurs; LLC (eff MOM) Crrown Castle' PT fric Crown Castle Ii Ricca Corp Grown Castle REIT lac %fary 27, 2014 Crown Castle Servces 11C (eff 6r241201 1) Crown Castle Sprites Ply Ltd- July 8, 2014 Crown Castle Solutons Comp. Crown Castle South LLC; Crown Castle TLA LIC Crown Castle Tower's D5 LLC Grown Castle Towers 06-2 LLC Grown Castle Towers 03 LLC Crown Castle Towem LLC Crown Castle Towers Pty Ltd June 5,'2014 Crown Castle USA Inc. Crown Commuricat(m LLC Crown Commumcatron LLC (fwmerly Crown Communication inc. eff III Ili 1) Crown Communication New'Yiork Inc Crown Mobile Systems, no X xj j Crystal Properties, LLC eff 12115114 Cyan Properties, LLC. eff 12115114 DO - CLEC LLC LET Holdings, LLC eff 12115114 Deke Land Enterprises, LLC eff 12115/14 Delta Real Estate Enterpnses, L1C eff 121151t4 Diamond Five, LLC, eff 12115114 Divame Pty Urnited (effechve '101261,12 Dumas Group, LLC eff 12/15114 Garnnia Ventures, LLC eff 12115114 Gernion, LLC, eff 12115114 Global Signal Acquisi6cns d LLC Global Signal Acquisiftons M LLC Global Signal Acquisitions IV LLC Global Signal Acquisitions LLC Global Signal GP LLC Global Sqnal Holdings Ill LLC Global Signal Holdings IV LLC Global Sgnal Operating Partner*p, L.P. Global Signal Services LLC GoldenState Towers,, LLC GS Savings Inc- GSPN lntangibNes LC Haiku Group, LLC eff '120'15114 HHO Realty Ventures, LLC eff 12115114 High Point Management Co LLC Holy Ghost Properties, LLC eff 12115114 Hot Corner, LLC eff 12115114 IC8 Towers, LLC III Properties, LLC eti 12115114 IL - CLEC LLC In SITE Fiber of Virginia LLC In&TE Solutions, LLC Interstate Tower, Comrnunicafions LLC Intracoastal City Towers LLC Iron Run, LLC eff 121151,14 Irth Realty, LLC eff 121504 Isosceles Rpalty, LLC eff 12J15il4 J6CM Towers LLC Jefferson Real Estate, LLC eff 12115114 Julex, LLC eft 12115114 Juno Real Estate, LLC eff 121,15114 Kanchen Holdings, LLC eff 12115/14 KAW Consulting Pty Ltd (eff 12112101) KP8 HcWing5, LLC eff 12/15114 Lindy Land Enterprises, LLC eff 121151,14 LIN= Land. LLC eff 12115114 LL 03-14 LLC MA - CLEC LLC Magi Investments, LLC eff 12t15114 Mazaru Real Estate, LLC eff 1211514 MD - CLEC LLC Md7 Capitol Cne, LLC fro W-To =or 17" 14 6120 Metspadmgn Group, LLC eff 121t5114 PA iner,va Reatty, LLC eff 12// 5114 14 Whie Medea California LLC Mologe Me6a National LLC Modeo LLC Molarur, LLC eff 12115114 MW Cell REtT I LLC (eff V31112) M'A Cel I TRS I LLC (eff 11311'12) Neptune Properties, LLC eff 12115114 New Path hletmorks, *, New Path Networks, LLC Nicke4 Gnoup, LLC eff 12115114 NJ - GLEC; LLC Norse Land Writures, LLC eff 12J15114 NY - CLEC LLC )H - CLEC LLC (effective 7120)11) OP 2 LILC OP LLC PA - CLEC LLC Pair Ptus, Properties, LLC eff 121/5114 Pertmeter Property, LLC eff 12fl5(14 Pinnacle San Antonio L.L.C: Pinnacle St. Lows LLC Pinnacle Towers Acquisition Holdings LLC Pinnacle Towers Acquisition LLC Pinnacle Towers Asset Holding LLC Pinnacle Towers Canada Inc. Pinnacle Towers HI LLC Pinnacle Towers Urnited Pinnacle Towers LLC Pinnacle Towers V Ind. Princeton Ancillary Services 11 LLC Formed 21288 14 Princeton Ancillary Services III LLC Formed 212812014 Proarchad Group, LLC eff I21t5M4 Radio Elation, INGLD LLC, RECC Properties Limited (eff 91200) Right: Realty, LLC eff 12115114 Scalene -STII Rreafty, LLC eff 12/15114 Sea Reafty, LLC eff 12115114 Shaffer & Associates, Inc 81hamrcoh EIGIVI, LLO eff 12115114 Sierra Towers., Inc. Sixteen Cents. LLC off 12115114 SpheTtri Pmpertaes LLC eff 12JI5114 Struiciel Pty Ltd Tamia Group LLC eff 12115/14 11 11 IffiVIIIII-mn-I ; ir��Iil;irrr:r Terbul@ian Ventures, LLC eff 12115/14 Third State Holdings, LLG eff 12115/14 Three Way SiCes, LLC eff 12115114 Thunder Towers LLC Tower Advisors, LLC elf 12115114 Tower System LLG Tower Technology Company of Jacksonvige LLC Tower Ventures tfl, LLC TowerOne 2012, LLC (eff 302012) TowerOne Allentown 001, LLC (eff 31212012p TowerOne Doylestown, LLG (eff 302012) TowerOne Mjdd9etown 003. LLG (eff 31212012) TowerOne North Coventry LLC (eff 38212012) TowerOne Partners, LLC (off 38212012) TowerCne Ulpper Potisgrove 002, LLC (eff 302012) TowerOne Warminster 001, LLC (eff 31212012) TowerOne Warnngton 002, LLC (efl 3=12) Towers Firco H LLC Towers Fircis 911 LLC Towers Firoo ILLG Triple Play, LLC off 12115114 ThStqr investors InGr eff 12115114 ThStar New Site AC Q 1, LLC eff 12115114 THStar Tower Group, LLC eff 1211514 TrsStar CPS Towers, LLG eff 12115114 TSL Realty, LLC eff 121'15114 T'VHT LLC WA - CLEC LLC Water Properties, LLC eff 12115114 WCP Wireless Lease Subsidiary, LLC (;eff 113V2012) WCP Wireless Site Funding LLC (eff 1131126112) WCP Wireless Site Holdco LLC (eff 12 1012) WCP Wireless Site Non -11E Funding LLG (eff 113112012q *CP Wireless Site Non-RE Hedco LLC' (eff 113112012) WCP Wireless Site RE Funding LLC (eff 1131012) WCP Wireless Site RE Ho&o LLC (eff 113112012) Weidl Mgt, LLC eff 121I5114 White Light Enterprises, LLC eff 015114 Wireless Funding, LLC (eff '113 112012) Wireless Realty Holdings k, LLC (effective 5115/11) Wireless Revenue Properties, LLG (eff 1131 f2612) A Wisdom Four, LL.0 eff 12115814 Wishbone Realty, LLC eff 1211511a ' ,w^��co Yangtze River Reafty, LLC eff 12115/14 YRB Tea, LLC eff 12115)'14 Zeus Properties, LLC eff 12115114