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A� O` CERTIFICATE OF LIABILITY INSURANCE <br />B�nom I <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 on <br />this certificate does not confer rights to the Certificate holder in lieu of such endorsements . <br />PRODUCER <br />Marsh USA Ire. <br />701 Market Street, Suite 1100 <br />St. Louis, MO 63101 <br />ABn: ATT.CedRegmsI@mamh.com <br />eOmAc US Centralized Services <br />. <br />PHONE 866-966-464 V" Not - <br />gl.1AIL AILCeN2eque0@mamh.mm <br />INSURERS AFFORDING COVERAGE <br />NAICe <br />INSURER A: OH Republic Insurance Company <br />24147 <br />CNIO3150778-GAW-CRT-20-21 Y Y kYI66g Y <br />INSURED <br />New Gngular Wireless PCS, LLC <br />INSURER B <br />INSURER C <br />One AT&T Plaza <br />208 South Akard <br />Room 1820 <br />INSURER D <br />INSURER E <br />Dallas, TX 75202 <br />INSURERF: <br />COVERAGES CERTIFICATE NUMBER: CHIA09523130-03 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 />TYPE OF INSURANCE <br />DLS <br />POLICY NUMBER <br />POLICY EFF <br />POLICY <br />LIMITS <br />A <br />X <br />cOMMERcuLGENEMLIJA9ILITY✓ <br />CLAIMS -MADE El OCCUR <br />MWZY 31363620 <br />06IOlQD20 <br />✓ <br />06,01/2021 <br />✓ <br />EACHOCCURRENCE <br />E 2,000,000 <br />PREMISES a rt <br />E 1,000,000 <br />MED UP ono p .. I <br />NIA <br />PERSONAL AADV INJURY <br />E 2,000.000 <br />GEN'LAGGREGATELIMIT APPLIES PER <br />X POLICY ❑ JET LOC <br />GENERAL AGGREGATE <br />E 10,0m.000 <br />PRODUCTS-COMP/OP AGG <br />$ 2,000,000 <br />E <br />OTHER: <br />A <br />A <br />AUTOMOBILEUABILRY <br />ANV AUTO <br />MWTB 31363520 <br />MWZ%31363720 (MI) <br />06J0112020 <br />WA1I2020 <br />06/011202 <br />O6/01/4021 <br />COMBINED SINGLED IT <br />ea <br />$ 1DD0000 <br />BODILY INJURY (Per person) <br />S <br />I <br />GINNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Peramdenq <br />E <br />HIRED NON-0Vi <br />AUTOS ONLY AUTOS ONLY <br />PROPERTYDAMAGE <br />War accident) <br />S <br />E <br />UMBRELL UAB <br />OCCUR <br />EACHOCCURRENCE <br />E <br />AGGREGATE <br />E <br />EXCESS LIAR <br />CLAIM$ -MADE <br />DIED RETENTIONS <br />S <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />MYPROECUTNE <br />OFFICERMtEMBERE%LLD ED?YIN <br />(Mandatory In NH) <br />MWC 31363820(AOS) <br />O6N1 1 <br />g PER U E ERµ <br />EL EACH ACCIDENT <br />E 1,000,000 <br />ELDISEASE DISEASE -EA EMPLOYEE <br />E 1,000,000 <br />S Yes, describe under <br />DESCRIPTION OF OPERATIONS belay <br />E.L. DISEASE -POLICY LIMIT <br />S 1000.000 <br />A <br />Excess Workers' Compensation / <br />MWXS 31363920 (CH,WA) <br />06/0112020 <br />ON112021 <br />EL Each Accident / EL Disease <br />1,000,000 <br />Employers' Liability <br />See Second Page <br />EL Disease -Policy Limit <br />1,000.000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1ACORD 101, Additional A ... irks Schedule, may be atbched It coon apse. Is ree ulnd) <br />Re City of Santa Ana Municipal Facilities License Agreement <br />City of Santa Ana, is Opened members, plficers, and employees islam included as Additional Insured under the General Liability policy but only with respect to the requirements of the contract between he <br />Certificate Holder and (he Insured. Waiver of Subrogation is provided for General Liability, as required by written contract and allowable bylaw ✓ <br />Atty of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION 20 ChicRisManagement Division JI�V/01 2020 ACCORDANCE WITH THE POLICY PROVISIONS. <br />E WILL BE DELIVERED IN <br />ZO Crvlo Center Plaza E—/�p7l/ <br />Santa Ana, CA 92701 <br />AUTHORMEDREPRESENTATIVE <br />ANgiE AcEVEdo of Merah USA Inc. <br />n 19RR-201R AODRn CORPnRATInN all rirehts ..s .d <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />