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<br /> A�R" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)
<br /> 03/27/2025
<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 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 endorsement(s).
<br /> PRODUCER ONTACT Crown Castle Inc.
<br /> Willislis Towers Wataon Northeast, Inc. NAME:PHONE FAX
<br /> c/o 26 Century Blvd AC,
<br /> C No):
<br /> P.O. Box 305191 E-MAIL c.p
<br /> est@arowncastle.com
<br /> COIRe est@arowncast].e.com
<br /> Nashville, TN 372305191 USA INSURERS AFFORDING COVERAGE NAIC 9
<br /> INSURERA: ACE American Insurance Company 22667
<br /> INSURED INSURER B:
<br /> Crown Castle Inc.
<br /> See Attached Named Insured List INSURERC:
<br /> 8020 Katy Freeway INSURERD:
<br /> Houston, TX 77024 `
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:W38382425 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 TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP
<br /> LTR POLICYNUMBER D❑IY-Y.YYI (MMIDDNYYYI LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br /> DAMAGE TO RF ED
<br /> CLAIMS-MADE X OCCUR PREMISES Ea or
<br /> $ 1,000,000
<br /> A MED EXP(Any one person) $ 10,000
<br /> Y Y HDO G48933889 04/01/2025 04/01/2026 PERSONAL.&ADVINJURY $ 2,000,000
<br /> GENT AGGRFGATF LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
<br /> X POLICY[I PRO- LOC PRODUCTS-COMPIOP AGO $ 4,000,000
<br /> JECT
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLF LIMIT
<br /> Eaauddent $ 2,000,000
<br /> X ANY AUTO BODILY INJURY(Per person} $
<br /> A OWNED SCHEDULED Y Y ISA H11357131 04/01/2025 04/01/2026 BODILY INJURY(Per ecoldent) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> $
<br /> A UM13RELLALIAB X OCCUR EACH OCCURRENCE $ 5,000,o00
<br /> EXCESSLIAO CLAIMS-MADF Y Y XL+oG47458262 002 04/01/2025 04/01/2026 AGGREGATE $ 5,000,OD0
<br /> DED I X RETENTION$25,000 $
<br /> WORKERS COMPENSATION X STATUTE ERH
<br /> AND EMPLOYERS'LIABILITY Y I N
<br /> A ANYPROPRIETOWPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICERIMEMSEREXCLUDED7 No NIA Y WLR C72611251 04/01/2025 04/01/2026
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,400,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
<br /> Business unit #828436 - TMO10 Jerome Park RL, 2115 3/4 W. McFadden Ave. Santa Ana, CA 92704
<br /> Additional Insureds: City of Santa Ana, its officers, agents, representatives, employees and volunteers
<br /> General Liability and Auto Liability policies shall be Primary and Non-contributory with any other insurance in force
<br /> for or which may be purchased by Additional insureds. , Certificate Holder is included as an Additional Insured under
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> APPROVED — --
<br /> 8y To Tran Nguyen at 10:16 am,Apr 01 21725 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 /> Tu Tran Digitally signed by
<br /> -Tu Tran Nguyen
<br /> CITY OF SANTA ANA Nguyen 100 6A4-0 000t AUTHORIZED REPRESENTATIVE
<br /> SA BOA 1988 M-23 IV
<br /> SANTA ANA, CA 92702 1
<br /> ©1988-2016 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br /> SR ID: 27488978 BATCH: 3893029
<br />
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