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AGENCY CUSTOMER ID: 713115 <br />LOC#: <br />1Cd e <br />r AI'11'11T1n AIAI OCRIIA ®1!Q Qf+LJ G1'1111 C <br />AGENCY NAMED INSURED <br />Crown Castle International <br />Willis of Pennsylvania, Inc. See Attached Named Insured List <br />Roucv NUMBER _- _ -- 1220 Augusta Dr. Suite 500 <br />Houston, TX 77057 <br />See First Page <br />CARRIER NAIC CODE <br />See First Page EFFECTIVEDATE: See First Page <br />AOOITIONAI_ RFMARKA <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMRER: 25 FORM TIT[ F- CERTIFICATE OF LIABILITY INSURANCE <br />Certificate Holder is included as Additional Insured under the General, Automobile and Umbrella <br />'.policies a§ their interest may appear and as required by written agreement and only with respect to <br />the liability arising out of he operations performed by or on behalf of the Named Insured. <br />General, Automobile, Umbrella Liability and Workers' Compensation include a Waiver of Subrogation <br />in favor of the Additional Insured when required by written contract but always subject to the <br />policy terms, conditions, exclusions and as permitted by law. <br />Additional Insureds. City of Santa Ana, its officers, agents, representatives, employees and <br />volunteers <br />General Liability policy shall be Primary and Non-contributo y with any other insurance in force <br />for or which may be purchased by Additional Insureds as requ red by written contract <br />ACORD 101 (2008101) Coll:4704127 Tpl:1933413 Cert:23245088 <br />The ACORD name and logo are registered marks of ACORD <br />reserved <br />