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Page 1 of 2 . a CERTIFICATE OF LIABILITY INSURANCE D07/23/2019 tL `� 07/23/2019 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 CERTIFICATE THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURE R(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 Willie of Pennsylvania, Inc. Century C/o 26 Cent Blvd P.O. Box 305191 Nashville, IN 372305191 USA CONTACT NAME: PHONE 1-877-945-7378 FAX WO.Np: 1-888-467-2378 EMAIL ADDRESS certificatesewillia.Cox INSURE 3 AFFORDING COVERAGE NAIC# INSURERA: Federal Insurance Company 20281 INSURED Crown Castle International rn INSURER B: National Union Fire Insurance Company of P 19445 INSURERC: Berkshire Hathaway Specialty Insurance Cox 22276 See Attached Named Insured Idst 1220 Augusta Dr. Suite 600 Houston, TX 77057 INSURER D: New Hampshire Insurance Company 23841 INSURER E : INSURER F: n.Ylolvn l NuwIOLR: 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. INSR LTR TYPE OF INSURANCE ADDL SU R POLIC'NUMBER MMMRIICY EFF MMIDD� LIMITS X COMMERCIAL GENERAL LIABILITY A CLAIMS-MADE X OCCUR EAMAGE $ 1,000,000 19RRERENTEDNCE PREMISES Ea ocwnenca E 1,000,000 ME ME O EXP (Any one person) $ 30,000 Y Y 3605-3335 04/01/2019 04/01/2020 PERSONAL 8AOV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY JEC LOC GENERALAGGREGATE $ 2,000,000 GEN'L X PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: OWNED SCHEDULED NLY AUTOSAUTOSNON-ONLYPROPERTY ED NLY AUTOS ONLY AtOABILfTY Y Y CA 4993141 04/01/2019 04/01/2020 COMBINED INGLE LIMIT (Ea accident It 1,000,000 BODILY INJURY (Far Person) $ BODILY INJURY(Per accdem) $ DAMAGE$ PeraccdenLALIAB D LIAR X OCCUREACH CLAIMS -MADE Y N/A y Y 47-UMO-303445-03 WC 012717225 04/Ol/2019 04/01/2019 04/Ol/2020AGGREGATE 04/Ol/2020 OCCURRENCE $ 5,000,000 $ 5,000,000 X RETENTIONS 25.000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOWPARTNERIEXECUTNE No OFFICERIMEMBEREXCLUDED7 (Mandatory in NH) Mes, tleecnbe antler SCRIPTIONOFOPERATIONSbelow X PER OTH- STATUTE ER $ E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ 11000,000 If 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) This Voids and Replaces Previously Issued Certificate Dated 03/28/2019 WITH ID: W10726641. BU#845344 - DOWNTOWN SANTA BNA, 1104 CIVIC CENTER DRIVE, SA14TA ANA,, CA 92703 (951 3/4 West 6th Street). REVIEWED & APPROVED BY RISk ANAGEMENT DIVISION ronrmrr ArC unr ..�.. City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th floor Santa Ana. CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN M. LAME3ERT ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE CORPORATION. All riohts reserved. I ne ACORD name and logo are registered marks of ACORD -- xo: 18296908 sares: 1295385