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HomeMy WebLinkAboutTOWERCO ASSETS LLC - 2009 `NSUR A N C 11 Nrj ON FILE A-2009-199 WORK MAY ?I PROCEED CLERK COUNCIL Tp' -11-D AMENDMENT TO LAND LEASE AGREEMENT THIS AMENDMENT TO LAND LEASE AGREEMENT ("Amendment") is entered as of the latter of the signature dates below 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 TOWERCO ASSETS LLC, a Delaware limited liability company ("Lessee"). RECITALS A. Lessor entered into that certain Land Lease Agreement (A-2004-140) dated July 6, 2004, with Sprint P.C.S Assets, L.L.C., a Delaware limited liability company Q7° ("Sprint/Nextel") (the "Agreement"), for certain real property and easements (collectively, the "Premises"), which are a portion of that certain parcel of real property located at 706 North Newhope St., Santa Ana, CA 92703 (the "Land"). B. Sprint/Nextel assigned all its right, title and interest in, to and under the Agreement to Tower Entity 4 LLC ("Tower Entity"), by that certain Assignment and Assumption of Ground Lease dated September 23, 2008 (the "Assignment"), Thereafter, Tower Entity was acquired by and merged into Lessee. C. The Assignment was recorded in the Official Records of the County of Orange, State of California, as Document No. 2009000088777, on February 26, 2009. B. Lessee desires to sublease space at the Premises to Clear Wireless LLC ("Clearwire"), and Lessor agrees to consent to such sublease, all in accordance with the terms and conditions as set forth below. NOW, THEREFORE, for and in consideration of the promises and mutual covenants herein contained and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties hereby agree to amend the Agreement as follows: 1. Sublease. Pursuant to the requirements of the Agreement, Lessor hereby consents to Lessee entering into a sublease with Clearwire ("Clearwire Sublease") to allow for the co- location of Clearwire equipment in conformance with the site plan, equipment plan and antenna configuration approved by the City. 2. Rent. As consideration for Lessor's consent to the Clearwire Sublease, the Rent shall be increased by the sum of Three Hundred and no/100 Dollars ($300.00) per month effective as of the first day of the month following the commencement date of the Clearwire Sublease and continuing through the term of the Clearwire Sublease (the "Sublease Fee"). The Rent, as increased hereby, shall continue to increase pursuant to the terms of the Agreement. The Sublease Fee shall terminate on the date the Clearwire Sublease terminates or expires and the Rent thereafter shall be reduced by an amount equal to the Sublease Fee as of the date of such termination or expiration. CAI-947 - Salgado Center First Amendment DM# VI Page 1 3. Notices. Notwithstanding anything to the contrary in the Agreement, facsimile notices shall not be permitted. The Lessee notice address set forth in Section 26 of the Agreement is hereby deleted and replaced with the following: LESSEE: TowerCo Assets LLC 5000 Valleystone Drive Cary, NC 27519 Attn: Property Management TowerCo ID: CA2935 4. Agreement in Full Force. All terms and conditions of the Agreement not expressly modified by this First Amendment shall remain in full force and effect, and, in the event of any inconsistencies between this First Amendment and the terms of the Agreement, the terms set forth in this First Amendment shall govern and control. Except as expressly amended hereby, the Agreement shall remain in full force and effect as of the date thereof. 5. Counterparts This First Amendment may be executed in one or more counterparts which shall be construed together as one document. 6. Defined Terms. Unless otherwise defined, all defined terms used in this First Amendment shall have the meanings ascribed to them under the Agreement. 7. Successors and Assigns Upon full execution by Lessee and Lessor, this First Amendment (i) shall be binding upon and shall inure to the benefit of each of the parties and their respective successors, assigns, receivers and trustees; and (ii) may be modified or amended only by a written agreement executed by each of the parties. 8. Non-Binding Until Fully Executed. This First Amendment is for discussion purposes only and does not constitute a formal offer by either party. This First Amendment is not and will not be binding on either party until and unless it is fully executed by both parties. 9. Recitals. The recitals at the beginning of this Amendment are incorporated in and made a part of this Amendment. [SIGNATURES APPEAR ON THE FOLLOWING PAGES.] CA2947 - Salgado Center First Amendment DM# V1 Page 2 IN WITNESS WHEREOF, the parties have executed this First Amendment as of the latter of the signature dates below. ATTEST: MARIA D. HUIZAR ? Clerk of the Council Approved as to Form Joseph W. Fletcher City Attomev Laura Sheedy Assistant City Atto y CA-7947 - Salgado Center First Amendment DM# V1 LESSOR: CITY OF SANTA ANA, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California By: Name: DAVID N REAM Its: City Manager Date: LESSEE: TOWERCO ASSETS LLC, limited liability company a Delaware By: Name: Michael P. MacPherson Its: Vice President / General Manager Date: /' S - /Q Page 3 Totvelfo Site Name Number Salgado CenterCA2947 SprintCleanvire Site Name Number. Sal=ado Center CA-0RC5467 LETTER OF AUTHORIZATION APPLICATION FOR ZONfNG/LA.,\TD USE ENTITLEMENTS Property Address: 706 N. Newhone St Santa Ana C a 92703 Assessor's Parcel Number: 100-252-01 UWe, the owner(s) of the above described property, ll t of Clearwire, an affiliate of Sprint, to act as n agentonzm} Reliant behalf ort the solecputpose of consummating any and all building and land-use permit applications, or any other entitlements necessary for the purpose of modifying, enhancing and/or operating the existing wireless teleconuntinications facility. I/We understand that any application may be denied, modified, or approved with conditions, and that such conditions or modifications must be complied with prior to issuance of building permits, and at all times thereafter. UWe further understand that signing of this authorization in no way creates an obligation of any kind. OWNER(S): THE CITY OF SANTA ANA Print Name Print Nanie Title Title Si-nature Signature Date: Date: State of California ) County of ) SS. On before me, personally proved to me on the basis of satisfactory evidence to be the person(s) appeared th name(s) is/are subscribed to the within instrument and acknowled.aed to me that he-she "they executed the same in hisfher.'their authorized capacity(ies), and that by his/her/their si;nature(s) on the instrument . the person(s), or the entity upon behalf of which the person(s) acted, executed die instrument. I certify under PENALTY OF PERJURY under the lax vs of the State of California that the foregoing paragraph is true and correct. ,. WITNESS my hand and official seal. Si,nature (Seal) °fy commission expires: .aco CERTIFICATE OF LIABILITY INSURANCE F DATE(MM/DD/YYYY) L? 06/24/2010 PRODUCER Aon Risk insurance Services west, Inc. Seattle WA office 1420 Fifth Avenue suite 1200 Seattle WA 98101-4030 USA PHONE-(206) 749-4800 FAX-(206, INSURED T-Mobile USA, Inc. its subsidiaries and Affiliates 12920 SE 38th street Bellevue WA 98006 USA ,.?- ;Zoo?- COVERAGES CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CIFICATE DOES NOT AMEND, EXTEND OR ALTER THE ERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURERA: Fidelity & Guaranty ins Co 35386 •• INSURERB: National union Fire ins Co of Pittsburgh 19445 ti w INSURER C: Discover Property & Casualty ins co 36463 d INSURERD: Fidelity & Guaranty Ins U/w 25879 INSURERE: United states Fidelity & Guaranty Co. 25887 6 SIR aoolies Der terms and conditions of the nolirv = 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 INSR D' LTR INS TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS ATE MM/DD/YYYY DATE MM/DD B ERAL LIABILITY GL2264628 05/01/2010 05/01/2011 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $1,000,000 CLAIMS MADE OCCUR PREMISES (Ea occurrence) ® one person X Contractual Liability Incl. PERSONAL & ADV INJURY $1 000 000 ? , , GENERAL AGGREGATE $2,000,000 AGGREGATE LIMIT APPLIES PER GENT , PRODUCTS -COMP/OP AGG $2,000,000 POLICY PRO- ? LOC JECT B AUTOMOBILE LIABILITY CA9835798 05/01/2010 05/01/2011 x ANY AUTO AOS COMBINED SINGLE LIMIT (Ea accident) $2,000,000 B CA 9835799 05/01/2010 05/01/2011 ALL OWNED AUTOS MA BODILY INJURY SCHEDULED AUTOS ( Per person) HIRED AUTOS FO RM OV A BODILY INJURY NON OWNED AUTOS APPR (Per accident) PROPERTY DAMAGE -rC I' C G (Per accident) n GARAGE LIABILITY TTOR l V AUTO ONLY - EA ACCIDENT H ANY AUTO OTHER THAN EA ACC AUTO ONLY AGG 8 EXCESS/UMBRELLA LIABILITY 15972273 05/01/2010 05/01/2011 EACH OCCURRENCE $5,000,000 OCCUR ? CLAIMS MADE AGGREGATE $5,000,000 DEDUCTIBLE ® RETENTION A D W 4 5 x C STATU• OTH- WORKERS COMPENSATION AND N y ' A05 To LIMITS I I ER E EMPLOYERS LIABILITY , ._L IN I ANY PROPRIETOR/PARTNER/EXE VE D003w00409 05/01/2010 05/01/2011 E.L. EACH ACCIDENT $1,000,000 CUTI LJ AZORWI REXCLUDED? nN E.L. DISEASE-EA EMPLOYEE $11000,000 D H Mandarory D003W00410 05/01/2010 05/01/2011 Ifyes, describe under SPECIAL PROVISIONS below HI E.L. DISEASE-POLICY LIMIT $1, OOO , 000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS site No.: LA33321B Site Name: Rosita Park Site Address: 4600 w. Hazard Ave Santa Ana CA 92703. 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 insurance coverage provided shall be primary and any other insurance ULKTINlCAI'E HOLDER CANCELLATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Attn: Laura Sheedy DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 20 Civic Center Plaza 8th floor 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Santa And CA 92 707 USA BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE &e. _4z.41uiuevetsaaes Y. ??-fir. ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserve The ACORD Dame and logo are registered marks of ACORD ` W no N Ch M O O O z w t U f? Attachment to ACO" 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 insurer(s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the policy. INSURED T-Mobile USA, Inc. its Subsidiaries and Affiliates 12920 SE 38th Street Bellevue WA 98006 USA INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY DESCRIPTION POLICY EFFECTIVE DATE POLICY EXPIRATION DATE LIMITS WORKERS COMPENSATION C D003w00411 NVN] 5/01/2010 05/01/2011 DESCRIPTION OF OPERATIONS/LOCATIONS/VEFIICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS maintained by the Additional Insured is excess and non-contributory. Certificate No : 570039298856 POLICY NUMBER: GL 2264628 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) City of Santa Ana. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II - Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. T FORM APPROVE FLETC HER ITY ATTORNEY CG 20 26 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ? OFFICE OF THE CITY ATTORNEY Phone: (714) 647-5201 Fax: (714) 647-6515 M-29 / T13 *Confidential* This document is subject to the attorney-client privilege. This form is for internal use only. TO: FROM: DATE: RE: INSURANCE CERTIFICATES: T In, Ao'c-A ? Approved as to form and returned. ? Need contract to verify Agreement terms. ? Need Contract to determine what other insurance is required. ? Please resubmit to me with additional information as requested. Please attach this form to your re-submittal. ? Accord certificate needs additional insured endorsement. ? Contract requires auto liability insurance. ? Needs general liability. ? Need proof of insurance: Workers Compensation ; Errors & Omissions ? Workers Compensation or Errors & Omission Certificates have expired. It must be renewed. ? Check policy expiration dates. ? Remind project manager insurance expires ? City requires cross-outs of following words in cancellation clause (bottom right corner) "endeavor to" and from "but failure to ....... to end. ? City requires 30 days notice of cancellation rather than 10 days. ? City requires additional insured endorsement (see attached sample) - for general liability insurance. City requires an additional insured endorsement - placing the wording on the certificate is not sufficient. ? The additional insured endorsement must contain a clause stating their insurance is primary and ours will not contribute in a loss. ? The endorsement must be signed by the insurance company or broker - not the insured. ? Policy number or insurance company on certificate differs from that on endorsement. ? The certificate/additional insured endorsement needs to name the CITY - its officers, employees, agents, volunteers and representatives - Not the department. ? Note: SPARTA certificates do not need to be approved by CAO. ? For Contracts with the City - NO additional insured endorsement is needed since the CITY is an insured under the Alliant and Sparta program. ? Other comments: t/ ,4co/2o- CERTIFICATE OF LIABILITY INSURANCE `? a/1/2o12 DATE (MM/DD/YYYY) 3/16/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEC?"?J\/ELJ(?(4N?f?, E?F?Ot?? TOF?i ¢T BETWEEN OTHESSUING INSURER(S)TAUTHOR ZIED BELOW. THIS CERTIFICATE OF INSURANCE DOE T TE REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the csrtiflcate holder Is an ADDITIQt?1A},IySURED?,the: Cy(la?)Erpyst be endorsed. If SUBROGATION IS WAIVED, sublact to the terms and condltlons of the policy, certain poi nfay.rsquire an: a OYL a A statement on this certlflcate does not confer rights to the cartiflcate holder in lieu of such endorsement(s). ? ?> ?' „ (?? i I' , r PRODUCER Lockton Companies, LLC-1 Kansas City 444 W. 47th Street, Suite 900 K Cit MO 64112 1906 N No Ezt : A/C No ansas y - (816) 960-9000 E-MAIL INSURER A : Continental Casual Com an 20443 INSURED SPRINT PCS ASSETS, L.L.C. INSURER B : American Casual Com an of Readin PA 20427 14966 6480 SPRINT PARKWAY OVERLAND PARK KS 66251 INSURER C : Trans ortation Insurance Com an 20494 ?--aoo? - EGG COVERA ES SPR O DE CERTIFICATE NUMBER: 2 12 7 REVI ION NUMBER: XXXXXXX 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 TYPE OF INSURANCE AD L SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A GENERAL LIABILITY N N GL4014104273 4/1/2011 4/1/2014 EACH OCCURRENCE 2 OOO OOO X COMMERCIAL GENERAL LIABILITY DAMA E TO RENTED XXXXXXX CLAIMS-MADE ? OCCUR MED EXP An one n:on XXXXXXX X CONTRACTUAL LIAB. PERSONAL 8 ADV INJURY $ 2 OOO OOO X *TENANTS LEGAL LIAB GENERAL AGGREGATE $ 1 O 000 000 GEN'L AGGREGATE LIMIT APPLIES PER' PRODUCTS -COMP/OP AGG $ 3 OOO OOO X PRO- Y S A AUTOMOBILE LIABILITY ]v T] BUA40141042$7 4/1/2011 4/1/2014 COMBINED SINGLE LIMIT $ 2 OOO OOO X ANY AUTO BODILY INJURY (Per person) $ XXXXXXX ALL WNED AUT S SCHEDULED AUTOS BODILY INJURY (Per aeeiCent $ XXXXXJ{?{ HIRED AUTOS AUT SWNED PROPERTY DAMAGE $ XXXXXXX Cara ekee ere $ Included UMBRELLA LIAB OCCUR EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS-MADE NOT APPLICABLE AGGREGATE $ XXXXXXX DED RETENTION $ $ C. WO AND RKERS COMPENSATION EMPLOYERS' LIABILITY Y/N N WC4014104225((RETRO)) 4/1/2011 4/1/2012 W STATT- OTH- X B B oFFICER/MEMe3E?xcLUD D?ECUnvE ? N/A WC4014104239(DEDUCTIBLE WC40141 U4242 /( CA) 4/]/2011 4/1 /2U11 4/1/2012 4/1/2012 E.L. EACH ACCIDENT $ 1000 000 B (M ?nOatory In NH) } , N/A IN MONOPOLISTIC STAT S E.L. DISEASE - EA EMPLOYEE 1 OOO OOO y DESCR PTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT I 000 000 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /(Attach ACORD 101, Addltlonal Remarks Schedule, li more apace le required) *FIRE DAMAGE IS INCLUDED IN BROADER TENANT'S LEGAL LIABILITY FORM WITH LIMITS OF $1 000,000 PER OCCURRENCE. THE , CITY OF SANTA ANA, ITS OFFICERS AGENTS, REPRESENTATIVES EMPLOYEES AND VOLUNTEERS ARE ADDITIONAL INSUREDS ON A , PRIMARY BASIS AS REQUIRED BY G?ONTRACT AND SUBJECT TO POLICY TERMS AND CONDITIONS. RE: INSTALLATION, OPERATION &c MAINTENANCE OF TELECOMMUNICATIONS EQUIPMENT. ' ,"'W S`? ?? - 6 77 706 NEWHOPE SANTA ANA CA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE A ?y _ THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN APPRO V 1.;L,7 A.`h 1'E3 ( . , :.ACCORDANCE WITH THE POLICY PROVISIONS. sss, zs? ? o l?3 CITY OF SANTA ANA -- ? ? ? ? - ?-' --' O S ATTN: CARLA MACK-THOMPKINS tt heedy ' '''j ? 20 CIVIC CENTER PLAZA i '+ttnrne} SANTA ANA, CA 92702 The ACORD name and logo are registered marks of ACORD r4 Z-Oar=1 - ?,°t?i SHOULD ANY OF THE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL MAIL WRITTEN NOTICE IN ACCORDANCE WITH THE POLICY PROVISIONS TO THE CERTIFICATE HOLDER NAMED WITHIN THE STATED TIME FRAMES OF 30 DAYS, EXCEPT FOR REASON OF NON-PAYMENT OF PREMIUM AT 10 DAYS. FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Miscellaneous Attachment : M463964 Master ID: 14966, CertiFcate ID: 2551287 POLICY NUMBER: SEE ATTACHED CERTIFICATE COMMERCIAL GENERAL ENDT. P7 LIABILITY CG 2010 03 97 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -- OWNERS, LESSEES OR CONTRACTORS -- SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: THE CITY OF SANTA ANA, ITS OFFICERS, AGENTS, REPRESENTATIVES, EMPLOYEES 8r. VOLUNTEERS. OR ANY PERSON OR ORGANIZATION FOR WHOM ADDITION AS ADDITIONAL INSURED USING THIS FORM, AS SPECIFICALLY REQUESTED IN A WRITTEN CONTRACT OR AGREEMENT. THE CITY OF SANTA ANA, IT'S OFFICERS, AGENTS, REPRESENTATIVES, EMPLOYEES, AND VOLUNTEERS, ARE ADDITIONAL INSUREDS WHICH IS ON PRIMARY BASIS, AND ALL OTHER INSURANCE SHALL BE NON-CONTRIBUTORY. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Who Is An Insured (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. Miscellaneous Attachment : M3185 Certificate ID :2227218 . 11I CERTIFICATE OF LIABILITY INSURANCE ?? 4/1/2013 F DATE 3/29/DD/YYYY) 3/29/2012 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 Lockton Companies, LLC-1 Kansas City CONTACT 444 W. 47th Street, Suite 900 K C 1 AX No EXt ; No ansas ity MO 64112-1906 (816) 960-9000 E-MAIL ADDRESS: INSURER(S) AFFORDING - - INSURER A : Continental Casual COm an 20443 INSURED SPRINT PCS ASSETS, L.L.C. ± 1 n L.CJ-Xtl V Vk-'?,S INSURER B : American Casual Company of Reading, PA 20427 14966 6480 SPRINT PARKWAY OVERLAND PARK KS 66251 ?Q GCS 1 INSURER C : Transportation Insurance Company 20494 1t k-1 Lli c i i -A p INSURER E, COVERAGES SPR0003 DE CERTIFICATE NUMBER. 222721 R REVISION NUMBER: XXXXXXX 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. MSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS A GENERAL LIABILITY N N GL4014104273 4/1/2011 4/1/2014 EACH OCCURRENCE 2 000 OOO X COMMERCIAL GENERAL LIABILITY PREMI ES [F. To RENTED CLAIMS-MADE EK]OCCUR MED EXP An one person) XXXXXXX X CONTRACTUAL LIAB. PERSONAL & ADV INJURY s2,000,000 X -TENANTS LEGAL LIAB GENERAL AGGREGATE $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 3,000,000 X P LI Y E LO $ A AUTOMOBILE LIABILITY N N BUA4014104287 4/1/2011 4/1/2014 COMBINED SINGLE LIMIT Ea accident $ 2,000,000 X ANY AUTO BODILY INJURY (Per person) $ XXXXXXX AUTOWNED AUTOSULED BODILY INJURY (Per accident $ XXXXXXX HIRED AUTOS AUUTOSWNED Perr acEcidenDAMAGE $ XXXXXXX Gara ekee ers $ Included UMBRELLA LIAB OCCUR EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS-MADE NOT APPLICABLE AGGREGATE $ XXXXXXX DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N N WC4014104225(RETRO) 4/1/2012 4/1/2013 WC STATU- OTH- X T CRY LIMITS[ I FR B B ANY OFFICER/MEMEREXCLUDED? ECUTIVE ? NIA WC4014104239(DEDUCTIBLE WC4014104242(CA) 4/1/2012 4/1/2012 4/1/2013 4/1/2013 E.L. EACH ACCIDENT $ 1000000 B (Mandatory in NH) If yes describe under N/A IN MONOPOLISTIC STAT S E.L. DISEASE - EA EMPLOYEE 1,000,000 , DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 000 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, if more space is required) *FIRE DAMAGE IS INCLUDED IN BROADER TENANT'S LEGAL LIABILITY FORM WITH LIMITS OF $1 000 000 PER OCCURRENCE THE , , . CITY OF SANTA ANA ITS OFFICERS, AGENTS, REPRESENTATIVES, EMPLOYEES & VOLUNTEERS ARE ADDITIONAL INSUREDS WHICH , IS ON A PRIMARY BASIS, AND ALL OTHER INSURANCE SHALL BE NON-CONTRIBUTORY, AS REQUIRED IN THE CONTRACT AND INCLUDED IN THE POLICY FORM. RE: INSTALLATION OPERATION & MAINTENANCE OF TELECOMMUNICATIONS EQUIPMENT AT , VARIOUS LOCATIONS. • x.11"' Y? (?. i ?, - -;. ???... .1t;a?. 11,. 2227218 CITY OF SANTA ANA PARKS, RECREATION & COMMUNITY SERVICES ATTN: DOLORES RAMOS 888 W. SANTA ANA BLVD, SUITE 200 PO BOX 1988 M-23 SANTA ANA CA 92702 ACORD 25 (2010/05) All rights reserved SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. f The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL MAIL WRITTEN NOTICE IN ACCORDANCE WITH THE POLICY PROVISIONS TO THE CERTIFICATE HOLDER NAMED WITHIN THE STATED TIME FRAMES OF 30 DAYS, EXCEPT FOR REASON OF NON-PAYMENT OF PREMIUM AT 10 DAYS. FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Miscellaneous Attachment : M463964 Master ID: 14966, Certificate ID: 2227218 POLICY NUMBER: SEE ATTACHED CERTIFICATE COMMERCIAL GENERAL ENDT. P7 LIABILITY CG 2010 03 97 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED --- OWNERS, LESSEES OR CONTRACTORS -- SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: THE CITY OF SANTA ANA, ITS OFFICERS, AGENTS, REPRESENTATIVES, EMPLOYEES & VOLUNTEERS. OR ANY PERSON OR ORGANIZATION FOR WHOM ADDITION AS ADDITIONAL INSURED USING THIS FORM, AS SPECIFICALLY REQUESTED IN A WRITTEN CONTRACT OR AGREEMENT. THE CITY OF SANTA ANA, IT'S OFFICERS, AGENTS, REPRESENTATIVES, EMPLOYEES, AND VOLUNTEERS, ARE ADDITIONAL INSUREDS WHICH IS ON PRIMARY BASIS, AND ALL OTHER INSURANCE SHALL BE NON-CONTRIBUTORY. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Who Is An Insured (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. Miscellaneous Attachment : M3185 Certificate ID : 2227218 CG 20 10 03 97 Copyright, Insurance Services Office, Inc., 1996 Page 1 of 1 Miscellaneous Attachment : M3185 Certificate ID : 2227218