HomeMy WebLinkAboutTOWERCO ASSETS LLC (2)A- 2009 -200
INSURANCE RIOT ON FILE
WORK MAY NQT PROCEED
CLERK OF COUINCIL
nAiF. 1 -Z7 -1p AMENDMENT TO LAND LEASE AGREEMENT
17� 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 ").
C� RECITALS
A. Lessor entered into that certain Land Lease Agreement dated June 3, 2002, with
�►
10 Sprint P.C.S Assets, L.L.C., a Delaware limited liability company ( "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 2915 West La Verne Ave., Santa Ana,
' CA 92704 (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. 2009000020370, on January 16, 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.
CA2930 — Windsor Park
First Amendment
DM# v I
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.
CA2930 — Windsor Park
First Amendment
DM# vl
[SIGNATURES APPEAR ON THE FOLLOWING PAGES.]
Page 2
V .
IN WITNESS WHEREOF, the parties have executed this First Amendment as of the latter of
the signature dates below.
ATTEST:
�T� 4VL--;:00 .���
MARIA D. HUIZAR
Clerk of the Council
Approved as to Form
Joseph W. Fletcher
City Attorney
Laura Sheedy
Assistant City Attorney
CA2930 — Windsor Park
First Amendment
DM# v I
LESSOR:
CITY OF SANTA ANA, a charter city and
municipal corporation organized and existing
under the Constitution and laws of the State of
California
B y.
✓
Name: DAVID N REAM
Its: City Manager
Date:
LESSEE:
TOWERCO ASSETS
limited liability company
LLC, a Delaware
By: – --
Name: Michael P. MacPherson
Its: Vice President / General Manager
Date: /- .5— w
Page 3
Towerio Site Name Lumber: Windsor Park CA293o
Sprint "Cleaneire Site Name Number: Windsor Park CA- ORC5299
LETTER OF AUTHORIZATION
APPLICATION FOR ZONING /LANI D USE ENTITLEiVIENTS
Property Address: 2915 W. La Verne Ave. Santa Ana. CA 92704
Assessor's Parcel Number: 109- 575 -01
UNVe, the owner(s) of the above described property, authorize Reliant Land Services, Inc. on behalf
of Cleanvire, an affiliate of Sprint, to act as an agent on my /our behalf for the sole purpose 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
telecommunications facility. UWe 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.
I/We further understand that signing of this authorization in no way creates an obligation of any kind.
O1iNNER(S): THE CITY OF SANTA ANA
Print Name
Print Name
Title
Title
Signature -� 6Z �--
Signature
Date: Date:
State of California )
) SS.
County of )
On before me, ( ), personally appeared
who proved to me on the basis of satisfactory evidence to be the person(s) whose
name(s) is /are subscribed to the within instrument and acknowledged to me that he /she.'they executed the
same in his: herrtheir authorized capacity(ies), and that by his;'her'their signature(s) on the instrument the
person(s), or the entity upon behalf of which the persons) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the la%vs of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Si- nature (Seal)
MY commission expires:
REQUEST FOR APPROPRIATION ADJUSTMENT
Appropriation Adjustment No: V _ 0G'1
Date: December 7, 2009
Department: Recreation Community Services
TYPE OF ADJUSTMENT
Transfer of Funds (No Council Action Required)
X❑ Transfer of Funds (Council Action Required)
From:
Unit - Account # -
05102002 57010 Misc. Recoveries
Total
Council Action Date /r , cps % Q cx j .o
Approved: � Yes No
Clerk of th ouncil
i1 Outlay Fund To: Capital Outlay Fund
iption Amount Accounting Unit - Account # - Description Amount
JUSTIFICATION FOR REQUEST:
10,800 05113263 66220 Improvements Other Than Bldgs. 10,800
10,800 Total 10,800
This appropriation adjustment is being requested to recognize revenue from TowerCo LLC for cell tower equipment at
Heritage, Rosita and Windsor parks.
Department Head
,4coRO- CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YWY)
�� 4/1/2012 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 NEGATIVELY AMEN�DT EXTENID�IOR ALTER THE COVERAGE AFFORDED BY THE POLICIES
REPRESENTATIVE ORIPRODUCER,SAND THE CERTIFICATE HOLDEN {� Ati�`� T�/�T ¢�JW�Ef�(.�TF,IE ISSUING INSURER(S), AUTHORIZED
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be entloresd. If SUBROGATION IS WAIVED, sub)ect to
the terms and conditions of the policy, certain policies may requlrpp��4�}grldgraamenQ., A: ataEemgnt�op this certificate does not confer rights to the
certificate holder In Ileu of such endoreement(s). 1. ! 4 : � � - : + � '�< � �
PRODUCER Lockton Companies, LLC -1 Kansas City �.. -:'� -. - - .y I t-
444 W. 47th Street, Suite 900 A/ No Ezt : A/C No :
Kansas City MO 64112 -1906 E -MAIL
(816) 960 -9000
INSURED SPRINT PCS ASSETS, L.L.C. INSURER e : American Casual Com an Of Readin PA 20421
14966 6480 SPRINT PARKWAY INSURER C : Trans ortation Insurance Com an
OVERLAND PARK KS 66251 20494
�- aoc�, -aoo__ _
C�T)D !x!1!\9 ������ • _ _ _ _ _ _ _ _ _ _
•ter -,v• •� ,� �-�u�,�. i_i_i�i� /� /1
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.
IN R
TYPE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMITS
A
GENERAL LIABILITY
N
N
GL4014104273
4/1/2011
4/1/2014
EACH OCCURRENCE
2 000 000
X COMMERCIAL GENERAL LIABILITY
DAMA E TO RENTED
XXXXXXX
CLAIMS -MADE � OCCUR
MED EXP An one raon
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:
X P PRO-
PRODUCTS - COMP /OP AGG
$ 3 000 000
$
A
AUTOMOBILE LIABILITY
N
N
BUA40141042$7
4/1/2011
4/1/2014
COMBINED SINGLE LIMIT
$ 2 OOO OOO
X ANYpAUTO EE
AUTOS NED gUTOSULED
BODILY INJURY (Per person)
$ XXXXXXX
BODILY INJURY (Per aeeitlant
$ j{J{}[�{XXX
NON -OWNED
HIRED AUTOS AUTOS
PROPER? nDAMAGE
$ XXXXXXX
Cara ekee ers
$ Included
UMBRELLA LIAB
EXCESS LIAR
OCCUR
CLAIMS -MADE
NOT APPLICABLE
EACH OCCURRENCE
$ XXXXXXX
AGGREGATE
$ XXXXXXX
DED RETENTION $
$
C
B
B
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N
OFFICER/MEMBER E%CLUOEOT �
IMyandatory In NHI
DESCRIPTION OF OPERATIONS below
N/A
N
WC4014104225SRETRO)
WC40I 41 04239 \DEDUCTIBLE
W(:4o 14104242 (CA)
N/A IN MONOP LI TIC STAT
4/1/2011
4/1/2011
Q /1/2011
S
4/1/2012
4/1/2012
Q/1/2012
W STATU- OTH-
X
E.L. EAGN ACCIDENT
'$ I OOO OOO
E.L. DISEASE - EA EMPLOYEE
I OOO OOO
E -L. DISEASE - POLICY LIMIT
I OOO OOO
DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /(Attach ACORD 101, Additional RamerKS 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 AND VOLUNTEERS ARE ADDITIONAL INSUREDS ON A
PRIMARY BASIS AS REQUIRED BY CONTRACT AND SUBJECT TO POLICY TERMS AND CONDITIONS. RE: INSTALLATION, OPERATION 8c
MAINTENANCE OF TELECOMMUNICATIONS EQUIPMENT.
r �.�, �M
- 3 99 9 V V N A � ���� (.Jut �
p ter+ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
APPROV�I3 AS 1 O PIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
DANCE WITH THE POLICY PROVISIONS.
255'1298
CITY OF SANTA ANA Laur titt Speedy
ATTN: CARLA MACK- THOMPKINS
20 CIVIC CENTER PLAZA "A,ssist t City Attorn
SANTA ANA, CA 92702
25 (20'10/05)
O AC4CD�ORPORATION. All rig
fhe ACORD name and logo are registered marks of ACORD
�� /
�- - aoc>°� -moo
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: 2551298
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 8c 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 : M3 185
Certificate ID :2227218
. 11I CERTIFICATE OF LIABILITY INSURANCE
�� 4/1/2013
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 INSURERS), 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
444 W. 47th Street, Suite 900
Kansas City MO 64112 -1906
(816) 960 -9000
CONTACT
1 No EXt ; AX A/C, No
E -MAIL
AFFORDING
POLICY EFF
INSURER A: Continental Casualty Comyany
20443
INSURED SPRINT PCS ASSETS, L.L.C. ± 1 n l
14966 6480 SPRINT PARKWAY
OVERLAND PARK KS 66251 1t� Q GCS 1 � � �
-A pci
INSURER B: American Casualty Company of Reading, PA
20427
INSURER C: Transportation Insurance Company
20494
4/1/2011
4/1/2014
INSURER E,
2 000 OOO
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE EK] OCCUR
COVERAGES SPRC003 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
•
GENERAL LIABILITY
N
N
GL4014104273
4/1/2011
4/1/2014
EACH OCCURRENCE
2 000 OOO
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE EK] OCCUR
PREMG ES [ RENTED
cccc nce
XXXXXXX
MED EXP (Any one person)
XXXXXXX
PERSONAL & ADV INJURY
s2,000,000
X CONTRACTUAL LIAB.
X
I *TENANTS LEGAL LIAB
GENERAL AGGREGATE
$ 10,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP /OP AGG
$ 3,000,000
X POLICY E LO
$
•
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
AUT OWNED SCHEDULED
BODILY INJURY (Per accident
$ XXXXXXX
NON-OWNED
HIRED AUTOS
PROPERTY acEcidenDAMAGE
$ XXXXXXX
Gara ekee ers
$ Included
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$ XXXXXXX
EXCESS LIAB
CLAIMS -MADE
NOT APPLICABLE
AGGREGATE
$ XXXXXXX
DED I RETENTION $
$
C
B
B
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/N
(Mandatory in ER EXCLUDED? ECUTIVE �
If yes, describe antler
if in and
DESCRIPTION OF OPERATIONS below
N / A
N
WC4014104225(RETRO)
WC4014104239(DEDUCTIBLE
WC4014104242 (CA)
N/A IN MONOPOLISTIC STAT
4/1/2012
4/1/2012
4/1/2012
S
4/1/2013
4/1/2013
4/1/2013
WC STATU- OT
X T H-
CRY LIMIT
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
1,000,000
E.L. DISEASE - POLICY LIMIT
1000,000
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 �, - -;.
���...
3t;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)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
The ACORD name and logo are registered marks of ACORD
All rights reserved
f
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 2010 03 97 Copyright, Insurance Services Office, Inc., 1996 Page 1 of 1
Miscellaneous Attachment: M3185
Certificate ID : 2227218
BACO -1 OP ID: NC
DATE QMMIDDJYYYY'I
I -
w.... -- CERTIFCAT OF LIABILITY INSURANCE Asl9nign,s
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 he 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
Henderson Brothers, Inc.
NT
NAOMEACT Clem J. Wandrisco
920 Ft Duquesne Blvd
PHONE Ext1: 412 -261 -1842 FAX, No): 412- 261.4149
Pittsburgh, PA 16222
Clem J. Wandrisco, Ili
E -MAIL
ADDRESS: cjwaindrisco @hendersonbrothers.com
GENERAL LIABILITY
INSURER(S) AFFORDING COVERAGE NAIL p.
900,000
INSURER A: Travelers Property Casualty Co 25674
INSURED SBA Communications Corporation
INSURER B: St Paul Fire & Marine Ins Cc 24767'
Thomas 0 51 1 Cci Cngress AVe. Hunt, Esquire
80
INSURER C:I'llinois Union Insurance Compa
Boca Raton, FL 33487
INSURER D:
PERSONAL rr. ADV INJURY S
INSURER E.
_
INSURER F:
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 1N'ITH 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 '.. ADDL SUBR'i
LTR. TYPE OF INSURANCE POLICY NUMBER
.POLICY EFF -. POLICY EXP -..
MMIDDIYYYY :.. MMVDDfYYYY LIMITS
GENERAL LIABILITY
'.. : EACH OCCURRENCE ! S
900,000
A X COMMERCIAL GENERALLIA94LITY X 7JEXGL474M8138TIL15
0311512015 0311512016 DAMAGETO7RENrEO
PREMISES (Ea 0murrance) S
900,000
CLAIMS-MADE X OCCUR
MED EXP (Any we person) : $
NIA
X $100,000 SIFT
PERSONAL rr. ADV INJURY S
800,000
_
GENERAL AGGREGATE S
2,000,000
,..GENT, AGGREGATE. LIMIT APPLIES PER ',..
PRODUCTS - COMPIOP AGG $
2,000,.000
POLICY X PRO- .. LOC
S
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
(Eaacchdent) ': S
1,000,000
A X ANY AUTO) TC2JCAP474M514AT1L15
0311512015 ! 03/1512016 ' BODRLY INJURY IPer person) S
',. ArL OWNED SCHEDULED
AUTOS ;AUTOS
_.X
BODLY INJURY IPeraccident): ". S
NON -OWNED :..
X HIREOAU "fOS AUTOS
PROPERTY DAMAGE S
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DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 4qt, Additional Remarks Schedule, If more spate Is required) .
Site Number: CA45888 -A -0, Site Name: 'Windsor Park,
Site Address. 2915 V7 LA Verne Ave . , Santa Ana, CAS
QhK l It -It;A I E HUL.Uht( (;AN(;hLLA IIUN ti •�
CA45888
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City Qt :Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
y ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: PRCSA.
26 Civic Center Plaza, M -75 AUTHORIZED REPRESENTATIVE.
Santa Ana, CA 92701
1983-2010 ACORD CORPORATION. All rights reserved
ACORD 26 (2010105) The ACORD name and logo are registered (narks of ACORD
NOTEPAD SBJ�4,� O-1 PAGE 2.
�NSURED'SNAME S13A Communications Corporatia�� CAP iii:. NC naka 0512012015
iD INSUREDS;
COMMUNICATION CORPORATION
NETWORK SERVICES, LLC
DAS HOLDINGS, LLC
DEPOSITOR LLC
GUARANTOR LLC
HOLDINGS LLC
INFRASTRUCTURE, LLC
LAND, LLC FKA TCO LAND LLC
MONARCH TOWERS I, LLC
MONARCH TOWERS III, LLC
MONARCH STEEL, LLC'
NETWORK MANAGEMENT, INC.
PUERTO RICO, LLC
SENIOR FINANCE II LLC
SENIOR FINANCE LLC
SITE MANAGEMENT, LLC
SITES, LLC
SBA STEEL LLC
SBA STEEL II, LLC
SBA STRUCTURES LLC
SBA TELECOMMUNICATIONS, LLC
SEA TOWERS II LLC
SBA TOWERS III LLC
SBA TOWERS IV, LLC.
SSA TOWERS V, LLC
SBA TOWERS US'V'I, INC.
SSA TOWERS, LLC
SITEXCELL VENTURES LLC
STC TOWER DEVELOPMENT ACQUISITION 2012, LLC
SUFFOLK WIRELESS ACQUISITION 2012, LLC
XCELL TOPERS ACQUISITION 2012 LLC
ATLAS TOWERS ACQUISITION 2011, LLC
SBA 2012 , TC ASSETS, LLC
SBA TOWERS VI, LLC
SBA TOWERS VII, LLC
SBA TRS HOLDCO, LLC
3A 2012 TC ASSETS LAND, LLC
3A 2012 TC ASSETS PR, LLC
3A 2012 TC HOLDINGS, LLC
3A 2012 TC LAND II, LLC
3A DAS, LLC
3A PROPERTIES, LLC
)LLIER ENTERPRISES II LLC
%TAPATH DEVELOPMENT TOWERS, LLC
7RCURY TOWERS ACQUISITION 2013, LLC
3A GC HOLDINGS, LLC
3A GC PARENT I, LLC
3A. GC PARENT II, LLC
3A GC TOWERS LLC
3A HQ, LLC
JWER FUNDING, LLC
rLAS TOWERS ALASKA ACQUISITION 2014, LLC
.W.. HOLDINGS ACQUISITION 2014, LLC
)NICIPAL ACQUISITION 2015, LLC
3A NEW BUILDS, LLC
SBA, TOWERS ACQUISITION 2014, LLC
COLOMBIA SHAREHOLDER, LLC
� � Poo
SBACO -1 OP ID: NC
" DATE' "DDIYYYY)
CERTIFICATE OF LIABILITY" INSURANCE 03109r2d16
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(iosi 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
certificates holder In lieu of such endorsement(s).
PRODUCER
4enderson Brothers, Inc.
X20 Ft Duquesne Blvd
Pittsburggh, PA 16222
Clem J. Mrldrisco, III
INSURED SBA Communications Corporation
Thomas Hunk, Esquire
5900 NW Broken Sound Parkway
Baca Raton, FL 33487
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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.
LTR 'TYPE OF INSURANCE ..... POLICY NUMBER .. _._, _ ..._ POLICY EFF ...,,..t�OL &CYEX.P....4. _.__...... ..._. - _._....._ ._.._ _ .......
It1SR AINSR UDR MMIDDIYYYY ) IMMDDfYYYYI LIMITS
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A Ih X COMMERCIAL GrN!ERALI..IADILITY X
TJEXGL474Mti138T1L16 0311612015
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900,000
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$ 2,000 00
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1 $ 25,ddQ,Od
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DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space. Is required)
Number: CA45892 -A -0, Site Name: Heritage 2, CA, 4815 W. Camille Street
Site
Santa Ana, CA"
CA46892
City of Santa Ana, Executive
Director Parks, Rec, and
Community Services (M -23)
28 Civic Center Plaza„ M -76
Santa Ana, CA 92701
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE, WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
W 15t$ii -LU1U AUUKU l::UKf'UKA I IUN, All rlgnts reservecl.
ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD
NOTEPAD MURED'S NAME SA Communications Corporation
NAMED INSUREDSc
SBA COMMUNICATION CORPORATION
SSA NETWORK SERVICES, LLC
SSA DAS HOLDINGS, LLC'
SSA DEPOSITOR LLC
SSA GU'ARANTO'R, LLC
SSA HOLDINGS LLC
SBA INFRASTRUCTURE, LLC
SBA LAND, LLC FICA TCO LAND LLC
SBA MONARCH TOWERS 2, LLC
SSA MONARCH TOWERS III, LLC
SBA MONARCH STEEL, LLC
SSA NETWORK MANAGEMENT, INC.
SBA PUERTO RICO, LLC
SSA SENIOR FINANCE II LLC
SBA, SENIOR FINANCE LLC
SBA SITE MANAGEMENT, LLC
SBA SITES, LLC
BA STEEL LLC
BA STEEL II, LLC
SA STRUCTURES LLC
BA TELECOMMUNICATIONS, LLC
BA TOWERS II LLC
SA TOWERS III LLC
BA TOWERS Iv, LLC
BA TOWERS V, LLC
BA TOWERS USVI, INC.
BA TOWERS, LLC
ITEXCELL VENTURES LLC
TC TOWER DEVELOPMENT ACQUISITION 2012, LLC
UFFOLK WIRELESS ACQUISITION 2012, LLC
CELL TOWERS ACQUISITION 2012 LLC
TL.AS TOWERS ACQUISITION 2011, LLC
BA 2012 TO ASSETS, LLC
BA TOWERS VI, LLC
SA TOWERS VII, LLC
SA TRS HOLDCO, LLC
BA 2012 TC ASSETS LAND, LLC
aA 2012 TO ASSETS PR, LLC
BA 2012 TO HOLDINGS, LLC
9A 2012 TO LAND 11, LLC.
SA DAS, LLC
9A PROPERTIES, LLC
OLLIER ENTERPRISES II LLC
kTAPATH DEVELOPMENT TOWERS, LLC
EERCURY TOWERS ACQUISITION 2013, LLC
BA GC HOLDINGS, LLC
3A GC PARENT I, LLC
3A GC PARENT II, LLC
BA GC TOWERS LLC
3A HQ, LLC
)WER FUNDING, LLC
CLAS TOWERS A.IASKA, ACQUISITION 2014, LLC
.W. HOLDINGS ACQUISITION 2014, LLC
JNICIPAL ACQUISITION 2015, LLC
3A NEW BUILDS LLC
SBACO -1 PAGE 2
OP ID: NC cal. 0311012015
SBA TOWERS ACQUISITION 2014, LLC
IAA
SBACO -1 OP ID: NC
' '`"' c ►
CERTIFICATE OF LIABILITY INSURANCE DATE(M9120YYY)
�- 0310912f }16
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), 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 rives not confer rights to the
certificate holder in lieu of such andorsement(s).
PRODUCER
Henderson Brothers, Inc.
920 Ft Duquesne Blvd
Pittsbur�ggh, PA 1522.2
Clem J.'Wandrisco, III
INSURED
Thomas Hunt, Esquire
5900 NW Broken Sound Parkway
Boca Raton, FL 33487
Clem J. Wandrisco
,& -4112-261-1842
INSURER A ::Travelers Property Casualty Co
INSURER B: St Paul Fire & Marine Ins Co
INSURER 1Illiinois Union Insurance Compa
r- rtlErmArJCC r1=0Tl1.117ATC fdIIURl =ra• PF:VIRIC)NI NIIRARr -P-
412-2614149
NAIL #
25674
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTER BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTW'atTHSTANDING 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 IINSR 1 11.11 ., POLICY NUMBER .....,...... ....
LTR
_.
.MIMk4?pF�YNEY WP1NIfp��YXYPY E .. . ..,. LIMITS
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EACH OCCURRENCE
$
900100
A
X COMMERCIAL GENERAL LIABILITY X TJE'XGL474IWI8138TI'.L16
e' DAMAGE TO RENTED
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900,00
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$
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,X $100,000 SIR
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..._.
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$
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Site Nunbe;C14589 OSiteName AdamrPa rkr 2302 w a.tt Santa Rn ®+ CA ,"', '�,/•Y
,
°,f r
?-e�
fj
[*1 9:2a1* 401:4 or-AN, v wl
CA46897
City of Santa Ana, Executive
Director Parks, Rec and
Community Serviced ('M -23)
26 Civic Center Plaza, M -76
Santa Ana, CA 92703
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
1988 -2010 ACORD CORPORATION. All rights reserved.
ACORD 26 (2010105) The ACORN name and logo are registered marks of ACORD
NOTEPAD SBACO -1
iNSURED�SNAME BA Communications Corporation OP ID: N
D INSUREDS:
COMMUNICATION CORPORATION
NETWORK SERVICES, LLC
DAS HOLDINGS, LLC
DEPOSITOR LLC
GUARANTOR LLC
HOLDINGS LLC
INFRASTRUCTURE, LLC
LAND, LLC FKA TCO LAND LLC
MONARCH TOWERS I, LLC
MONARCH TOWERS III, LLC
MONARCH STEEL, LLC
NETWORK MANAGEMENT, INC.
PUERTO RICO, LLC
SENIOR FINANCE II LLC
SENIOR FINANCE LLC
SITE MANAGEMENT, LLC
SITES, LLC
SBA STEEL LLC
SBA STEEL II., LLC
SBA STRUCTURES LLC
SSA TELECOMMUNICATIONS, LLC
SBA TOWERS II LLC
SBA TOWERS III LLC
SBA TOWERS IV, LLC
SBA TOWER'S V, LLC
SSA TOWERS USVI, INC.
SBA TOWERS, LLC
SITEXCELL VENTURES LLC
STC TOWER. DEVELOPMENT ACQUISITION 2012, LLC
SUFFOLK WIRELESS ACQUISITION 2012, LLC
XCELL TOWERS ACQUISITION 2012 LLC
ATLAS TOWERS ACQUISITION 2011, LLC
SBA 2012 TC ASSETS, LLC
SBA TOWERS VI, LLC
SBA TOWERS VII, LLC
SSA TRS HOLDCO, LLC
SBA 2012 TC ASSETS LAND, LLC
SBA. 2012 TC ASSETS PR, LLC
SEA 2012 TC HOLDINGS, LLC
SEA 2012 TC LAND II, LLC
SSA DAS, LLC
SSA PROPERTIES, LLC
COLLIER ENTERPRISES II LLC
DATAPATH DEVELOPMENT TOWERS, LLC
MERCURY TOWERS ACQUISITION 2013, LLC
SSA GC' HOLDINGS, LLC
SBA. GC PARENT I, LLC'
SSA GC PARENT II, LLC.
SSA GC' TOWERS LLC
SBA HQ, LLC
TOWER FUNDING, LLC
ATLAS TOWERS ALASKA ACQUISITION 2014, LLC
D.W. HOLDINGS ACQUISITION 2014, LLC
MUNICIPAL ACQUISITION 2015, . LLC
SBA NEW BUILDS LLC
SBA. TOWERS ACQUISITION 2014, LLC
PAGe 2
Date 0311...012015
SBACO OP 110- NC
n, rr YI
CERTIFICATE OF LIABILITY
0310912016
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
CONTACT NAME: Clem J. WVand'risco
Henderson Brothers, Inc.
920 Pt Duquesne Blvd
PHONE -.... _.... ,.. __ _ -. , fAX D
(AIC, No, Ext); 412 -261 1$42 Iarc, Na). 412W- 2 1-414
Pittsburggh, PA 16222
EMAIL
ADDRESS: cjwandrisco @hendersonbrothers .cam
- -.
Clem J. Wandriaco, Ill
INSURERS) AFFORDING COVERAGE NAIC N
'"COrporatiOPN ............. _
INSURER Property Casualty Ca 25674
_ ....
INSURED .. + SBA. ComIIriliInIGations
INSURER B: St Paul Fire ter` Marine Ins Cc .;24767
Thomas Hunt, Esquire
RC:lllinais Union Insurance Carrrpa
6900 NW Broken Sound Parkway
-NSU
Boca Raton, FL 33487
INSURER D:
{'i PE[15WNALL B ADV INJURY
INSURER E:
INSURER f :
COVERAGES rFRTIFICATF NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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 _ A001. SUER
LTR TYPE OF INSURANCE POLICY NUMBER
1
POLICY EFF .POLICY EX
MMIDDIYYYY MMIDDIYYYY LIMITS
GENERAL LIABILITY
I EACH OCCURRENCE '
$ 900,00'
A X COMMERCIAL GENERAL LIABILITY X
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Site Number: CTA1 r9 C+enterDr.,,��•��"`
er:
Santa, Ana, CA
�wt�
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I,NdtZL01114014V
CA46019
City of Banta Ana, Executive
Director Perks, Roe and
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26 Civic Center Plaza, M -76
Banta Ana, CA 92701
SHOULD ANY CIF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
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i4V I'V00 -4U'IU M%,Vr%L.7 I..VI°ar'Vicre I IVIV. HIF r1gl Ills FVZJeFYCLI...
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
IED INSUREDS
COMMUNICATION CORPORATION
1 NETWORKS SERVICE'S, LLC
DAS HOLDINGS, LLC
I DEPOSITOR LLC
GUARANTOR LLC
HOLDINGS LLC
1 INFRASTRUCTURE, LLC
L LAND, LLC FCSA 'TCO LAND LLC
1 MONARCH TOWERS I, LLC
1 MONARCH TOWERS III, LLC
k MONARCH STEEL, LLC
E NETWORK MANAGEMENT, INC.
t PUERTO RICO, LLC
1 SENIOR FINANCE II LLC
t SENIOR FINANCE LLC
1 SITE MANAGEMENT, LLC
L SITES, LLC
SBA STEEL LLC
SBA STEEL II, LLC
SBA STRUCTURES LLC
SBA TELECOMMUNICATIONS, LLC
SBA TOWERS II LLC
SBA TOWERS III LLC
SBA TOWERS IV, LLC
SBA TOWERS V, LLC
SBA TOWERS USVI, INC.
SBA TOWERS, LLC
SITEXCELL VENTURES LLC
STC TOWER DEVELOPMENT ACQUISITION 2012, LLC
SUFFOLK WIRELESS ACQUISITION 2012, . LLC
XCELL TOWER'S ACQUISITION 2012 LLC
ATLAS TOWERS ACQUISITION 2011, LLC
SBA 2012 TC ASSETS, LLC
SBA TOWERS VI, LLC
SBA TOWERS VII, LLC
SBA TRS HOLDCO, LLC
3A 2012 TC ASSETS LAND, LLC
3A 2012 TC ASSETS PR, LLC
3A 2012 TC HOLDINGS, LLC
3A 2012 TC LAND II, LLC
3A DAS, LLC
3A PROPERTIES, LLC
7LLIER ENTERPRISES II LLC
kTAPATH DEVELOPMENT TOWERS, LLC
3RCURY TOWERS ACQUISITION 2015, LLC
3A GC HOLDINGS, LLC
3A GC PARENT I, LLC
3A GC PARENT II, LLC
3A GC TOWERS LLC
3A HQ, LLC
3WER FUNDING, LLC
CLAS TOWERS ALASKA ACQUISITION 2014, , LLC
.W. HOLDINGS ACQUISITION 2014, LLC
7NICIFAL ACQUISITION 2015, LLC
3A NEW BUILDS .LLC
SBACO -1 PAGE 2
OP ID: NC Dat. 0311012015
SBA TOWERS ACQUISITION 2014, LLC
�r SBACO -1 OP Iii: RC
DATE(MMIDDIYYYY)
, cca n CERTIFICATE OF LIABILITY INSURANCE
+..�.. --. 03109'12015
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 IS'S'UING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate Molder is an ADDITIONAL INSURED', the poiicy(les) 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.
Henderson Brothers, Inc,
920 Ft Duquesne Blvd'
Pittsburg®h, PA 16222
Clem J. 91, III
INSURED SBA, Communications Corporation
Thomas Hunt, Esquire
5900 NW Broken Sound Parkway
Boca Raton, FL 33457
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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 13 SUBJECT TO ALL THE
TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR .,..... TYPE OF INSURANCE p.DDLSUIBR POLICY NUMBER
LTR
T M'diAIDD /YYYY MM1DD YTYY LIMITS
_
GENERAL LIABILITY '',..
EACH OCCURRENCE
$
900,000
A X COMMERCIAL GENERAL LIABILITY X �TJEXGL474M8138TIL15
0311612016 0311512016
DAIVIAGD'r0 RENTED .
P,RENHISES (Ea occurrence .
1
$..
....... m...
900,000
_..
CI.AIMSMADE OCCUR
MED EXP (Any one person) I
S
NI
X $100,000 SIR
PERSONAL & ADV INJURY 1
-
S -
900,000
y
GENERAL AGGREGATE I
$
2000,00..
GEN'L AGGREGATE LIMIT APPL.ILS PEI'd
PROD UCTS - COMPIOP AGG '
$
2,000,00
POLICY f X PO Lf?C �
AUTOMOBILE LIABILITY `
(E dpD SINGLE LIMIT .
$
1,000,000
A X ANY AUTO
T
0311612015 ! 03/1612016
BODILY INJURY (Per person)
g
...._.
ALL OWNED SCHEDULED
__ _ .
BODILY INJURY (Per accldenl)
.._..
S
.m ....
AUTOS AUTO"
WOW - OWNED
ly P &II %FD AUTOS X'
X 100,000 DED MCPD
.M
�•
PRQPEIZPH DFSWACaE
(NEFI ACCIDEN'f1
S
...w
X INMIBRELLA LIAR X OCCUR
EACH OCCUR._RENCE
. _
$
26,000,000
EXCESS LIAR
B CIAIMS MAriF�
�ZUP16N3740616NF
0311612016 0311612016
AGGREGATE
$
25,000,00
a..
DED X I'iETENI'ION$ 10,'000
$
WORKERS COMPENSATION
�ER..�..$
T1,000,000''
AND OPRIETORMARBTINETYEXECUTIVEYI„N� WIA
A
EXCLUDED? fv...)
TC2JUB476M43781S(AOS)
0311612015
031151201E
1, El. EACHACCIDENT
IC ER/MEMBER
A iMandata'ry in NH} ',.
TRJUB476fJW38A16
03/16120151(
031161201E
E.L. DISEASE, « LJA EMPLOYEE
S
1,000,001]
H yes, describo under
...... ....._......
I Wff
11000,000
DESCRIPTION OF OPERATIONS Wow
E.L. DISEASE - POLICY
$
C PROFESSIONAL
COOG24541800006
0311612015
03111612016
CLAIMIAGG
6,000,00
(POLLUTION
SIR
100,00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attache. ACORD 1.01, Additional Remarks Schedule, If mare space is re+qulredl
Site Number: CA45903 -A -0, Site Name: Salgado Center, 706 N. Newhope, Santa.
Area"
�� y \\
CA45903
City of Santa Ana, Executive
Director' Parka, Rec, and
Community Services (M-23)
25 Civic Center Plaza, RI «76
Santa Ana, CA 92701
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED' BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
AUTHORIZED REPRESENTATIV E
V lt$Utl -ZUIU AIL.:VKL7IwVKI'UKA I IVN. Au rlgnis reserveo.
ACORD 26 (2010106) The ACORD name and logo are registered marks of ACORD
NOTEPAD MSURED'SN OV SBA Communications Corporation
NAMED INSUREDS:
SSA COMMUNICATION CORPORATION
SSA NETWORK SERVICES, LLC
SSA DAS HOLDINGS, LLC
SSA DEPOSITOR LLC;
SBA GUARANTOR LLC
SBA HOLDINGS LLC
SBA INFRASTRUCTURE, LLC
SBA LAND, LLC k FAA TCO LANCE LLC'
SSA 14ONARCH TOWERS 1, LLC
SBA MONARCH TOWERS 111, LLC
SBA MONARCH STEEL, LLC
SSA NETWORK MANAGEMENT, INC.
SBA PUERTO RICO, LLC
SEA SENIOR FINANCE II LLC'
SSA SENIOR FINANCE LLC
SBA SITE MANAGEMENT, LLC
SSA SITES, LLC
SA STEEL LLC
BA STEEL II, LLC'
BA STRUCTURES LLC
BA TELECOMMUNICATIONS, LLC
BA TOWERS II LLC'
SA TOWERS III LLC
BA TOWERS IV, LLC
BA TOWERS "V, LLC
SA TOWERS USVI, INC,
BA TOWERS, LLC
ITEXCELL VENTURES LLC
TC TOWER DEVELOPMENT ACQUISITION 2012, LLC
UFFOLK WIRELESS ACQUISITION 2012, LLC
CELL TOWERS ACQUISITION 2012 LLC
TLAS TOWERS ACQUISITION 2011, LLC
BA 2012 TC ASSETS, LLC
BA TOWERS VI, LLC
BA TOWERS VII, LLC
BA TRS HOLDCO, LLC
3A 2012 TC ASSETS LAND, LLC
3A 2012 TC ASSETS PR, LLC
3A 2012 TC HOLDINGS, LLC
3A 2012 TC LAM 11, LLC
3A DAS, LLC
3A PROPERTIES, LLC
3LLIER ENTERPRISES II LLC
kTAPATH, DEVELOPMENT TOWERS, LLC
i.RCURI TOWERS ACQUISITION 2013, LLC
3A GC HOLDINGS, LLC
3A GC PARENT I, LLC
3A GC PARENT II, LLC
3A GC TOWERS LLC
3A HQ', LLC
?WER, FUNDING, LLC
CLAS TOWERS ALASKA ACQUISITION 2014, LLC
,W'. HOLDINGS ACQUISITION 2014, LLC
JNICIPAL ACQUISITION 2015, LLC
3A NEW 'BUILDS LLC
Im
SBA, TOWERS ACQUISITION 2014, LLC
PAGE 2
Date 0311012015
TJ-EoGL-e74M8138-TzL-15
EFFECTIVE 03-I5-15
COMMERCIAL GENERAL LIABILITY
4239011 r011,1119
This endorsement modifies insurance provided under the hdlow|ng�
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PROVISIONS 3
1. WHO IS AN INSURED (SECTION N)|mamended
to include as an insured any person or organiza-
tion (called hereafter "additional insured") with
whom you have agreed in a vvh8em contract, 4
executed prior to loss, to name aoenadditional
insured, but:
a. Only with respect to liability because of
"bodily injury" or "property damage" arising
out of "your work" for that additional insured
performed by you or for you: and
b. Subject to any limitations in the written con-
tract regarding the scope of the additional
immwnmd status.
This insurance does not apply bo"bodily injury"
or "property damage" arising out of "your work"
included in the "prod ucta-connpUehad operations
hazard'^ unless you are required to provide such
coverage by written contract and then only for
the period of time magukred by the contract, but
in no event beyond the expiration date of the
pp1|ny�
2. The Limits of Insurance provided to Such addi-
tional insured shall be:
a. The limits which you have agreed topravido�
or
b�. The limits shown un the Declarations
whichever is less,
This insurance is excess over any vm0d and col-
lectible insurance unless you have agreed in m
written contract for this insurance to apply on m
primary or contributory basis.
This insurance does not apply on any bmain�
a. To any person ororganization for whom you
have purchased an Owners and Contractors
Protective policy.
b. To any person or organization who dis-
tributes or uoUe "your products" in the regular
course of its business.
c. To any person or organization from whom
you have acquired any products, or any im'
g/adiemt. part or conteimer, entering in1o, ac-
companying or containing such products.
dl. To any manager or lessor, of pnarniaeswhh
respect to liability arising out of the owner-
ship, maintenenoe, or use of that part of any
premises leased tmyou.
e. Tu any lessor mf leased equipment.
t To any architect, engineer or surveyor for
injury or damage arising out of:
(1) The praparing, approving or failing to
prepare or approve mopm, drowinQa,
opinions, nepoMa. Sumeym, change or-
ders, designs or specifications; and
(2) SupemimVry, inspection or engineering
services.
v*/^
e e6
CG DI 44 01 96 Copyright, The Travelers Indemnity Company, 1996. Page 1 of 1