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HomeMy WebLinkAboutROYAL STREET COMMUNICATIONSA-2007-042.01 N 5 1 •Mobile.. August 10, 2016 INSURANCE ON VILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES r_ i_17 Mr. Ron Ono City of Santa Ana Parks, Recreation and Community Services Agency — M23 20 Civic Center Plaza, 2nd Floor, Room #272 P.O. Box 1988 Santa Ana, CA 92702 Re: T-Mobile Site #: LA93010A 2008 McGaw Ave, Irvine, CA 92614 Jos eph.Thompson@T-Mobi le, com Site Address: 211.5 W. McFadden Ave., Santa Ana, CA 92704 Consent Request and Acknowledgement for Antenna Facilities Modification Dear Mr. Ono: T-Mobile West LLC, as successor in interest to Royal Street Communications, LLC a Delaware limited liability company ("Lessee") and the City of Santa Ana, a charter city municipal corporation organized and existing under the Constitution and laws of the State of California ("Lessor"), are parties to a Lease Agreement dated February 20'h, 2007 (the "Lease") for a site located at 2115 W. McFadden Ave., Santa Ana, CA 92704, upon which T-Mobile operates wireless antenna facilities. Pursuant to the Lease, T-Mobile can modify or upgrade its facilities at any time during the term of the Lease after obtaining Landlord's approval. T-Mobile needs to replace and/or upgrade its facilities. All equipment will be installed within the existing premises. To confirm your approval of the modifications described in this letter, please sign and date the following acknowledgement on both copies of this letter, keep one copy for your records and return the other signed letter to T-Mobile in the enclosed envelope. For your convenience, if you choose not to respond to this request within thirty (30) calendar days, T-Mobile will deem consent to be granted. If you have any questions, please contact Jordon DiBiase at 949-336-1550 or JDiBiaserCoastalBuyinessGrop ai llet. Thank you for your cooperation and attention to this matter. Sincerely, /Joe Thompson Partner Delivery Manager Southern California Market T-Mobile West LLC 0 Acknowledged, Accepted and Agreed: Landlord: By-- Na me: David Cavazos Tittle: City Manager Date: Approved as to Form: J64r� M. Funk Assistant City Attorney 7COMMENpED FQR AP L: GERARDO MOUET Executive Director of Parks, Recreation and Community Services Agency ATTEST - - MARIA D. HUIZAR Clerk of the Council acoR6' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDI(YI'Y) ll 5/1/2017 4/13/20I6 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 Three City Place Drive, Suite 900 St. Louis MO 63141-7081 (314)432-0500 CON NAME: T A/C, No, Ezt: AJC' No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIL id INSURER A: XL Insurance America, Inc. 24554 INSURED T-Mobile US, Inc. 1358772 Its Subsidiaries and Affiliates F'a--co2%,I� i„ (T 11 12920 BE 38th Street INSURER B: Greenwich Insurance Company 22322 INSURER C: NRtional Union Fire Ins Co Pins, PA 19445 -- NSURERD: Bellevue WA98006 _- INSURER E INSURER F : COVERAGES TMOBI CERTIFICATE NUMBER: 12325146 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR MD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP (MMIDDlci LIMITS B X COMMERCIAL GENERAL LIABILITY y Y RGD5000259-05 5/1/2016 5/1/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADEnOCCUR LLnJJ PREMISES Ea occurrence $ 1 000000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECT �LOC GENERAL AGGREGATE $2000000 PRODUCTS-COMP/OP AGG $ 2,000000 is OTHER B AUTOMOBILE LIABILITY y Y RAD5000257-05 5/1/2016 5/1/2017 Ee BINEaccIde� SINGLE LIMIT $ 2,000,000 X BODILY INJURY (Per Fecund) $ XX.XXXXX ANY AUTO AUTOS NCO AUTULED BODILY INJURY (Per accident $ XXXXXXX HIRED AUTOSPSCHEDNON OSWNED PROPER accden DAMAGE $ XX)CX}.i{X $XXXXXXX _ C G C X UMBRELLA LIAR EXCESS LIAR X OCCUR CI -AIMS -MADE ADE Y N 19096894 SIR applies per policy terms & conditions 5/1/2016 5/1/2017 EACH OCCURRENCE S 5 000 000 AGGREGATE $ 5 OOO OOO DEO X RETENTION $25,000 $ XXXXXXX A `� WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICEWMEMBER EXCLUDED4 (Mandatory in NH) f yes, describe Antler DESCRIPTION OF OPERATIONS below NIA N RV✓D500030-04 WI R{NRSON0302-g4 W1 5/1/2016 5/1/2016 5/1/2017 5/1/2017 PER OTH- X STATUTE E.L. EACH ACCIDENT $ I OOO,OOO E.L, DISEASE -EA EMPLOYEE I OOO OOO E.L. DISEASE POLICY LIMIT R 1000000 {gyp DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Addition marks Bob are, by be did If more space is required) The Certificate Bolder and other entities defined by written contract, statute, ppermit application orri we e tlitional insureds on a primary and non-conh'ibutory basis tinder general liability and are additional insured under automobile liability as required by MIT n r tr ryyEEpp Subrogation applies under general liability and automobile liability as regwred by writteu contract. **See Attached Endorsements** Re: Site #: LA I �^l%fadden Ave., Santa Ana, CA 92704GIs CERTIFICATE HOLDER CANCELLATION See Attachments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 12325146 AUTHORIZED REPRESENTATIVE City of Santa Ana -City Attorneys Office 20 Civic Center Plaza (M-23) PO Box 1988 Santa Ana CA 92702 ei__ ACORD 25 (2014101) ©1988-htPIiCORD CO7TP—ORArZN. All rights reserved The ACORD name and logo are registered marks of ACORD ENDORSEMENT This endorsement, effective 12:01 a.m., May 1, 2016 forms a part of Policy No. RGD5000259-05 issued to T-MOBILE US, INC. by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY WASHINGTON - CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT In the event coverage is cancelled for any statutorily permitted reason, other than nonpayment of premium, advanced written notice will be mailed or delivered to person(s) or entity(ies) according to the notification schedule shown below: Name of Person(s) or Entity(ies): Per the most current schedule Of Certificate Holders maintained by Lockton Companies and furnished to XL Insurance on a monthly basis Mailing Address: Number of Days Advanced Notice of Cancellation: In the event of cancellation for nonpayment of premium, ten (10) days notice will be given. All other terms and conditions of the Policy remain unchanged. IXI 405-WA 1210 Miscellaneous Attaclnnent : M481510 Master ID: 1358772, Certificate ID: 12325146 30 ENDORSEMENT This endorsement, effective 12:01 a.m., May 1, 2016 forms a part of Policy No. RAD5000257-05 issued to T-MOBILE US, INC. by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY WASHINGTON - CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT In the event coverage is cancelled for any statutorily permitted reason, other than nonpayment of premium, advanced written notice will be mailed or delivered to person(s) or entity(s) according to the notification schedule shown below: Name of Person(s) or Entity(ies): Per the most current schedule Of Certificate Holders maintained by Lockton Companies and furnished to XL Insurance on a monthly basis Mailing Address: Number of Days Advanced Notice of Cancellation: In the event of cancellation for nonpayment of premium, ten (10) days notice will be given. All other terms and conditions of the Policy remain unchanged. IXI 405-WA 1210 Miscellaneous Attachment: M481533 Master ID: 1358772, Certificate ID: 12325146 30 (:� �OVt G� CuOV �S Digitally signed by Francine R. Francine R. Villareal Villareal Date: 2021.10.1913:22:29-07'00' ACORO° CERTIFICATE OF LIABILITY INSURANCE 5/l/2022 DATE (MMIDDIYYYY) 10/12/2021 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 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 Lockton Companies CONT NAMEACT Three City Place Drive, Suite 900 St. Louis MO 63141-7081 (314)432-0500 PHONE FAX Ext : A/C Na E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Continental Casualty Co=my 20443 INSURED T-Mobile US, Inc. 1358772 Its Subsidiaries and Affiliates INSURER B: The Continental Insurance Company 35289 INSURER C : Transportation Insurance Company 20494 INSURER D : 12920 SE 38th Street Bellevue WA 98006 INSURER E INSURER F : COVERAGES TMOBI CERTIFICATE NUMBER: 12325146 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y N 7012343900 5/l/2021 5/1/2022 EACH OCCURRENCE $ 10,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 10,000,000 MED EXP (Any one person) $ 25,000 PERSONAL & ADV INJURY $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 20,000,000 POLICYEl JE � LOC PRODUCTS -COMP/OP AGG $ 20,000,000 $ OTHER: A AUTOMOBILE LIABILITY N N 7012343878 5/t/2021 5/l/2022 COMBINED SINGLE LIMIT Ea accident $ 5,000,000 X BODILY INJURY (Per person) $ XXXXXXX ANY AUTO BODILY INJURY (Per accident) $ XXXXXXX OWNED SCHEDULED AUTOS ONLY AUTOS PROPERTY DAMAGE Per accident $ XXXXXXX HIRED NON -OWNED ONLY AUTOS ONLY $XXXXXXX B X UMBRELLA LIAB X OCCUR N N CUE 7014886953 5/l/2021 5/1/2022 EACH OCCURRENCE $ 5,000,000 B B EXCESS LIAB CLAIMS -MADE Slit applies per policy terms & conditions AGGREGATE $ 5,000,000 DED I X I RETENTION $ 10,000 $ XXXXXXX 1 1 B B C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? NI (Mandatory in NH) NIA N 7012343895 (AOS) 7012343881 CA 7012447142 AZ,MA,OR,WI) 5/1/2021 5/l/2021 5/l/2021 5/1/2022 5/1/2022 5/1/2022 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TFRM(S) REFERENCED. The Certificate Holder and other entities defined by written contract, statute, permit application or written agreement are additional insureds on a primary and non-contributory basis under general liability and are additional insured tinder automobile liability as required by written contract. Waiver of Subrogation applies under general liability and automobile liability as required by written contract. **See Attached Endorsements** LA93010A/LA0620A - 2115 W Mcfadden Ave Santa Ana, CA 92704 12325146 City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Exec. D1reClOre, Parks, BCC. & Community Services y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza .Santa Tina CA 92702 AUTHORIZED REPRIESENTAT ,,, oRaNc RA Mwag'tM erd DiVisi n REVIEWED & APPROVED BY: © 1988-2 ACORD C L v� ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ` Risk Management Analyst Attachment Code: D590641 Master ID: 1358772, Certificate ID: 12325146 City of Santa Ana Exec. Directore, Parks, Rec. & Community Services Attn: Risk Management Division 20 Civic Center Plaza Santa Ana CA 92702 IMPORTANT NOTICE Dear Certificate Holder for T-Mobile and its subsidiaries (including Sprint): In our continued effort to provide timely certificate delivery, Lockton Companies is transitioning to paperless delivery of Certificates of Insurance going forward. To ensure future renewals of this certificate, we need your email address. Please contact us via one of the methods below, referencing Certificate ID 12325146 -Email: stl-edelivery@lockton.com -Phone: 314-812-3888 If we do not receive your email address via one of the above methods prior to the client's next renewal, we will assume you no longer need the certificate. If you received this certificate through an internet link where the current certificate is viewable, we have your email and no further action is needed. The above inbox is for coffecting email addresses for renewal electronic certificate delivery ONLY. You wiff not receive a response from this inbox. Thank you for your cooperation. Lockton Companies Lockton Companies Three CityPlace Dr, Suite 900 / St. Louis, MO 63141-7088 314-432-0500 / lockton.com HORaN } r RAManWmentDMsian REVIEWED & APPROVED BY: f R. VSA44a Risk Management Analyst Attach ekVAK 8 Master ID: 1358772, Certificate ID: 12325146 It is understood and agreed that: If the Named Insured has agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if the Insurer cancels a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificate holders at least 30 days in advance of the date cancellation is effective. If notice is mailed, then proof of mailing to the last known mailing address of the Certificate holder on file with the Agent of Record will be sufficient to prove notice. Any failure by the Insurer to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon the Insurer or the Agent of Record. All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy. Form No: CNA75014XX (01-2015) Endorsement Effective Date: 5/1/2021 Endorsement No: Page: 1 of 1 Underwriting Company: Continental Casualty Company Policy No Policy Eff , RisleMa�agementONeawn ' REVIEWED & APPROVED BY.- 3 r Risk Management Analyst V Copyright CNA All Rights Reserved. Attachment Code: D559289 Master ID: 1358772, Certificate ID: 12325146 ■ NOTICE OF CANCELLATION TO CERTIFICATEHOLDERS It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificateholders at least 30 days in advance of the date cancellation is effective. If notice is mailed, then proof of mailing to the last known mailing address of the Certificateholder on file with the Agent of Record will be sufficient to prove notice. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon us or the Agent of Record. All other terms and conditions of the policy remain unchanged. its endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, kes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another fective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy. Form No: CNA68021XX (02-2013) Endorsement Effective Date: 5/1/2021 Endorsement No: Underwriting Company: Continental Casualty Company P of i c Risk MwagmentDMsian oRaN POI IC i REVIEWED & APPROVED BY. - a POlic V Copyright CNA All Rights Reserved. Risk Management Analyst ttachmcnt Code: D559325 crtificatc ID: 12325146 CNA Additional Insured — State or Governmental Agency or Subdivision or Political Subdivision — Permits or Authorizations Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: Any State or Political Subdivision you have agreed to include as an additional insured under written contract, permit application, statute or agreement, provided such contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. It is understood and agreed as follows: A. The WHO IS AN INSURED is amended to add as an Insured any state or governmental agency or subdivision or political subdivision shown in the Schedule that has issued a permit or authorization for operations performed by or on behalf of the Named Insured, but only with respect to bodily injury, property damage or personal and advertising injury arising out of the permitted or authorized operations. However, if coverage for the additional insured is required by written contract or written agreement, subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: 1. coverage broader than required by such contract or agreement; or 2. a higher limit of insurance than required by such contract or agreement. B. This insurance provided to the additional insured does not apply to: 1. bodily injury, property damage or personal and advertising injury arising out of operations performed for the federal government, state or municipality; or 2. bodily injury or property damage included within the products -completed operations hazard. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, CNA74739XX (1-15) Policy No: P 1 f1 7012343900 age o CONTINENTAL CASUATLY COMPANU\Y Insured Name: T-MOBILE US, INC. En Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., " .—`` Risk MmRgzmerdDiAsiun REVIEWED & APPROVED BY. - Risk Management Analyst ttachmcnt Code: D559285 crtificatc ID: 12325146 CNA Primary and Noncontributory - Other Insurance Condition Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART It is understood and agreed that the condition entitled Other Insurance is amended to add the following: Primary And Noncontributory Insurance Notwithstanding anything to the contrary, this insurance is primary to and will not seek contribution from any other insurance available to an additional insured under this policy provided that: a. the additional insured is a named insured under such other insurance; and b. the Named Insured has agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, CNA74987XX (1-15) Policy No: 7012343900 Page 1 of 1 Endorsement No: Effective Date: 5/1 /2021 CONTINENTAL CASUALTY COMPANY Insured Name: T-MOBILE US, INC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., wit �oRaN 3 RiskMwagemerdDiAsiun REVIEWED & APPROVED SY: z a F R. V Risk Management Analyst ttachmcnt Code: D559280 crtificatc ID: 12325146 CNA Additional Insured - Designated Person or Organization Endorsement This endorsement modifies insurance provided under the following: SCHEDULE Name Of Additional Insured Person Or Organization: Any person or organization for whom the Named Insured has agreed to provide insurance prior to loss as provided by this policy but only to the limit and scope of insurance agreed to by the Named Insured. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. It is understood and agreed that the section entitled WHO IS AN INSURED is amended with the addition of the following: A. The person or organization shown in the Schedule is an Insured, but only with respect to such person or organization's liability for bodily injury, property damage or personal and advertising injury caused in whole or in part, by: the Named Insured's acts or omissions, or the acts or omissions of those acting on the Named Insured's behalf: 1. in the performance of the Named Insured's ongoing operations; or 2. in connection with premises owned by or rented to the Named Insured. B. However, if coverage for the additional insured is required by written contract or written agreement, subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: 1. coverage broader than required by such contract or agreement; or 2. a higher limit of insurance than required by such contract or agreement. C. The coverage granted by this endorsement does not apply to bodily injury or property damage included within the products -completed operations hazard. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, CNA74745XX (1-15) Policy No: Page 1 of 1 7012343900 CONTINENTAL CASUALTY COMPANY Insured Name: T-MOBILE US, INC. Endo Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., �oRaN RiskMmRgzmerdDiAsian REVIEWED & APPROVED SY: 3 r f R. VSA44a Risk Management Analyst T • •Mobile• T-Mobile USA, Inc. 12920 SE 38th Street, Bellevue, WA 98006 # SENT BY UPS OR CERTIFIED MAIL August 11, 2021 City of Santa Ana Office of the City Attorney 20 Civic Center Plaza (M-29) PO Box 1988 Santa Ana, CA 92702 Re: Notice of Merger of Tenant into Affiliate entity pertaining to Lease by and between City of Santa Ana ("Landlord") and MetroPCS Networks California, LLC ("Existing Tenant") for the Premises at 2115 W McFadden Ave, Santa Ana, CA 92704 (the "Lease") Site ID: LA93010A Landlord Site ID: Dear Landlord: T-Mobile is continuing the process of simplifying its corporate structure by combining additional subsidiaries for corporate entity consolidation purposes. As part of that process, the Lease between Landlord and Existing Tenant for the above referenced Premises has been transferred to T-Mobile West LLC ("New Tenant'). This letter serves as notice that effective July 1, 2021, New Tenant is the successor -in -interest to the Existing Tenant as a result of certain intercompany restructurings, mergers, assignments to T-Mobile subsidiaries or affiliates, or other transfers by operation of law. Following these consolidations or corporate restructurings, any notices pertaining to the Lease should be sent to: T-Mobile West LLC 12920 SE 381h Street Bellevue, WA 98006 Attn: Lease Administration Site ID: LA93010A If you have any questions, please reach out to Pro pertyManagement@t-mobile.com. Respectfully, ;VarT4 a 9zaKl¢eew Patricia Franklin Director, Network Supply Chain + Partner Management Ride Management DMsbn REVIEWED & APPROVED BY. z o?waiiu f� P VjjW"4,j Risk Management Analyst �1 T is aMobiles" 10- INSURANM9NH1 E- VIORK MAY PROCEE15 UNTI1_ INSURANCE EYPIRD3 'CLERK OF COUNCIL _ 0.- A-2007-042-01 2008 McGaw Ave, Irvine, CA 9261.4 Josepli.Tlionipson a,T-Mobile.com August 10, 2016 _ . Mr. Ron Ono City of Santa Ana. Parks, Recreation and Community Services Agency M23 20 Civic Center Plaza, 2°° Floor, Room #272 P,O. Box 1988 Santa Ana, CA 92702 Re: T-Mobile Site #: LA93010A Site Address: 21.15 W. McFadden Ave., Santa Ana, CA 92704 Consent Request and Acknowledgement for Antenna Facilities Modification Dear Mr. Ono: T-Mobile West LLC, as successor in interest to Royal Street Communications, LLC a Delaware limited liability company ("Lessee") and the City of Santa Ana, a charter city municipal corporation organized and existing under the Constitution and laws of the State of California ("Lessor"), are parties to a. Lease Agreement dated February 201h, 2007 (the "Lease") for a site located at 2115 W. McFadden Ave., Santa Ana, CA 92704, upon which T-Mobile operates wireless antenna facilities. Pursuant to the Lease, T-Mobile can modify or upgrade its facilities at any time during the term of the Lease after.obtaining Landlord's approval. T-Mobile needs to replace and/or upgrade its facilities. All equipment will be installed within the existing premises. To confirm your approval of the modifications described in this letter, please sign and date the following acknowledgement on both copies of this letter, keep one copy for your records and return the other signed letter to T-Mobile in the enclosed envelope. For your convenience, if you choose not to respond to this request within thirty (30) calendar [lays, T-Mobile will deem consent to be granted. If you have any questions, please contact Jordon DiBiasc at 949-336-1550 or JDil3iasc((-i,)Coasta1BusinessGraut net, Thank you for your cooperation and attention to this matter. _._.._.._.___w_.___ Sincerely, roe Thompson Partner Delivery Manager Southern California Market T-Mobile West LLC oR,H F Risk Manag=w1UiMsion & APPR.OgVq D BY. ccREMEWED Risk Management Analyst Acknowledged, ,accepted and Agreed: Landlord: _ ..,.� By: Marne: David Cavazos Title. City Manager Date: Approved as to Form: (L4 f J641T Ma Funk Assistant City Attorney �MMENNEEDK:� L: GERARDO MOUET Executive Director of Parks, Recreation and Community Services Agency ATTEST MARIA D. HUIZAR Clerk of the Council oR,H F RlskMwwg mmtUiMs€on REM EWED & APPR.OgVq D BY. Risk Management Analyst