HomeMy WebLinkAboutInsurance Certificate: Sprint Communications CO LP 1114_ ' CERTIFICATE OF LIABILITY INSURANCE DA3/29/ 012 Y)
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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(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 endoreement(s).
PRODUCER Lockton Companies,LLCA Kansas City CONTACT
444 W.47th Street,Suite 900 a Ne Ban: AIC Na
Kansas City MO 64112-1906 EMAIL
(816)960-9000
INSURER A: Continental Casualty Comoany 20443
INSURED SPRINT COMMUNICATIONS CO.,LP INSURER B: American Casualry Company of Reading,PA 20427
14966 6480 SPRINT PKWY INSURER C: Transportation Insurance CompImy 20494
OVERLAND PARK KS 66251
LINSURER P;
INSURER E
INSURER F:
COVERAGES SPRC003 DE CERTIFICATE NUMBER: 2699825 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY UP DMms
Im• GENERAL LIABILITY N N GL4014104273 4/1/2011 4/1/2014 EACH OCCURRENCE 2,000,000
X COMMERCIAL GENERAL LABILITY PR MI E O RENTED XXXXXXX
fEe CLAIMS-MADE EKI OCCUR MED UP(My one rson) sXXXXXXX
X CONTRACTUAL LIAR. PERSONAL a ADV INJURY $ 2,000,000
X "TENANTS LEGAL LIAR GENERAL AGGREGATE $ 10,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 3,000,000
X PRO- Loc
POLICY E7JEcT F $
• AUTOMOBILE LIABILITY N N BUA4014104287 4/12011 4/1/2014 COMBINED SINGLE LIMIT $ 2,000,000
X ANY pAUTO BODILY INJURY(Per person) $ XXXXXXX
AUTOS�ED AUTOSULED BODILY INJURY(Per accident $ XXXXXXX
HIRED AUTOS NON-OWNED PROPERdTY DAMAGE $ XXXXXXX
Gara ekee ers $ Included
UMBRELLA LIAB OCCUR EACH OCCURRENCE $ XXXXXXX
EXCESS LIAB CLAIMS-MADE NOT APPLICABLE AGGREGATE $ XXXXXXX
DED RETENTION$ $
WORKERS COMPENSATION WC STATU- OTH-
C AND EMPLOYERS'LIABILITY N WC4014104225( DUD 4/1/2012 4/1/2013 X FR
B ANY PROPRIETORIPARTNER ECUTIVE YIN WC4014104239 DEDU TIBLE 4/1/2012 4/1/2013 E.L.EACH ACCIDENT
B OFFICER/MEMBER EXCLUDED? N❑ NIA WC4014104242(CA) 4/1/2012 4/1/2013 $ 1000000
B IMyena.ro,y In NHI N/A IN MONOPOLISTIC STAT S E.L.DISEASE EA EMPLOYEE 1,000.000
DESLRIPTIOIJ OF OPERATIONS celox
E L.DISEASE-POLICY LIMIT 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/(Attach ACORD 101,Additional Remarks Schedule,if more space is required)
'FIRE DAMAGE IS INCLUDED fN BROADER TENANTS LEGAL LIABILITY FORM WITH LIMITS OF$1,000,000 PER OCCURRENCE. ELECTED
AND APPOINTED OFFICERS,OFFICIALS,AGENTS AND EMPLOYEES ARE ADDITIONAL INSURED AS REQUIRED BY CONTRACT AND
SUBJECT TO POLICY TERMS AND CONDITIONS. RE: INSTALLATION,OPERATION& MAINTENANCE OF TELECOMMUNICATIONS
EQUIPMENT.
CERTIFICATE HOLDER ILLATION See Attachment
D S LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
11 XPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
A RDANCE WITH THE POLICY PROVISIONS.
2699825 APR - 9 2012 T LZEO REPRESENTATNE
CITY OF ASHLAND,OREGON
ATTN:CITY ADMINISTRATOR
CITY HALL,20 EAST MAIN STREE
ASHLAND OR 97520
ACORD 25(2010105) @T9118-2010 ACCFDFORPORATION.All rights reserved
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:2699825
166_ O CERTIFICATE OF LIABILITY INSURANCE DATE 0112 V)
�� a/uzo13 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(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 Lockton Companies,LLC-1 Kansas City CONTACT
444 W.47th Street,Suite 900 a Ne E.t: FAX No
Kansas City MO 64112-1906 E-MAIL
(816)960-9000
ADDRESS-
INSURER A: Continental Casualty Company 20443
INSURED SPRINT CORPORATION et at INSURER B: American Casualty Company of Reading,PA 20427
14966 6480 SPRINT PARKWAY INSURER C: Transportation Insurance Company 20494
OVERLAND PARK KS 66251
INSURER F
COVERAGES SPRC003 DE CERTIFICATE NUMBER: 130743 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 TYPE OF INSURANCE ADDL SILBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS INN MAID I
• GENERAL LIABILITY N N GL4014104273 4/1/2011 4/1/2014 EACH OCCURRENCE 2,000,0 0
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
.occurrence) XXXXXXX
CLAIMS-MADE[K]OCCUR MED EXP(Any one rsm XXXXXXX
X CONTRACTUAL LIAB. PERSONAL a ADV INJURY $ 2,000,000
X *TENANTS LEGAL LIAR - GENERAL AGGREGATE $ 10,000,000
GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO $ 3,000,000
X POLICY JECOT L $
•IC AUTOMOBILE LIABILITY N N BUA4014104287 4/1/2011 4/1/2014 COMBINED SINGLE LIMIT
Ee acciden s 2 000 000
X ANY AUTO BODILY INJURY(Per person) $ x')(X}(xxx
AUTOS�ED SCHEDULED BODILY INJURY(Per accident $ XXXXXXX
HIRED AUTOS NON-OWNED Wer accident)DAMAGE $ XXXXXXX
Gara ekee ers $ Included
UMBRELLA LIAS OCCUR EACH OCCURRENCE $ XXXXXXX
EXCESS LIAR CLAIMS-MADE NOT APPLICABLE AGGREGATE $ XXXXXXX
DED RETENTION$ is
AND EMPLOYERSELIAea�TY N WC40I4104225(RETRO 4/1/2012 4/1/2013 X WC SLr,MU- 0TH WORKERS
B YIN WC4014104239(DEDUC�TIBLE 4/1/2012 4/1/2013 EL EACH ACaoENr
B omcERMIEMSER EXCCLUDED?E`�I� N❑ NIA WC4014104242(CA) 4/1/2012 4/12013 s 1000000
B nfia d .'in NN) N/A IN MONOPOLISTIC STAT S E L DISEASE-EA EMPLOYEE 1,000,000
DESCRIPTION OFO E.L.DISEASE-POLICY LIMIT 1,000,000
DESCRIPTION OF OPERATIONS Celax
DESCRIPTION OF OPERATIONS I LOCATIONS I 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$1000 000 PER OCCURRENCE. THE
CITY OF ASHLAND, ITS OFFICERS, EMPLOYEES&AGENTS ARE ADDITIONAL INSUREDS AS RESPECTS LIABILITY COVERAGE,ONLY AS
REQUIRED BY CONTRACT.RE:FIBER OPTIC TELECOMMUNICATIONS SYSTEM.
CERTIFICATE HOLDER CANCELLATION See Attachment
D G C CE 0 M E SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
q ACCORDANCE WITH THE POLICY PROVISIONS.
(]
130743 APR — J 201' NUTHORIZED REPRESENTATIVE
CITY OF ASHLAND
CITY HALL
20 E.MAIN STREET
ASHLAND,OR 97520
ACORD 25(2010/05) @T998-2010 ACCPKDFORPORATION.All rights reserved
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: 130743