HomeMy WebLinkAboutInsurance Certificate: T-Mobile US, Inc. Its Subsidiaries and Affitiates, including Sprint Corporation .4corzc�� CERTIFICATE OF LIABILITY INSURANCE FDATE(MMJDD/YYYY)
�... 5/1J2027 04/08/2026
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,LLC CONTACT
DBA Lockton Insurance Brokers,LLC in CA PHONE -
tC No xt: A/C No):
CA license#0F15767 E-MAIL
Three City Place Dr.,Ste.900
St.Louis MO 63141-7081 INSURERS AFFORDING COVERAGE NAIC#
(314)432-0500 midwestcertificates@lockton.c INSURERA: Continental Casualty Company 20443
INSURED T-Mobile US,Inc. INSURER B:The Continental Insurance Company 35289
1358772 Its Subsidiaries and Affiliates, INSURER C: Transportation Insurance Company 20494
including Sprint Corporation
12920 SE 38th Street INSURER D
Bellevue WA 98006 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 16984381 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 COND TIONS OF,9UCH POLICIES.LIMITS SH WN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
INSR ADDL SUB POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
A X COMMERCIAL GENERAL LIABILITY 7012343900 05/01/202 05/01/2027 EACH OCCURRENCE $ 10 000 000
CLAIMS-MADE a OCCUR DAMAGE T RENTED $ O,000 000
P occurrence)
Y Y MED EXP(Any oneperson) $ 25,000
PERSONAL&ADV INJURY $ 10,000,000
GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 20,000,000
POLICY JECT LOC PRODUCTS-COMP/OP AGO $ 20,000,000
OTHER: $
A AUTOMOBILE LIABILITY 7012343878 05/01/202 05/01/202ED
EOa MBI a.id.n ri
SINGLE LIMIT $ 5,000,000
X ANY AUTO BODILY INJURY(Per person) $XXXXXXX
OWNED SCHEDULED Y y BODILY INJURY(Per accident) $ XXXXXXX
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY AMAGE $ XXXXXXX
AUTOS ONLY AUTOS ONLY er accident
$XXXXXXX
B X UMBRELLA LIAB NCLAIMS-MADE
OCCUR 7014886953 05/01/202 05/01/202 EACH OCCURRENCE $ 5,000,000
B EXCESS LIAB N N SIR applies per policy AGGREGATE $ 5,000,000
B DED X RETENTION$10,000 terms&conditions $ XXXXXXX
WORKERS COMPENSATION X R TH-
B AND EMPLOYERS'LIABILITY Y/N 7012343895�CA)
OS) 05/01/202 05/01/202 'TAT TE ER
B ANY PROPRIETORIPARTNDED' CUTIVE � NfA N 7012343,881 05/011202 05/01/202 E.L.EACH ACCIDENT $ 2,000,000
C OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) 7012447142 AZ,MA,WI) 05/01/202 05/01/2027 E.L.DISEASE-EA EMPLOYEE $ 2,000,000
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 2,000,000
DESCRIPTION OF OPERATIONS i LOCATIONS t VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
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 under 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** f
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.
16984381 AUTHORIZED REPRESENTATIVE
CITY OF ASHLAND,OREGON
ATTN:CITY ADMINISTRATOR
CITY HALL,20 EAST MAIN STREET
ASHLAND OR 97520
@ 1988-2015 ACORD-CORPORATION.All rights reserved
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
Attachment Code : D590641 Master ID: 1358772, Certificate ID: 16984381
LOr
CITY OF ASHLAND, OREGON ATTN: CITY ADMINISTRATOR
CITY HALL, 20 EAST MAIN STREET
ASHLAND OR 97520
kk'" , Se `
E Pr JAI
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
16984381
• Email : stZ-edel iverj19Zockton. 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 collecting email addresses for renewal eZectronic
certificate delivery ONLY. You will not receive a response from this inbox.
Thank you for your cooperation.
Lockton Companies
Lockton Companies
Y }} j
Attachm 9278 Master ID: 1358772, Certificate ID: 16984381
n
L £ L X b S 4 LL
1 aa"4!
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,
Anv failure by the Insurer to notifv such Dersons or organizations will not extend or invalidate such
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
Form No: CNA75014XX (01-2015) Policy No: 7012343900
Endorsement Effective Date: 05/01/2026 Policy Effective Date: 05101/2026
Endorsement No: Page: 1 of 1
Underwriting Company: Continental Casualty Company
C Copyright CNA All Rights
Attachment Code : D559289 Master ID: 1358772, Certificate ID: 16984381
w ,
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.
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
Form No: CNA68021XX(02-2013) Policy No: 7012343878
Endorsement Effective Date: 05/01/2026 Policy Effective Date:05/01/2026
Endorsement No: Policy Page:
Underwriting Company: Continental Casualty Company
O Copyright CNA All Rights
CERTIFICATE
OF LIABILITY INSURANCE DATE{MMIDDIYYYY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFOICATE HOLDER27 08TH21S 28
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 GOmpanies,LLC
DBA Lockton Insurance Brokers,LLC in CA PHONE
CA license#0F15767
Three City Place Dr.,Ste.900 E-MAIL 21,
St.Louis MO 63141-7081 INSURED INSURERS AFFORDING COVERAGE
(314)432-0500 midwestcertificates@Iockton.c INSURER Continental Casualty -Ompany 20443ca
T-Mobile US,Inc.
358772 Its Subsidiaries and Affiliates, INSURER B:The Continental Insurance Com an 35289
including Sprint Corporation INSURER c:Trans ortation Insurance Corn an 20494
12920 SE 38th Street INSURER D:
Bellevue WA 98006 INSURER E:
COVERAGES INSURER F
CERTIFICATE NUMBER: 16975097
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE REVISION
IED ABOBVERFOR HE 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
L H TE I N A D N TI H LI IE .LIMITSH
INSR DDL 5U a D I
A H V N R D ED Y
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF POLICY EXP
A X COMMERCIAL GENERAL LIABILITY 7012343900 MM/DD/YYYY MM/DD LIMITS_
EACH OCCURRENCE $
CLAIMS-MADE�OCCUR 05/01/202 05/011202 10000000
A A E T D
$10 000 000
Y Y MED EXP An one arson $ 25 000
GENT AGGREGATE LIMIT APPLIES PER: PERSONAL&ADV INJURY $ 10 000 000
POLICY❑ SEC LOC GENERAL AGGREGATE $ 20 000 000
OTHER: PRODUCTS-COMP/OP AGG $ 20 000 000
A AUTOMOBILE LIABILITY $
X ANY AUTO 7012343878 05/01/202 05/01/202 EaaccideDSINGLELIMIT $
nt 5000000
OWNED SCHEDULED y y BODILY INJURY(Per person) $XXXXXXX
AUTO
IRED S ONLY AUTOS NON-OWNED BODILY INJURY(Per accident) $X)O(}(X}O(
H
AUTOS ONLY AUTOS ONLY PROPERTY AMAGE
era ident $XXXXXXX
B X UMBRELLA LIAR X OCCUR $XXXXXXX
B EXCESS LIAB 7014886953 05/01/202 05/01/202 EACH OCCURRENCE
B CLAIMS-MADE N N SIR applies per policy $ cj 0(}0 0Od
DED X RETENTION$10,000 terms&conditions AGGREGATE $ 5000000
WORKERS COMPENSATION $XXXXXXX
B AND EMPLOYERS'LIABILITY y/N 7012343895��AOS'
X
B ANY PROPRIETORIPARTNER/EXECOTIVE 05/01/202 05101/202 G, (MandaOFFICtory
in N ER EXCLUDED? N/A (y 7012343881 CA) 05/01/202 05/01/202 E.L.EACH ACCIDENT $2_000,000
If IMandatoryin and 7012447142 Z,MA,WI) 05/01/202 05/01/202DES describe underE.L.DISEASE__EA EMPLOYEE $ 2 000 000
DESCRIPTION OF OPERATIONS below .,
E.L.DISEASE-POLICY LIMIT $2 000 000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
basis under general liability and are additional insured under auto
The Certificate Holder and other entities defined written contract,statute,permit application or written agreement are additional insureds on a primary and non-contributory
mobile liability as required by written contract.Waiver of Subrogation applies under general liability and
automobile liability as required by written contract.**See Attached Endorsements** !
CERTIFICATE HOLDER
CANCELLATION ee ac men S
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
FASHLAAND,
SHLAND AUTHORIZED REPRESENTATIVE
STREET
OR 97520 4110
ACORD 26(2016/03) The ACORD name and logo are registered marks o ACORD O 0 T A rig is reserve