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PROOF OF INSURANCE (2019) CLOSED CERTIFICATE OF LIABILITY INSURANCE °3it'M"°°°"""' 3/2018 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 pollcy(les) 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 ondorsoment(s). CONTACT PRODUCER Lockton Companies NAME. 444 W.47th Street,Suite 900 PHONE FAX Kansas City MO 64112-1906 a�M: ....................................... ..............................................................................r�.111t: (816)960-9000 _&gDRES : ..............................................................ww..... !.NS.u.R.E.R@).A.FPORDINO COVERAGE. N819..N... __.......... INSURER Ay y Continerrll. l 1x.11 1t ... �.fn ._an... 20443........ INSURED SPRINT PCS ASSETS,L.L.C. INSURER 8:American,Casualty Company of Reading,PA 20427 14971 6480 SPRINT PARKWAY INSURER C:TranspOrtatlon Insurancg,Compan.y„............,_____,,,,,, 20494 OVERLAND PARK KS 66251 INSURER 0:Starr Indemnity ' &Liability Com at1 38318 ... p...-y ------------ INSURER E: INSURER F: COVERAGES SPRC0D03 CERTIFICATE NUMBER: 146911052 REVISION NUMBER: X'X' X' XX 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 'ERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH DOLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. jN TYPE OF INSURANCE Ab OL 0UN POLICY NUMBER �'OLic P 1 08606Y,9*0 ,•„SIV IMM/OD/YYYYI I1 YYYJ LIMITS A wX... COMCLA MIAL S-MADE GENERAL LIABILITY y N GL5082521363 4/1/2018 4/1/2019 .I.'EACH��yOCCURRENCE ��I^...,.,,.,..a OCCUR PR, s 25 .._... .. ............................ CONTRACTUAL LIAB., w......wwww.. MED EXP(Anyone„Peroon) s XXXXXXX v, *TENANTS LEGAL LIAB PERSONAL&ADV INJURY s 2,0 0,,000 GEN1 IIAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,0 0000 „V' �J JEC OTHER LOC PRODUCTS•COMP/OP AGG ..$-3,000,000. ............................ A AUTuOMOBILELIABILITY N N BUA5082521329 4/1/2018 4/1/2019S 2,000,00 COMand'JEO�r9P+tlG1.E LIMIT XXXXXXX ._. O 'Pia wa'Yw fqq $ .BODILY INJURY(Per eocldent) .XXXX.xXXXXXXXXAUTOS OAUTOS HIRED NON-OWNED UTOS ONLY AUTOS ONLY (Poll p%Cle t). X .............. s s Included D w;KW. UMBRELLA AB •� OCCUR N N 1000706013181 4/1/2018 4/1/2019EACH EXCESS LIAB CLAIMS-MADE AGGREGATERRENCE.................... a...1_0,00.0,0^00.................... DEQ i-RETENTIONS $ XXXXXXX WORKERS COMPENSATION �. X PER CITH- C AND EMPLOYERS'LIABILITY YIN WtM.5082521282 Rl.l lt¢�� 4/1/2018 4/1/2019 �,.Fli... m...� B ANY PROPRIETORIPARTNER/El(ECUTIVE �+C508252E29�i1'JI'.121�CTIBLE) 4/1/2018 4/1/2019 EL.EACHACCIDENT S 1 (.100000 C DESCRIPTION un OPERATIONS below ❑ N/A Wt '08252'1279((A ) 4/1/2018 4/1/2019 E.L.DISEASE-POLICY LIMIT IIS 1,000,000 (Mandatory M ndat scriIn be under N GAP 5082521315(S 1)t)I GAP 4/1/2018 4/1/2019 E L DISEASE•EA EMPLOYEE_S 1,000,000,,,. DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached Ii more space Is required) *FIRE DAMAGE IS INCLUDED IN BROADER TENANTS LEGAL LIABILITY FORM WITH LIMITS OF$1,000,000 PER OCCURRENCE. City of EI Segundo is an additional insured where required by contract and subject to policy terms and conditions,Re:installation,operation&maintenance of telecommunications equipment. LEASED LOCATION:-Site ID:LA25XC361,400 Lomita Street EI Segundo CA CERTIFICATE HOLDER CANCELLATION See Attachments 14691052 City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 350 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EI Segundo CA 90245 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIV I /;I /� ®19'88 016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) 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: 14971,Certificate ID: 14691052 Attachment Code:D463108 Certificate ID: 14691052 G-1 9160-A Page 1 of 1 (Ed. 01/93) Attachment Code:D461205 Certificate ID: 14691052 CNA PARAMOUNT 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 Additional Insured Person(s) or Organizations: Any person or organization whom you are required by a written contract to add as additional insured on this Coverage Part under endorsement CG 20 10. Location(s) of Covered Operations: Any location in the coverage territory that is subject to the written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. I. If the written contract requires you to add the person or organization as an additional insured under endorsement CG 20 10 04 13, or requires you to use CG 20 10 without specifying an edition date, then the following provisions apply: CG 20 10 04 13 A. Section II -Who is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for"bodily Injury", "property damage"or"personal and advertising injury" caused, in whole or in part, by; 1. Your acts or omissions; or 2. The acts or omiasions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional Insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply; This Insurance does not apply to"bodily injury"or"property damage"occurring after: 1. All work, Including materials, parts or equipment furnished in connection with such work, on the project(other than service, maintenance or repairs)to be performed by or on behalf of the additional insureds) at the location of the covered operations has been completed; or 2. That portion of"your work"out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the Insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to"bodily Injury" or"property damage" occurring after: 1. All work, including materials, parts or equipment furnished In connection with such work, on the project(other than service, maintenance or repairs)to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of"your work"out of which the Injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CNA69737XX(4-17) CONTINENTAL CASUALTY COMPANY POLICY NUMBER: GL5082521363 EFFECTIVE DATE: 4/1/2018 Attachment Code:D461205 Certificate ID: 14691052 CNA PARAMOUNT ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION II. If the written contract requires you to add the person or organization as an additional insured under endorsement CG 20 10 07 04, then the following provisions apply: CG 20 10 07 04 A. Section II —Who Is An Insured is amended to include as en additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for"bodily injury", "property damage" or"personal and advertising Injury" caused, in whole or in part, by 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to"bodily injury" or"property damage"occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project(other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of"your work"out of which the Injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. III. If the written contract requires you to add the person or organization as an additional insured under endorsement CG 20 10 10 01, then the following provisions apply: CG 20 10 10 01 A. Section II Who Is An insured 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. B. With respect to the Insurance afforded to these additional Insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to "bodily injury"or"property damage"occurring after: (1)All work, including materials, parts or equipment furnished in connection with such work, on the project(other than service, maintenance or repairs)to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (2) That portion of"your work"out of which the Injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. IV. If the written contract requires you to add the person or organization as an additional insured under endorsement CG 20 10 11 85, then the following provisions apply: CG 20 10 11 85 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 work"for that Insured by or for you. 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 effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA89737XX(4-17) CONTINENTAL CASUALTY COMPANY POLICY NUMBER: GL5082521363 EFFECTIVE DATE: 4/1/2018 Attachment Code:D463108 Certificate ID: 14691052 CNA G-1 9160-A Policy#WC5082521279 (CA) (Ed. 01/93) WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS This endorsement changes the policy to which it is attached. It is agreed that Part One-Workers' Compensation Insurance G. Recovery From Others and Part Two - Employers' Liability Insurance H. Recovery From Others are amended by adding the following: We will not enforce our right to recover against persons or organizations. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) PREMIUM CHARGE -Refer to the Schedule of Operations The charge will be an amount to which you and we agree that is a percentage of the total standard premium for California exposure.The amount is 2%. All other terms and conditions of the policy remain unchanged. Sprint Corporation