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HomeMy WebLinkAboutCROWN CASTLE INTERNATIONAL CORP - INSURANCE CERTIFICATE (4)CERTIFICATE OF LIABILITY INSURANCE Page 1 of 2 ED 04/(01/2014) 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 Willis of Pennsylvania, Inc. c/o 36 Century Blvd. P. O. So: 305191 Nashville, IN 37230-5191 PHONE FAX 77- -7 7 888- 7- -MAIL certificatea0willis.coin INSURER(S)AFFORDING COVERAGE NAICR INSURERA: Federal Insuremce Company 20281-005 INSURED CROWN CASTLE INTERNATIONAL CORP. INSURER B: North AmexiCtn Elite InslsramCa Company 29700-001 INSURER C: See Attached Named Insured List 1220 Augusta Dr. Suite 500 Houston, TX 77057 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:21410291 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. RiSR TYPEOFINSURANCE ADD' SUB POLICY NUMBER POLICY EFFnaaaffi� POLICY E%P LIM'AaAfnAS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE® OCCUR 7021-02-28 /l/2014 4/1/2015 EACHHOEECCTTURRENCE $ 1,000,000 MI ES E',1EN renoe $1,000,009 MEDEXP one rain $ 51000 PERSONALS ADV INJURY $ 1,000,000 GENERALAGGREGATE S 2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PIFCTRO LOC PRODUCTS-COMP/OP AGG $ 2,000,000 $ A AUTO MOBILE LIABILITY $ ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS HIREDAUTOS AU�OT!�OWNED 7021-02-29 /1/2014 4/1/2015 COMBIAcc,ID�INGLE LIMIT $ 1,000,000 BODILY INJURY(Per person) $ BODILY INJURY(PeraccitleM) $ raccitlenOAMA $ $ H X UMBRELLA LAB EXCESS LIAB X OCCUR CLAIMS -MADE UMB 2000165-00 /1/2014 4/l/2015 EACH OCCURRENCE $ 5,000,000 AGGREGATE S 5,000,000 LIED X RETENTION$ 25,00 $ A WORKERS COMPENSATION AND EMPLOYERVUABILRY ANY PROPRIETOR/PARTNER/EXECUTIVE� OFFICER/MEMBER EXCLUDED? Brna eetory in NH) II yyea, essence under DESCRIPTIONOF OPERATIONS below N/A 7171-06-98 Ill 4/1/2015 X E.LEACHACCIDENT $ 1,000,ODO E.L. DISEASE -EA EMPLOYEE $ 1,000,000 E.L. DISEASE• POLICY LIMB $ 1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS VEHICLES (Anacc Acord 101, ACditonal Remarks Schedule, it more space is requlrml) RE: 877023 See Attached IL FORT COLLINS, CITY OF PO BOX 580 ATTN EDNA HOERNICKE FORT COLLINS, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2010/05) :4377348 :1794642 Cert:21410291 ©198B-2010 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 71311 LOC#: A� d ADDITIONAL REMARKS SCHEDULE Page 7 of AGENCY Willie of Pennsylvania, Inc. POLICY NUMBER See First Page CARRIER NAIC CODE Fe1 Q 111111@]11/91 CROWN CASTLE INTERNATIONAL CORP. See Attached Named Insured List 1220 Augusta Dr. Suite 500 Houston, TX 77057 EFFECTIVE DATE: See First THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, cnDRA til uADCD. 25 cnDu Tm c- CERTIFICATE OF LIABILITY INSURANCE Certificate Holder is included as Additional Insureds under the General, Automobile and Umbrella policies as required by written agreement and only with respect to the liability arising out of the operations performed by or on behalf of the Named Insured. General, Automobile, Umbrella Liability and Workers Compensation include a Waiver of Subrogation in favor of the Additional Insureds when required by written contract and as permitted by law but always subject to the policy terms, conditions and exclusions as permitted by law. ACORD 101 (2008/01) Coll:4377348 Tpl:1794642 Cert:21410291©2008ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Crown Castle International Corp. Consolidated Subsidiaries AirConsn of Avon, LLC. Crown Caste MM FkAding Carp Amnahi Tower Nearm LLC Crown Caste MM Holding LLC Adantia Car Communications LLC Crown Caste MU LLC CA - CLEC LLC Crown Castle MUPA LLC Crown Castle NG Atlantic LLC. lelf 5/4n2l'112 Nett Newaas CC Caste Intemational LLC Atlantic roc. Crown Castle NG Central LLC (eF S11'1Z 1ka Ne dG. Nebolte Cr CC Finance LLC rands nc Crown Castle NG East LLC {elf Ba'12) Ra Nett Netwcxs a rav CC Holdings GS V LLC Inc CC Site Aagm5idons II LLC Crown Castle NG NeWorks Inc (eft M12) ila NatG NeC rlai Inc Crown Castle NG West LLC ;elf 5WI2F ti tee963 NeMrcls x CC TM PA LLC (elf 1 m3 V2012) calncm'a Inc CC Towers Waranhr LLC Crown Castle Operating Company CC Towers Hddelg LLC Crown Castle Operating LLC CCATT Holdings LLC Crown Castle Or'ando Corp, CCATT LLC Craven Castle PR LLC CCATT PR LLC Crown Castle PR Solutions LLC Pelf 9't b't 3) CCGS Holdings Corp. Crown Castle FT Inc. CCPE Acquisitions LLC Crown Castle Puerto FSm Corp. CCPR 41 LLC Crown Castle Services LLC (eR 6242C-11) CCTM Holdings LLC (eff la31JX112) Crown Castle Solutions Corp. CCTMI LLC (efi l lyda'12) Crown Castle South LLC CCTM2 LLC (effective 11M 12) Crown Castle TLA LLC CCfMO LLC (eff 1 Q31IM12) Crown Caste Towers 05 LLC CC17A Pry Limited (elf &13,W) Gown C"Je Towers 05-2 LLC Coa-.al Arrtennas LLC Crown Caste Towers OB LLC Comsite Venture. Inc- Crown Caste Towers LLC Coverage Pus Antenna Systems LLC Gown Castle USA Inc. Gown Communiction LLC LmrmMy Crosn Corrrwm w Irc. elf Crown Atlantic Company LLC 1111111 Crwri Castle Administration Py Ltd Crown Communication New York, Inc. Crown Castle .A5 LLC d er 42511; Crown Mobile Systems. Inc Crowrt Caste Atlantic LLC DC - CLEC LLC Crown Castle.Augusa LLC Divarre Ply Liniled (effective 1(12&12) Crown Cast- Australia !ioidings P.y Ltd Global Signal Acglusitials II LLC Crown Castle Auszatia Pty Ltd Global Signal Ao p isiGacs III LLC Crown Caste BP ATT LLC Global Signal Pcgnuseoris IV LLC Crown Castle CA Carp. Gobal Signal AcWtsborts LLC Crown Castle GS II! Corp_ Global Sigrid GP LLC Crown Caste GT Company LLC Global Signal Holdngs III LLC Crwet Castle GT Corp. Global Signal Fioldl ngs IV LLC Crown Castle GT Folding Sub LLC Global Sigrid Operating Partnership. LP. Gown Castle International Corp. Global Signal Services LLC Crown Cast International Corp. de Puerto Rim GddenStte Towers. LLC Crown Castle Itemaaonal LLC GS Savings Inc Crown Castle Inuesune q Corp GSPN Imagibles LLC Cro+m Castle Irnrestrrerit I I Corp High Point Maragenlent Co. LLC Crown Castle International Corm Consolidated Subsidiaries IC13 Tours, LLC fL - CLEC LLC IN - CLEC LLC In SITE Fil r of Virginia LLC InSITE Sakl6ons. LLC Interstate Town Comrnimcadons LLC Intamastal City Toww' LLC JBCM-1ci 1 LLC KAW ConsuN g Ply Lid Jeff 12n=l) MA - CLEC LLC MD - CLEC LLC Md7 CapwI One. LLC Motile Media Calftma LLC Mobile Media National LLC Modeo LLC MW Cell RUT 1 LLC (l71131n2) MW Cell TRS 1 LLC (eff 1131112) New Pair Netaorks, Inc. New Path Networks. LLC NJ - CLEC LLC NY - CLEC LLC CH -CLEC LLC lerte n7,20111 OP 2 LLC OF LLC PA - CLEC LLC Pinnacle San Anl LLC. Pinnacle St Loris LLC Pinnade Toeefs Acclumbon Ho"s LLC Pinnacle Tw Acquv on LLC Pi made To Asset 4olding LLC Pinnacle Towers Canada Inc. Pinnade Towers III LLC Rnrrade Toeias Limner Pinnacle Tw LLC Pinnacle Towers V Inc. Ratio Staaon WGLD LLC RECC Properaies Limited Jeir 92=5) Shaffer &.Associates. Inc. Giena Twers. Inc- Strercel Pry Ltd Thunder Towers LLC Tower Systems LLC Tower TechnoloW Company of Jadcsornike LLC Tower'Jenlures III, LLC ToverOne 2012. LLC (eff 3ZWIZ2, TowetOne A9erdown 00!, LLC (Of 3,1=012;. TowerOne Doylests , LLC (eff 3,'220121 I awerple Udd4to m 003. LLC (off 3/ MIZ ToweiOne Nmfh Cvuerdry LLC (cif W 2JZ 12) TowerOne Partners. LLC (eff 322012) TowerOrw Upper Potsgiwe MZ LLC (eft 3=12) TowerCm Vifanninsa r 001. LLC (cif 302012) T owerOne Wamn2t n 002. LLC (eff 3=12) Towers =noo II LLC Towers Fnoo III LLC Towers Finco LLC TVHT. LLC WA- CLEC LLC WCP Wireless Lease Subsidiary, LLC (er 1,11,21112) WCP Wveless Sire Funding LLC (e r 1131=2) WCP Wreless Site Hddco LLC (eff 15112012) WCP Wireless See Non -RE Funding LLC(e.R imizu) WCP Winless Site Non -RE Hddm LLC Jeff 1Ai(m12) WCP Wweless Site RE Fundirg LLC (eff 1latnml2) WCP Wireless Sate RE Holdcc LLC (ea u3i=12) Wireless Fundng. LLC (elf 113112012) 'W'imiii s Reality I bldirgs It, LLC (elfettae &W 1) Wireless Reaenue Properties. LLC (eff 113112012) INSURER CANCELLATION TERMS NAMED INSURED CROWN CASTLE INTERNATIONAL CORP. POLICY NO. Various EFFECTIVE DATE SEE PAGE t Person or Organization: Person(s) or organization(s) that you are obligated, pursuant to written contract or agreement between you and such person or organization, to provide with notice of cancellation for any reason other than non-payment of premium, provided that, within 10 days of the date the producer or the first named insured receives a copy of the notice of cancellation, the producer or the first named insured provides us with a spreadsheet containing the name, address and, if available, e-mail address of the person(s) or organization(s) to whom such notice of cancellation is to be sent. All other terms and conditions remain unchanged. Cancellation Terms: When we cancel this policy as described in the Cancellation condition for any reason other than non-payment of premium, we will also send to the person or organization described in the Schedule a notice of at least 30 days in advance of the cancellation date. Any failure on our part to deliver such notice will not: • impose liability of any kind upon us; or • invalidate the cancellation. Cancellation Terms Apply to the Following Coverages: General Liability, Automobile Liability and Workers Compensation Willis 101