HomeMy WebLinkAboutCRICKET COMMUNICATIONS INC - INSURANCE CERTIFICATE (4)ACCORLY CERTIFICAT OF LIABILITY INSURANCE °W2W �°mT�)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOR ATION 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 polrey(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 endorsement(s).
PRODUCER
Marsh USA Inc.
701 Market Street Suite 1100
SL Louis, MO 63101
Attn: ATT.CeMleWest@marsh.com
CONTACT
NAME:
PHONE FAX
A/C No
EMAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAICY
INSURER A:Old R ublicInsuranm an
24147
CN103150778-GAW-ACO.20-21 N Y CMW N
INSURED _
Cricket Communications, Inc.
INSURERB.:
One AT&T Plaza
INSURER C :
INSURER D :.
208 South Allard
Room 1820
Dallas TX 75202
INsuRER E:
INSURER F:
VV�.LMV VV THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SH
- -
BELOW HAVE -BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
CONDITION OF ANY CONTRACT OR OTHER. -DOCUMENT WITH RESPECT TO WHICH THIS
AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
WN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR LTR
-.
TYPE OF INSURANCE
AmuL
S B
POUCY
NUMBER
�Uu
MMIDDY EFF
MM DD/YYYY
LIMITS
A
X
COMMERCULL GENERAL LIABILITY
MWZY 31363620
06101/2020
06101I2021
$ 3,000,000
CLAIMSAMDE Fq OCCUR
DAMAGE TORENTEff-
PREMISES Ea oamuffericel
$ 1,000,000
MED EXP Any oneperson)
$ NIA
PERSONAL & ADV.INJURY
$ 3,000,000
GEML AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 10,000,000
PRODUCTS -COMP/OP.AGG
$ 3,000,000
X POLICY JET LOC
A
OTHER:
AuTOMosILEUABRITY
--
-
MWfB 313636
20
1
06/0112020
06/0112021
-
COMBINED SINGLE LIMIT
(Ea accident)
-
$ 3,000,000
BODILY INJURY (Per Parson)
$
A
X ANY AUTO
MW2X 31363720
(Ml)
06101/2020
06/01/2021
BODILY INJURY (Per accident)
$
OWNED SCHEDULED
AUTOS ONLY AUTOS -
HIRED NON -OWNED
AUTOS ONLY HAUTOS ONLY
PROPERTY DAMAGE
Per acciderx
$
UMBRELLAWIB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIMB
CLAIMS -MADE
DED I I RETENTION$
WORKERSCOMPENSATION
X STATUTE ERH.
$
A
---
MWC 31
O(A S)
ANO EMPLOYERS' uAsiuTY
ANYPROPRIETORIPARTNERIEXECUiIVE YIN
OFFICER/MEMBEREXCLUDED? - a
(Mandatory in NH)
0 yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
E.L. EACH ACCIDENT
$ 3,000,000
E.L. DISEASE - EA EMPLOYEE$
3,000.000
E.L. DISEASE - POLICY LIMIT
_ 3,000,000
A
Excess Workers' Campensatim I
MWXS 31363920
(OH,WA)
06/012020
06/01/2021
EL Each Accident I EL Disease
1,000,000
Employers' Lability
See Second
I
Page
EL Disease -Policy Limit
1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addlitlorull
Remarks Schedule, may be attached N more space is required)
RE: FNL-UD, City Park Site Address:137 N. Bryan, Fort Collins, CO.
City of Fort Collins
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
PO Box 580
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Fort Collins, CO 80522-0580
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTNORIZE&MPRESENTATIVE
-
of Marsh USA Ind.
DReL%^V'&,•: �4Atitewar �r
W IwOO-AV IV ^VWmw VVr.r v.v�..v... �g .,y..w..app.........
ACORD 25 (2016103) The ACORD name and Iogo are registered marks of ACORD
AGENCY CUSTOMER a CN103150778
LOG#: St. Louis
REMARKS SCHEDULE Page 2 of 2
AGENCY NAMED INSURED
Marsh USA Inc. Cricket Communications, Inc.
One AT&T Plaza
POLICY NUMBER - 208 South Akard
Room 1820
Dallas, TX 15202
CARR_ IER NAIC CODE
EFFECTIVE DATE:
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FnRM NUMBER: 25 FORM TITLE: Certificated Liability Insuf
Excess Workers' Compensation -MWXS 31363920 (OH -WA)
Self Insured Retentions
OH & WA - $500,000.000 (except Terrorism)
OH & WA - $600.000,000 Terrorism
Excess Automobile Liability - MWZX 31363720 (MI)
Combined Single Limit -S1.000,000
Self Insured Retention - $1,060,000
ACORD 101 (2008/01) _ C 2.008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD