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HomeMy WebLinkAboutCITYOFBREMERTON_W20539852 04-01-2022 COISHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY Willis Towers Watson Northeast, Inc. c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 372305191 USA Crown Castle International See Attached Named Insured List 1220 Augusta Dr. Suite 600 Houston, TX 77057 CITY OF BREMERTON 345 6TH STREET STE 100 TAX & LICENSE DIVISION BREMERTON, WA 98337-1891 03/31/2021 COIRequest@crowncastle.com Federal Insurance Company 20281 National Union Fire Insurance Company of P National Fire & Marine Insurance Company 19445 20079 AIU Insurance Company 19399 W20539852 A 1,000,000 1,000,000 10,000 1,000,000 2,000,000 2,000,000 3605-33-35 LIO 04/01/2021 04/01/2022 B 1,000,000 04/01/202204/01/2021CA 7030894 C 5,000,000 25,000 47-UMO-303445-07 04/01/2021 04/01/2022 5,000,000 WC 016393106D 1,000,000No04/01/2021 04/01/2022 1,000,000 1,000,000 BU #846273 - 1301 UNION AVENUE, BREMERTON, WA 98312 204050520920331SR ID:BATCH: Crown Castle International Page 1 of 1 Crown Castle International Corp. Consolidated Subsidiaries as Named Insureds Entity Name 7/23/19 Edition 24/7 Chesapeake Holdings, LLC Crown Castle GT Corp. 24/7 Mid-Atlantic Network of Virginia, LLC Crown Castle GT Holding Sub LLC 24/7 Mid-Atlantic Network, LLC Crown Castle International Corp. Access Fiber Group Holdings LLC Crown Castle International Corp. de Puerto Rico Access Fiber Group, Inc. Crown Castle International LLC AirComm of Avon, L.L.C.Crown Castle Investment Corp. Atlantic Coast Communications LLC Crown Castle Investment II Corp. CA - CLEC LLC Crown Castle MM Holding Corp. CC Castle International LLC Crown Castle MM Holding LLC CC Edge LLC Crown Castle MU LLC CC Edge Solutions LLC Crown Castle MUPA LLC CC Finance LLC Crown Castle NG Atlantic LLC CC FN Holdings LLC Crown Castle NG Central LLC CC Holdings GS V LLC Crown Castle NG East LLC CC Site Acquisitions II LLC Crown Castle NG Networks LLC CC Sunesys Fiber Networks LLC Crown Castle NG West LLC CC TM PA LLC Crown Castle Operating Company CC Towers Guarantor LLC Crown Castle Operating LLC CC Towers Holding LLC Crown Castle Orlando Corp. CC TS LLC Crown Castle PR LLC CCATT Holdings LLC Crown Castle PR Solutions LLC CCATT LLC Crown Castle PT Inc. CCATT PR LLC Crown Castle Puerto Rico Corp. CCGS Holdings Corp.Crown Castle Services LLC CCPE Acquisitions LLC Crown Castle Solutions LLC CCPR VI Tower Newco LLC Crown Castle South LLC CCS & E LLC Crown Castle TDC LLC CCT2 Holdings LLC Crown Castle TLA LLC CCTM Holdings LLC Crown Castle Towers 05 LLC CCTM1 LLC Crown Castle Towers 06-2 LLC CCTM2 LLC Crown Castle Towers 09 LLC CCTMO LLC Crown Castle Towers LLC Chesapeake Fiber, LLC Crown Castle USA Inc. Coastal Antennas LLC Crown Communication LLC ComSite Venture, Inc. Crown Communication New York, Inc. Coverage Plus Antenna Systems LLC Crown Mobile Systems, Inc. Cross Connect Solutions, Inc. (PA)DAS Development Corporation Crown Atlantic Company LLC Fiber Technologies Networks, L.L.C. (NY) Crown Castle AS LLC Fibernet Direct Florida LLC Crown Castle Atlantic LLC Fibernet Direct Holdings LLC Crown Castle Augusta LLC Fibernet Direct TEL LLC Crown Castle BP ATT LLC Fibernet Direct Texas LLC Crown Castle CA Corp.Fibertech Facilities Corp. (NY) Crown Castle Fiber Holdings Corp. (formerly LTS Group Holdings LLC)Fibertech Holdings Corp. Crown Castle Fiber Enterprise LLC (formerly Sunesys Enterprise LLC)Fibertech Networks, LLC Crown Castle Fiber LLC f/k/a Lightower Fiber Networks II, LLC Freedom Telecommunications, LLC Crown Castle GS III Corp.Global Signal Acquisitions II LLC Crown Castle GT Company LLC Global Signal Acquisitions III LLC Crown Castle International Corp. Consolidated Subsidiaries as Named Insureds Entity Name 7/23/19 Edition Global Signal Acquisitions IV LLC P3 OASA-1, LLC Global Signal Acquisitions LLC P3 PBA-1, LLC Global Signal GP LLC PA - CLEC LLC Global Signal Holdings III LLC Pinnacle San Antonio L.L.C. Global Signal Holdings IV LLC Pinnacle St. Louis LLC Global Signal Operating Partnership, L.P.Pinnacle Towers Acquisition Holdings LLC Global Signal Services LLC Pinnacle Towers Acquisition LLC GoldenState Towers, LLC Pinnacle Towers Asset Holding LLC GS Savings Inc.Pinnacle Towers Canada, Inc. GSPN Intangibles LLC Pinnacle Towers III LLC High Point Management Co. LLC Pinnacle Towers Limited ICB Towers, LLC Pinnacle Towers LLC InfraSource FI, LLC Pinnacle Towers V Inc. InSITE Fiber of Virginia LLC PR Site Development Corporation InSITE Solutions LLC PR TDC Corporation Interstate Tower Communications LLC Princeton Ancillary Services II LLC Intracoastal City Towers LLC Princeton Ancillary Services III LLC IX2 Center, LLC Radio Station WGLD LLC IX2 Wilshire, LLC RGP Tower Group, LLC JBCM Towers LLC Shaffer & Associates, Inc. Light Tower Clearinghouse LLC Sidera Networks UK Limited (UK) Light Tower Fiber New York, Inc. (NY)Sidera Networks, Inc. Light Tower Holdings LLC Sierra Towers, Inc. Light Tower Management, Inc.Sunesys Enterprise LLC n/k/a Crown Castle Fiber Enterprise LLC Light Tower Metro Fiber LLC Sunesys of Massachusetts, LLC Lightower Fiber Infrastructure Corp.Sunesys of Virginia, Inc. Lightower Fiber Networks I, LLC Sunesys, LLC Lightower Fiber Networks II, LLC n/k/a Crown Castle Fiber LLC Thunder Towers LLC LL Q1-18, LLC Tower Development Corporation LTS Buyer LLC Tower Systems LLC LTS Group Holdings LLC n/k/a Crown Castle Fiber Holdings Corp Tower Technology Company of Jacksonville LLC LTS Intermediate Holdings A LLC Tower Ventures III, LLC LTS Intermediate Holdings B LLC TowerOne 2012, LLC LTS Intermediate Holdings C LLC TowerOne Allentown 001, LLC Md7 Capitol One, LLC TowerOne Bethlehem 001, LLC Mobile Media California LLC TowerOne Doylestown, LLC Mobile Media National LLC TowerOne East Rockhill 001, LLC Modeo LLC TowerOne Marple, LLC MW Cell REIT 1 LLC TowerOne Middletown 001, LLC MW Cell TRS 1 LLC TowerOne Middletown 002, LLC NEON Transcom, Inc.TowerOne Middletown 003, LLC NewPath Networks Holding LLC TowerOne North Coventry, LLC NewPath Networks LLC TowerOne Partners, LLC NY - CLEC LLC TowerOne Richland, LLC OP 2 LLC TowerOne Upper Pottsgrove 002, LLC OP LLC TowerOne Upper Pottsgrove, LLC P3 CHB-1, LLC TowerOne Warminster 001, LLC P3 Holdings 2014 LLC TowerOne Warrington 002, LLC Crown Castle International Corp. Consolidated Subsidiaries as Named Insureds Entity Name 7/23/19 Edition Towers Finco II LLC Towers Finco III LLC Towers Finco LLC TriStar Investors LLC TVHT, LLC WA - CLEC LLC WCP Wireless Lease Subsidiary, LLC WCP Wireless Site Funding LLC WCP Wireless Site Holdco LLC WCP Wireless Site Non-RE Funding LLC WCP Wireless Site Non-RE Holdco LLC WCP Wireless Site RE Funding LLC WCP Wireless Site RE Holdco LLC Wilcon Holdings LLC Wilcon Operations LLC Wilshire Connection, LLC Wilshire Services, LLC Wireless Funding, LLC Wireless Realty Holdings II, LLC Wireless Revenue Properties, LLC Yankee Metro Parent, Inc.