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HomeMy WebLinkAboutCrown Castle - 4807 Ins. 04012021CERTIFICATE OF LIABILITY INSURANCE I Page 1 of 2 DATE (MMIDDIYVVV) 04/01/2020 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 ~2ij1~CT Willia Towers Watson Certificate Center Willia Towers Watson Northeast, Inc. fka Willis of Pennsylvania, flJRNJ~ r:vn, 1-877-945-7378 I rti~ No\: 1-888-467-2378 Inc. ifl~~SS: oertifioatea@willia.com c/o 26 Century Blvd P.O. Bo>< 305191 Nashville, TN 372305191 USA ,___ ______ IN_S_U_RE __ R~(S) AFFORDING COVERAGE I NAIQJL...___ INSURER A: Federal Insurance Company j202Bl INSURED Crown Castle International See Attached Named Insured List 1220 Augusta Dr. Suite 600 Houston, TX 77057 INSURER B :_ National Union Fire Insurance Company of P 11 19445 INSURERC: Berkshire Hathaway Specialty Insurance Co.ml 22~~-- INSURER D : New Hampshire Insurance Company 23 841 INSURERE: Travelers Property Casualty Company of Amel 25674 INSURER F: COVERAGES CERTIFICATE NUMBER: Wl6071644 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. lt-fSR TYPE OF INSURANCE f Acici(!s0BRj r;~~hliM'tvi POLICY EXP LIMIT$ LTR '""n wvn POLICY NUMBER IMM/00/VVVVl ITTMERCIAL GENERAL LIABILITY I EACH OCCURRENCE 1$ 1,000,000 CLAIMS-MADE [xJ OCCUR I DAMAGE TO RENTED $ 1,000,000 PREf.:11SE$.{Ea_occurrence) .. A I MED EXP (Any one person) $ 10,000 [j y y 3605-3335 04/01/2020 04/01/2021 1,000,000 PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _$ 2,000,000 lBJ LJ r'RO· LJ LOC -----~ ,~·--~---· -----··-- , POLICY I JECT PRODUCTS· COMP/OP AGG $ 2,000,000 i OTHER: $ AUTOMOBILE LIABILJTV COMBINED SINGLE LIMIT $ 1,000,000 -~ (Ea accidenlL ____ X ANY AUTO BODILY INJURY (Per person) $ B -OWNED ~ SCHEDULED y y CA 6631248 04/01/2020 04/01/2021 BODILY INJURY (Per ac<Jidenl) $ -AUTOS ONLY ,_ AUTOS I PROPERTY DAMAGE HIRED NON-OWNED $ -AUTOS ONLY -AUTOS ONLY (Peraccidenl) I I $ ~ ""'"''" "'" tJ oco,e I EACH OCCURRENCE $ s,000,000 C I ·- EXCESS LIAB CLAIMS-MADE y y 47-UM0-303445-05 04/01/2020 04/01/2021 AGGREGATE $ 5,000,000 , DED !xl RETENTION$ 25,000 I $ WORKERS COMPENSATION XI ~¥fruTE I I 0TH AND EMPLOYER$' LIABILITY ER VIN D ANYPROPRIETOR/PARTNERIEXECUTIVE El y E.L. EACH ACCIDENT $ 1,000,000 OFFICEFvMEMBEREXCLUDED? NIA WC 023096097 04/01/2020 04/01/2021 (Mandatory In NH) E.l. DISEASE · EA EMPLOYEE $ 1,000,000 II yes, describe under ,___ DESCRIPTION OF OPERATIONS below E.L. DISEASE· POLICY LIMIT $ 1,000,000 E All Risk Personal Property I I QT-630-5D736475-TIL-20 04/01/2020 04/01/2021 Limit: $1,000,000 100% Replacement Cost I DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORO 101, Addlllonal Remarks Schedule, may be attached II more space Is required) BU# 880446 -SEATTLE QWEST -BRE005, 3000 BLOCK, HWY 16 SW, Port Orchard, WA 98367 *Property: Business/Personal Property City of Bremerton, and its elected and appointed officers, officials, agents, employees, representatives, engineers, consultants, and volunteers areincluded as an Additional Insured under the General Liability, Auto Liability and CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE CITY OF BREMERTON 345 6TH STREET SUITE 100 ~J,, J~~~ BREMERTON, WA 98337-1891 © 1988·2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 19463626 BATCH: 1635634 17 of 25 2206 AGENCY CUSTOMER ID:------------------ LOC #: ---------- ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Willia Towers Wat.son Northenst, Ina. £kn. Willia of Pennsylvania, Inc. Crown Castle International t-------------------------------------1 See Attached Na.med Insured List POLICY NUMBER See Page l CARRIER See Pagel ADDITIONAL REMARKS 1220 Augusta Or. Suite 600 Houston, TX 77057 NAICCODE Se,e Page 1 EFFECTIVE DATE: See Page l THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of •' -'-' 1 ',ty Insurance Page 2 of 2 Umbrella Liability policies as their interest may appear and 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 Liability, Automobile Liability, Umbrella Liability and Workers Compensation policies include a Waiver of Subrogation in favor of the certificate holder when agreed in written contract prior to the loss, but always subject to the policy terms, conditions and exclusions as permitted by law. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR ID: 19463626 BATCH: 1635634 CERT: Wl6071644 Crown Cas tl e In te rn at iona l Co rp. Co nso li dated S ubs idi a ri es as Na med In s ureds Entity Name 7/23/19 Edition 24/7 Chesapeake Holdings , LLC 24/7 Mid -Atlantic Network of Virginia , LLC 24/7 Mid-Atlantic Network , LLC Access Fiber Group Holdings LLC Access Fiber Group , Inc . AirComm of Avon , L.L.C. Atlantic Coast Communications LLC CA -CLEC LLC CC Castle International LLC CC Edge LLC CC Edge Solutions LLC CC Finance LLC CC FN Holdings LLC CC Holdings GS V LLC CC Site Acquisitions II LLC CC Sunesys Fiber Networks LLC CC TM PA LLC CC Towers Guarantor LLC CC Towers Holding LLC CC TS LLC CCA TT Holdings LLC CCATT LCC CCATT PR LLC CCGS Holdings Corp . CCPE Acquisitions LLC CCPR VI Tower Newco LLC CCS & E LLC CCT2 Holdings LLC CCTM Holdings LLC CCTM1 LLC CCTM2 LLC CCTMO LLC Chesapeake Fiber, LLC Coastal Antennas LLC ComSite Ventur e, Inc . Coverage Plus Antenna Systems LLC Cross Connect Solutions, Inc. (PA) Crown Atlantic Company LLC Crown Castle AS LLC Crown Castle Atlantic LLC Crown Castle Augusta LLC Crown Castle BP ATT LLC Crown Castle CA Corp. Crown Castle Fiber Holdings Corp . (formerly LTS Group Holdings LLC) Crown Castle Fiber Enterprise LLC (formerly Sunesys Enterprise LLC) Crown Castle Fiber LLC f/k/a Lightower Fiber Networks II , LLC Crown Castle GS Ill Corp . Crown Castle GT Company LLC Crown Castle GT Corp. Crown Castle GT Holding Sub LLC Crown Castl e International Corp. Crown Castle International Corp. de Puerto Rico Crown Castle International LLC Crown Castle Investment Corp . Crown Castle Investment II Corp . Crown Castle MM Holding Corp. Crown Castle MM Holding LLC Crown Castle MU LLC Crown Castle MUPA LLC Crown Castle NG Atlantic LLC Crown Castle NG Central LLC Crown Castle NG East LLC Crown Castle NG Networks LLC Crown Castle NG West LLC Crown Castle Operating Company Crown Castle Operating LLC Crown Castle Orlando Corp . Crown Castle PR LLC Crown Castle PR Solutions LLC Crown Castle PT Inc . Crown Castle Puerto Rico Corp. Crown Castle Services LLC Crown Castle Solutions LLC Crown Castle South LLC Crown Castle TDC LLC Crown Castle TLA LLC Crown Castle Towers 05 LLC Crown Castle Towers 06 -2 LLC Crown Castle Towers 09 LLC Crown Castle Towers LLC Crown Castle USA Inc . Crown Communication LLC Crown Communication New York , Inc. Crown Mobile Systems , Inc . DAS Development Corporation Fiber Technologies Networks , L.L .C. (NY) Fibernet Direct Florida LLC Fibernet Direct Holdings LLC Fibernet Direct TEL LLC Fibernet Direct Texas LLC Fibertech Faciliti es Corp. (NY) Fibertech Holdings Corp . Fibertech Networks , LLC Freedom Telecommunications , LLC Global Signal Acquisitions II LLC Global Signal Acquisitions Ill LLC 18 of 25 22 06 Cro wn Castle Int e rn at ion al Co rp. Conso lid ated Sub sidi aries as Named Ins ured s Entity Name 7/23/19 Edition Global Signal Acquisitions IV LLC Global Signal Acquisitions LLC Global Signal GP LLC Global Signal Holdings Ill LLC Global Signal Holdings IV LLC Global Signal Operating Partnership , L.P . Global Signal Serv ices LLC Go ldenState Towers , LLC GS Savings In c. GSP N Int angibles LLC High Point Man ageme nt Co . LLC IC B Towers , LLC lnfraSource Fl , LLC lnSIT E Fib er of Virgini a LLC lnSIT E Solutions LLC Int erstate Tower Communications LLC lntr acoasta l City Towers LLC IX2 Center, LL C IX2 Wil shir e, LLC JBCM Tower s LLC Li ght Tower Cl earinghouse LLC Light Tower Fiber New York , Inc. (NY) Light Tower Holding s LLC LightTower Management, Inc . Light Tower Metro Fiber LLC Lightower Fiber Infrastructure Corp . Lightower Fiber Networks I, LLC Lightower Fiber Netw ork s II , LLC n/k/a Crown Castle Fiber LLC LL 01-18, LLC LTS Buyer LLC L TS Group Holdings LLC n/k/a Crown Castle Fib er Holding s Corp LTS Intermed iate Holdings A LLC LTS Interm ed iate Holdings B LLC L TS Intermed iate Holdings C LLC Md7 Capitol One, LLC Mobile Media Ca liforni a LLC Mobil e Med ia National LLC Mod eo LLC MW Cell REIT 1 LLC MW Cell TRS 1 LLC NEON Transcom, Inc. NewPath Networks Holding LLC NewPat h Networks LLC NY -C LEC LLC OP 2 LLC OP LLC P3 CHB -1, LLC P3 Holdings 2014 LLC P3 OASA -1, LLC P3 PBA-1, LLC PA -CLEC LLC Pinnacle San Antonio L.L.C. Pinnacle St. Louis LLC Pinnacle Towers Acquisition Holdings LLC Pinnacle Towers Acquisrtion LLC Pinnacle Towers Asset Holding LLC Pinnacle Towers Canada, In c. Pinnacle Towers Ill LLC Pinnacle Towers Limited Pinnacle Towers LLC Pinnacle Towers V Inc . PR Site Development Corporation PR TDC Corporation Princeton Ancillary Serv ice s II LLC Princeton Ancillary Serv ices Ill LLC Rad io Stat ion WGLD LLC RGP Tower Group , LLC Shaffer & Associates, Inc . Sidera Networks UK Limited (UK) Sidera Networks , Inc . Sierra Towers, In c. Sunesys Enterprise LLC n/k/a Crow n Castle Fib er Enterprise LLC Su ne sys of Massachusetts , LLC Sunes ys of Virginia , Inc . Sunesys , LLC Thunder Towers LLC Tower Development Corporation Tower Systems LLC Tower Technology Compan y of Jacksonville LLC Tower Ventur es Ill , LLC TowerOne 2012 , LLC TowerOne Allentown 001 , LLC TowerOne Bethlehem 001 , LLC TowerOne Doylestown , LLC TowerOne East Rockhill 001, LLC TowerOne Marple, LLC TowerO ne Middletown 001 , LLC TowerOne Middl etown 002 , LLC TowerOne Middl etown 003 , LLC TowerOne North Coventry , LLC TowerOne Partners , LLC TowerO ne Richland , LLC TowerOne Upper Pottsgrove 002 , LLC TowerO ne Upper Pottsgrove , LLC TowerOne Warm in ster 001 , LLC TowerOne Warr ington 002, LLC C rown Castle Internat iona l Co rp. Co nso li dated S ubs idia ri es as Named In su reds Entity Name 7/23/19 Edition Towers Finco II LLC Towers Finco Ill LLC Towers Finco LLC TriStar Investor s LLC TVHT , LLC WA -CLEC LLC WCP Wireless Lease Sub sidi ary, LLC WCP Wireless Site Funding LLC WCP Wir eless Site Hold co LLC WCP Wir eless Site Non -RE Funding LLC WCP Wireless Site Non -RE Holdco LLC WC P Wireless Site RE Funding LLC WCP Wireless Site RE Holdco LLC Wilcon Holding s LLC Wilcon Operations LLC Wilshire Conne ction , LLC Wil shire Servic es , LLC Wireless Funding , LLC Wir ele ss Realty Holding s II , LLC Wirele ss Revenu e Properti es, LLC Yank ee Metro Par ent, Inc . 19 of 25 2206 INSURER CANCELLATION TERMS NAMED INSURED POLICY NO. Crown Castle International Various EFFECTIVE DATE SEE PAGE 1 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 llabillty 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