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HomeMy WebLinkAboutUS-WI-5107_COI_022822 Vertical BridgesINSR ADDLSUBRLTRINSRWVD DATE (MM/DD/YYYY) PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE INSURER(S) AFFORDING COVERAGE NAIC # Y / N N / A (Mandatory in NH) ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? EACH OCCURRENCE $ DAMAGE TO RENTED $PREMISES (Ea occurrence)CLAIMS-MADE OCCUR MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $ PRO- OTHER: LOCJECT COMBINED SINGLE LIMIT $(Ea accident) BODILY INJURY (Per person)$ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS AUTOS ONLYHIRED PROPERTY DAMAGE $AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $$ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below POLICY NON-OWNED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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 any rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) ACORDTM CERTIFICATE OF LIABILITY INSURANCE Hanover Insurance Company Lloyds 2/28/2022 McGriff Insurance Services 5850 Waterloo Road, Suite 240 Columbia, MD 21045 410 480-4400 Jennifer Burton 410 480-4400 866-548-4197 Jennifer.burton@McGriff.com Vertical Bridge REIT LLC 750 Park of Commerce Drive Suite 200 Boca Raton, FL 33487 22292 A X X X LHQA33010207 06/03/2021 06/03/2022 1,000,000 1,000,000 10,000 1,000,000 2,000,000 2,000,000 A X X X AHQD961361 06/03/2021 06/03/2022 1,000,000 A X X X 0 UHQA33283607 06/03/2021 06/03/2022 10,000,000 10,000,000 A N WHQA931504 06/03/2021 06/03/2022 X 1,000,000 1,000,000 1,000,000 B Professional Liab LL0007402 06/03/2021 06/03/2022 $2M Per Wrongful Act $2M Aggregate RE: US-WA-5107 If required by written contract, City of Bremerton, and its elected and appointed officers, officials, agents, employees, representatives, engineers, consultants, and volunteers are named as Additional Insureds with respects to General Liability, subject to policy provisions. Insurance is primary and noncontributory as respects to the City of Bremerton, and its elected and appointed officers, officials, (See Attached Descriptions) City of Bremerton 345 6th street, STE 100 Bremerton, WA 98337 1 of 3 #S29542399/M28751835 140VERTIBRI1Client#: 1700812 CDR 1 of 3 #S29542399/M28751835 SAGITTA 25.3 (2016/03) DESCRIPTIONS (Continued from Page 1) agents, employees, representatives, engineers, consultants, and volunteers. A Waiver of Subrogation applies to General Liability in favor of City of Bremerton as required per written contract. A severability of interest clause applies with regards to the General Liability policy. A 30 day notice of cancellation applies in favor of City of Bremerton. ** ADDITIONAL NAMED INSUREDS ** AWN Tower Company B.A.C.K. TOWERS, LLC BAY COMMUNICATIONS III, LLC BRT GROUP, LLC CIG COMP TOWER, LLC CIG SERVICES, LLC CIG WIRELESS CORP. DATA PATH VERTICAL BRIDGE, LLC GOTHAM VERTICAL BRIDGE, LLC INDEPENDENT TOWER & WIRELESS CORP. INLAND-VB, LLC MIDWEST NT 1 LLC MIDWEST NT 2 LLC NTCH-VB, LLC RANGE TOWERS, INC ROWSTAR, LLC TELCOM BRIDGE, LLC TOWER ECONOMICS COMPANY, LLC VB LPE Parent, LLC VB LPE, LLC VB MIDWEST I, LLC VB MIDWEST II, LLC VB MIDWEST III, LLC VBA II, LLC (DE) VBA II, LLC (FL) VBDTP, LLC VB-JV4, LLC VB-JV5, LLC VB-JV6, LLC VB-S1 Assets, LLC VB-S1 Issuer, LLC VB-S1 Parent, LLC VB-TC, LLC VERTICAL BRIDGE ACQUISITIONS III, LLC Vertical Bridge Acquisitions II (FL) VERTICAL BRIDGE ACQUISITIONS, LLC VERTICAL BRIDGE AM II, LLC VERTICAL BRIDGE AM, LLC VERTICAL BRIDGE ABM, LLC VERTICAL BRIDGE BAY, LLC VERTICAL BRIDGE BROKERAGE LLLP (FL) VERTICAL BRIDGE CC AM, LLC VERTICAL BRIDGE CC FM, LLC VERTICAL BRIDGE CC PARENT, LLC VERTICAL BRIDGE CC, LLC Vertical Bridge CCR, LLC VERTICAL BRIDGE CJV, LLC VERTICAL BRIDGE DC, LLC VERTICAL BRIDGE DEVELOPMENT II, LLC VERTICAL BRIDGE DEVELOPMENT, LLC Vertical Bridge Employees, LLC VERTICAL BRIDGE ENGINEERING LLC 2 of 3 #S29542399/M28751835 SAGITTA 25.3 (2016/03) DESCRIPTIONS (Continued from Page 1) VERTICAL BRIDGE GRAND CANYON, LLC Vertical Bridge Holdco Parent, LLC VERTICAL BRIDGE HOLDCO, LLC VERTICAL BRIDGE HOLDINGS,LLC VERTICAL BRIDGE LANDCO, LLC VERTICAL BRIDGE MANAGEMENT,LLC VERTICAL BRIDGE MIDWEST, LLC VERTICAL BRIDGE NT, LLC VERTICAL BRIDGE NTCF LLC VERTICAL BRIDGE PR, LLC VERTICAL BRIDGE REAL ESTATE II, LLC VERTICAL BRIDGE REAL ESTATE, LLC VERTICAL BRIDGE REIT, LLC VERTICAL BRIDGE S3 ASSETS, LLC VERTICAL BRIDGE STRUCTURES, LLC VERTICAL BRIDGE TOWERS II, LLC VERTICAL BRIDGE TOWERS III, LLC VERTICAL BRIDGE TOWERS, LLC VERTICAL BRIDGE-CONTERRA TOWERS, LLC VERTICAL SKY I, LLC VERTICAL SKY II, LLC VERTICAL SKY III, LLC VBHV, LLC VB Acquisitions 2018, LLC VB US REIT, LLC VOGUE XIII, LLC VBT SUB 1, LLC Datapath Vertical Bridge II, LLC Berkley Assets, LLC VB Berkley, LLC VB Nimbus, LLC Vertical Bridge 500, LLC Toro Vertical Parent, LLC Toro Vertical, LLC VB BTS, LLC VB E1 Parent, LLC VB E1, LLC VB E2, LLC VB E3, LLC VB E3, LLC Eco-Site, LLC VB Bridger JV Member LLC Bridger Cell Assest, LLC VB Edge, LLC Precision Cell Assets, LLC VB Precision JV Member, LLC Mercury Cell Assets, LLC VB Mercury JV Member, LLC VB RUN, LLC VBT SUB 2, LLC 3 of 3 #S29542399/M28751835 This page has been left blank intentionally.