VC•K.
ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDYYYY 5/1/2026 5/1/2025
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 INSURERS), 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.
I 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 endorsements).
CONTACT
PRODUCER Lockton Companies, LLC NAME:
Three City Place Dr., Ste. 900 PHONE
(A/C, No, Ext):
St. Louis MO 63141-7081
ADDRESS:
(314) 432-0500
[email protected] INSURERS) AFFORDING COVERAGE NAIC # INSURERA: Continental Casualty Company 20443
INSURED INSURER B: The Continental Insurance Company 35289 T-Mobile US, Inc.
1359691 Its Subsidiaries and Affiliates 20494
INSURER C: Transportation Insurance Company
12920 SE 38th Street
INSURER D:
Bellevue WA 98006
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 19071269
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
EXCLUSION POLISH HAVE BEEN HERE SUBJECT TO ALL THE TERMS,
INSR ADDL SUBR
TR TYPE OF INSURANCE INSD WVD. POLICY NUMBER LIMITS
COMMERCIAL GENERAL LIABILITY Y 7012343900 5/1/2025 5/1/2026 EACH OCCURRENCE $ 10,000,000
DAMAGE TO RENTED
CLAIMS-MADE [X OCCUR PREMISES (Ea occurrence) $ 10,000,000 MED EXP (Any one person) $ 25,000
PERSONAL & ADV INJURY $ 10,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 20,000,000
PRO- PRODUCTS - COMPIOP AGG
POLICY JECT X LOC $ 20,000,000
OTHER:
AUTOMOBILE LIABILITY 5/1/2025 5/1/2026 $ 5,000.000
A Y Y 7012343878
ANY AUTO BODILY INJURY (Per person) $ XXXXXXX
OWNED 1 SCHEDULED BODILY INJURY (Per accident) XXXXXXX
AUTOS ONLY AUTOS
HIRED NON-OWNED
AUTOS ONLY AUTOS ONLY $ XXXXXXX
$ XXXXXXX
UMBRELLA LIAB OCCUR N Y 7014886953 5/1/2025 5/1/2026 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE R applies per pol AGGREGATE $ 5,000,000 B rms & conditio
DED X RETENTIONS 10,000 $ XXXXXXX
WORKERS COMPENSATION N X STATUTE T
AND EMPLOYERS LIABILITY 7012343895 (AOS) 5/1/2026
YIN 7012343881 (CA) 31/2035 5/1/2026
MU NY PROPRIETOR/PARTNER/EXECUTI EL. EACH ACCIDENT $ 2,000,000 FFICER/MEMBER EXCLUDEL N N/ A 7012447142 (AZ,MA,OR,WI) 5/1/2026 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 2,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE • POLICY LIMIT $ 2,000,000 MICHAEL J. VIGLIOTTA
CITY ATTORNEY
CITY OF HUNTINGTON BEACH
CERTIFICATE HOLDER CANCELLATION See Attachments
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 19071269 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
ity of Huntington Beac
Attn: Real Estate Services Manage
AUTHORIZED REPRESENTATIV
2000 Main Street
Huntington Beach CA 92648 Bun
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Attachment Code: D648954 Certificate ID: 19071269
CNA CNA PARAMOUNT
Additional Insured - State or Governmental Agency
or Subdivision or Political Subdivision -
Permits or Authorizations Endorsement
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
State Or Governmental Agency Or Subdivision Or Political Subdivision:
City of Huntington Beach, its officers, elected or appointed officials, employees, agents and volunteers
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
It is understood and agreed as follows:
A. The WHO IS AN INSURED is amended to add as an Insured any state or governmental agency or subdivision or political subdivision shown in the Schedule that has issued a permit or authorization for operations performed by or on behalf of the Named Insured, but only with respect to bodily injury, property damage or personal and advertising injury arising out of the permitted or authorized operations.
However, if coverage for the additional insured is required by written contract or written agreement, subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with:
1. coverage broader than required by such contract or agreement; or
2. a higher limit of insurance than required by such contract or agreement.
B. This insurance provided to the additional insured does not apply to:
1. bodily injury, property damage or personal and advertising injury arising out of operations performed for the federal government, state or municipality; or
2. bodily injury or property damage included within the products-completed operations hazard.
Any coverage granted by this endorsement shall apply solely to the extent permissible by law.
All other terms and conditions of the Policy remain unchanged This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy.
CNA74739XX (1-15) Policy No: 7012343900
CONTINENTAL CASUALTY COMPANY Effective Date: 5/1/2025
Insured Name: T-MOBILE US, INC.
CopyrightCNAAllRightsReserved. IncludescopyrightedmaterialofinsuranceServicesOffice,Inc., withitspermission.
Attachment Code: D651006 Certificate ID: 19071269
CNA PARAMOUNT
CNA
Additional Insured - Owners, Lessees Or Contractors -
Completed Operations
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s)
CITY OF HUNTINGTON BEACH, ITS OFFICERS ELECTED OR APPOINTED OFFICIALS
EMPLOYEES AGENTS AND VOLUNTEERS
CG 20 37 12 19 No: No: 7012343900
CONTINENTAL CASUALTY COMPANY
Attachment Code: D651006 Certificate ID: 19071269
CNA PARAMOUNT
CNA
Additional Insured - Owners, Lessees Or Contractors —
Completed Operations
Location And Description Of Completed
Operations
Information required to complete this Schedule, if not shown above, will be shown in the Declarations. that additional insured and included in the products-completed operations hazard.
However:
1. The insurance afforded to such additional insured only applies to the extent permitted by law; and
2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.
B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance:
1. Required by the contract or agreement; or
2. Available under the applicable limits of insurance;
whichever is less.
This endorsement shall not increase the applicable limits of insurance.
CG 20 3712 19 Policy No: 7012343900
CONTINENTAL CASUALTY COMPANY Effective Date: 5/1/2025
Insured Name: T-MOBILE US, INC.
Copyright Insurance Services Office, Inc., 2018
Attachment Code: D559285 Certificate ID: 19094841
CNA
Primary and Noncontributory - Other Insurance
Condition Endorsement
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
It is understood and agreed that the condition entitled Other Insurance is amended to add the following:
Primary And Noncontributory Insurance
Notwithstanding anything to the contrary, this insurance is primary to and will not seek contribution from any other insurance available to an additional insured under this policy provided that:
a. the additional insured is a named insured under such other insurance; and b. the Named Insured has agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured.
All other terms and conditions of the Policy remain unchanged This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown 74987XX 1-15) Policy No: 7012343900
Endorsement No: 24
CONTINENTAL CASUALTY COMPANY
Insured Name: T-MOBILE US, INC.
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Attachment Code: D559278 Master ID: 1359691, Certificate ID: 19071269 CNA
POLICY HOLDER NOTICE - COUNTRYWIDE
It is understood and agreed that:
If the Named Insured has agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if the Insurer cancels a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificate holders at least 30 days in advance of the date cancellation is effective.
If notice is mailed, then proof of mailing to the last known mailing address of the Certificate holder on file with the Agent of Record will be sufficient to prove notice.
Any failure by the Insurer to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon the Insurer or the Agent of Record.
All other terms and conditions of the policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy.
Form No: CNA75014XX (01-2015) Policy No: 7012343900
Endorsement Effective Date: 5/1/2025 Policy Effective Date: 5/1/2025 Endorsement No: Page: 1 of 1
Underwriting Company: Continental Casualty Company
© Copyright CNA All Rights Reserved.
Attachment Code: D559289 Master ID: 1359691, Certificate ID: 19071269 CNA
NOTICE OF CANCELLATION TO CERTIFICATEHOLDERS
It is understood and agreed that:
If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificateholders at least 30 days in advance of the date cancellation is effective.
If notice is mailed, then proof of mailing to the last known mailing address of the Certificateholder on file with the Agent of Record will be sufficient to prove notice.
Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon us or the Agent of Record.
All other terms and conditions of the policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy. -orm No: CNA68021XX (02-2013) Policy No: 701234387:
endorsement Effective Date: 5/1/2025 Policy Effective Date: 5/1/202:
Endorsement No: Policy Page:
Underwriting Company: Continental Casualty Company
© Copyright CNA All Rights Reserved.
AMAR A Contine 10. 101269
DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement.
This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Named Insured: T-MOBILE US, INC.
Endorsement Effective Date: 5/1/2025
SCHEDULE
Name Of Person(s) Or Organization(s):
Where required by written contract executed prior to loss.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Each person or organization shown in the Schedule is an " insured" for Covered Autos Liability Coverage, only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II - Covered Autos Liability Coverage in the Business Auto and Motor
Form No: CA 20 48 10 13 olicy No: 701234387
Endorsement Effective Date: 5/1/202 olicy Effective Date: 5/1/202 Inderwriting Company: Continental Casual Policy Page:
© Copyright Insurance Services Office, Inc., 2011
Attachment Code: D559325 Certificate ID: 19071269
CNA
Additional Insured - State or Governmental Agency
or Subdivision or Political Subdivision -
Permits or Authorizations Endorsement
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
State Or Governmental Agency Or Subdivision Or Political Subdivision:
Any State or Political Subdivision you have agreed to include as an additional insured under written contract, permit application, statute or agreement, provided such contract or agreement was executed prior to date of loss * Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
It is understood and agreed as follows:
A. The WHO IS AN INSURED is amended to add as an Insured any state or governmental agency or subdivision or political subdivision shown in the Schedule that has issued a permit or authorization for operations performed by or on
behalf of the Named Insured, but only with respect to bodily injury, property damage or personal and advertising injury arising out of the permitted or authorized operations.
However, if coverage for the additional insured is required by written contract or written agreement, subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with:
1. coverage broader than required by such contract or agreement; or
2. a higher limit of insurance than required by such contract or agreement.
B. This insurance provided to the additional insured does not apply to:
1. bodily injury, property damage or personal and advertising injury arising out of operations performed for the federal government, state or municipality; or
2. bodily injury or property damage included within the products-completed operations hazard.
Any coverage granted by this endorsement shall apply solely to the extent permissible by law.
All other terms and conditions of the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below,
CNA74739XX (1-15) Policy No:
7012343900
CONTINENTAL CASUATLY COMPANUIY
Insured Name: T-MOBILE US, INC.
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.