DATE (MM/DD/YYYY)
ACORD® CERTIFICATE OF LIABILITY INSURANCE
5/1/2024 4/3/2023
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 endorsements).
PRODUCER Lockton Companies
Three City Place Drive, Suite 900
(314) 432-0500
INSURERS) AFFORDING COVERAGE
INSURER A : Continental Casualty Company 20443
INSURED INSURER B: The Continental Insurance Company 35289 T-Mobile US, Inc.
1358772 Its Subsidiaries and Affiliates, INSURER C: Transportation Insurance Company 20494 including Sprint Corporation INSURER D:
12920 SE 38th Street
INSURER E:
Bellevue WA 98006
INSURER F:
CERTIFICATE NUMBER: REVISION NUMBER: XXXXXXX
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 TYPE OF INSURANCE POLICY NUMBER LiMITS
X COMMERCIAL GENERAL LIABILITY Y Y 5/1/2023 EACH OCCURRENCE $ 10,000,000 A 7012343900 5/1/2024
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
RO PRODUCTS - COMP/OP AGG
POLICY LOC $ 20,000.000
FCT
$
OTHER
A AUTOMOBILE LIABILITY Y Y 7012343878 5/1/2023 5/1/2024 SEEN SINGLE LIMIT $ 5,000.000 X ANY AUTO BODILY INJURY (Per person) $ XXXXXXX
WNED SCHEDULED BODILY INJURY (Per accident) $ XXXXXXX
UTOS ONL AUTOS
HIRED NON-OWNED ROPERTY DAMAG $ XXXXXXX
AUTOS ONLY AUTOS ONLY (Per acciden
$ XXXXXXX
UMBRELLA LIAB X OCCUR N N CUE 7014886953 5/1/2023 5/1/2024 EACH OCCURRENCE $ 5,000,000 B EXCESS LIAB CLAIMS-MADE I applies per polic AGGREGATE $ 5.000.000 rms & condition
DED X RETENTIONS 10.000 s XXXXXXX
WORKERS COMPENSATION N 7012343895 (AOS) 5/1/2023 X STATUTE AND EMPLOYERS' LIABILITY 5/1/2024
Y/N 7012343881 (CA) 5/1/2023 5/1/2024
MU ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 2.000.000 OFFICER/MEMBER EXCLUDED? N/ A 7012447142 (AZ,MA,OR,WI) 5/1/2023 5/1/2024 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 2,000.000 STOPERATIONS below EL DISEASE - POLICY LIMIT $ 2,000,000 CERTIFICATE HOLDER CANCELLATION See Attachments
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 19528798 ACCORDANCE WITH THE POLICY PROVISIONS.
Evidence of Insurance
AUTHORIZED REPRESENTATIV
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© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Attachment Code: D590641 Master ID: 1358772, Certificate ID: 19528798
LOCKTON
Evidence of Insurance
IMPORTANT NOTICE
Dear Certificate Holder for T-Mobile and its subsidiaries (including Sprint):
In our continued effort to provide timely certificate delivery, Lockton Companies is transitioning to paperless delivery of Certificates of Insurance going forward.
To ensure future renewals of this certificate, we need your email address. Please contact us via one of the methods below, referencing Certificate ID 19528798
•Email: [email protected]
•Phone: 314-812-3888
If we do not receive your email address via one of the above methods prior to the client's next renewal, we will assume you no longer need the certificate.
If you received this certificate through an internet link where the current certificate is viewable, we have your email and no further action is needed.
The above inbox is for collecting email addresses for renewal electronic certificate delivery ONLY. You will not receive a response from this inbox.
Thank you for your cooperation.
Lockton Companies
Lockton Companies
Three CityPlace Dr. Suite 900 / St. Louis, MO 63141-7088 314-432-0500/ lockton.com
Attachment Code: D559278 Master ID: 1358772, Certificate ID: 19528798 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: 5/1/2023 Policy Effective Date: 5/1/2023 Endorsement No: Page: 1 of 1
Underwriting Company: Continental Casualty Company
© Copyright CNA All Rights Reserved.
Attachment Code: D559289 Master ID: 1358772, Certificate ID: 19528798 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.
Form No: CNA68021XX (02-2013) Policy No: 7012343878
Endorsement Effective Date: 5/1/2023 Policy Effective Date: 5/1/2023 Endorsement No: Policy Page:
Underwriting Company: Continental Casualty Company
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