2019/06/01 AT&T Corp Certificate of Liability InsuranceiC_i ,
_� CERTIFICATE OF LIABILITY INSURANCE JUN 0 ' a5123/2019DnYYY►
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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 AFFORQE@I'f !dTHE 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).
CONTACT US Centralized Services
PRODUCER NAME;
Marsh USA Inc
701 Market Street, Suite 1100 PHONE 866-966 4664 FAX
No
St. Louis, MO 63101 a MAIL AtLC9rtRequast@mnh.com
Attu: ATT.CertRequest@marsh com
INSURERS AFFORDING COVERAGE NAIC #
CN 1 03150778-GAW-CRT-1 9-20 INSURER A: Old Republic Insurance Company 24147
INSURED INSURER B :
AT&T Corp.
One AT&T Plaza INSURER C ,,
208 South Akard Street, INSURER D :
Room 1830.06
Dallas, TX 75202 INSURERS: _
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V 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.
INSR B POLICY EFF POLICY EXP LIMITS
L R TYPE OF INSURANCE INSD I V.IVD POLICY NUMBER /DD/YYYY MM1DDrYYY
A
X
COMMERCIAL GENERAL LIABILITY
MWZY 31363619
06/01/2019
06/01/2020
EACH OCCURRENCE
$ 1,000.000
CLAIMS -MADE M OCCUR
PREMISES Ea occur(encel
$ 1,000,000
MED EXP (Any one person)
$ N/A
$ 1,000,000
PERSONAL & ADV INJURY
$ 10,000,000
GEN'LAGGREGATE LIMIT APPLIES PER: �
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
X POLICY PRO- LOC
JECT
$ 1,000,000
OTHER:
COMBINEDF
$
AUTOMOBILE LIABILITY
q5ae�SINGLELIMIT
BODILY INJURY (Par person)
ANY AUTO
$
OWNED SCHEDULED
BODILY INJURY (Per accident)
$
AUTOS ONLY AUTOS
HIRED NON -OWNED
$
PROPEfiTY DAMA13E
Per accident
AUTOS ONLY AUTOS ONLY
F_
$
UMBRELLALIAB
EACH OCCURRENCE
$ _
HOCCUR
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED RETENTION $
$
WORKERS COMPENSATION
PER TH-
7AT TE ER
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE
E.L EACH ACCIDENT
$
E.L. DISEASE -EA EMPLOYEE
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory in NH)
NIA
$
E L. DISEASE - POLICY LIMIT
If yes, describe under
DESCRIPTION OF OPERATIONS below
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Re: Encroachment Permit application from the City of Menifee to allow AT&T to relocaate cable and conduit on Bradley road in Menifee, CA
City of Menifee is/are included as Additional Insured under the General Liability policy but only with respect to the requirements of the contract between the Certificate Holder and the Insured. This insurance is
primary with respect to the interest of the Additional Insured and any other insurance maintained by Additional Insured is excess and non-contributory with this insurance.
LICKII1-14,AIC rIVLUCK
City of Menifee
29714 Haun Road
Menifee, CA 92586
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
of Marsh USA Inc.
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ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
City of Menifee
rity r.lerk
IL 10 (12/06) OLD REPUBLIC INSURANCE COMPANY JUN 0 6 2019
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. `'''Dived
ADDITIONAL INSURED WHERE REQUIRED
UNDER CONTRACT OR AGREEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
Paragraph 2. of SECTION II - WHO IS AN INSURED is amended to include any person or organization
for whom you have agreed under contract or agreement to provide insurance. However, the insurance
provided shall not exceed the scope of coverage or limits of this policy. Notwithstanding the foregoing
sentence, in no event shall the insurance provided exceed the scope of coverage or limits required by
said contract or agreement.
Where required by contract, we will consider our policy to be primary under any other insurance
maintained by the additional insured for injury or damage covered by this endorsement and that their
policy will be noncontributing with this insurance.
GL 739 006a 0609
MVVZY 313636 19 AT&T Inc. 06/01/2019 - 06/01/2020