2019/03/15 SBA Communications Corporation Certificate of Liability Insurance5t5AUUMM-U1 MMUNt
CERTIFICATE OF LIABILITY INSURANCE DATE 03/12/2019Y)
03/12/2019
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 ritlhts to the certificate holder in lieu of such endorsement(s).
PRODUCER
Henderson Brothers Inc
920 Ft. Duquesne Blvd.
Pittsburgh, PA 15222
INSURED
SBA Communications Corporation
8051 Congress Ave.
Boca Raton, FL 33487
City of Menifee 31EVE412� {A/C261-1842 FAx 412 261-4149
city Clerk , No) -�
q [� . info@hendersonbrothers.com
MAR 2OIJ ^^^ INSURERS AFFORDING COVERAGE NAIC
r. ,.,,,r...� o. ,.....F., o_ 1112ec-7n
Received
INSURER F :
9682
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.
A
B
TYPE OF INSURANCE
COMMERCIAL GENERAL LIABILITY
_J CLAIMS -MADE rR
I OCCU
$100,000 SIR
L AGGREGATE LIMIT APPLIES PER;
POLICY X JECT [_] LOC
POLICY NUMBER
EXGL-474M8138
03/15/2019 J 03/15/2020
AUTOMOBILE LIABILITY 1
7 ANY AUTO 4CAP-474M814A 03/15/2019 03/15/2020
OWNED SCHEDULED
AIUgTEOpS ONLY AUTOSSy� p
—.; AUTOS ONLY AUTOS ONLY
A UMBRELLA LIAB A OCCUR
EXCESS LIAB CLAIMS -MADE ZUP-15N37405 03/15/2019 03/15/2020
DED I X I RETENTION $ 10,000
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY r AA�NYPROPRIETOR/PARTNER/EXECUTIVE Y'� UB-4L099102 03/15I2019 03/15/2020
(IUIFandalory in NH) EXCLUDED? N I A
II yes, describe under
A Worker's Comp
D Prof/Poll (100k SIR)
LIMITS
ADV
5/2019 1 03/15/2020 1 Each Acc/Policy Lmt
CPI HA6405 ' 03/15/20191 03/15/2020 1Claim/Agg
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Addflional Remarks Schedule, may bo attached if more space is required)
If required by written contract, certificate holder will be included as additional insured on a primary and noncontributory basis per forms CGD2460805,
CAT4740817, and E000010716. If required by written contract, a waiver of subrogation will be provided for certificate holder per forms CG24041093,
CAT3400215, E000010716 and WC000313(00), where applicable by law. 30 day notice of cancellation provided for certificate holder per forms ILT4050311 and
ILT4050311 when required by written contract.
The insurance provided will not exceed the lesser of:
1. The coverage and/or limits of this policy, or
2. The coverage and/or limits required by said contract or agreement.
City of Menifee
c/o Finance Department
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
ACORD 25 (2016/03)
01988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
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