Loading...
CERTIFICATE OF LIABILITY INSURANCE (64) . ACORD,,, CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY) 07/31/2008 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Woodruff-Sawyer & Co. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 220 Bush St., 7th Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR San Francisco CA 94104 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (415) 391-2141 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: OneBeacon America Insurance Company 20621 NextG Networks, Inc., NextG Networks of NY, Inc, INSURER B: Travelers Indemnitv Company of Connectic It 25682 dba NextG Networks East INSURER c: 2216 O'Toole Avenue San Jose, CA95131 INSURER 0: I INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I~~: ~~~~ POLICY NUMBER P~H~Y EFFECTIVE POLICY EXPIRATION LIMITS A ~NERAL LIABILITY 7110100050001 08/02/2008 08/02/2009 EACH OCCURRENCE $ ,'. 1,000,000 X COMMERCIAL GENERAL LIABILITY ~~~~~~~9E~~~~~~nce\ $ 1,000,000 I CLAIMS MADE 00 OCCUR MED EXP (Anyone person) $ 10,000 - PERSONAL & ADV INJURY $ 1,000,000 c-- GENERAL AGGREGATE $ 2,000,000 n'L AGGREAE LIMIT APnS PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY ~~RT LOC A ~TOMOBILE LIABILITY 7110100050001 08/02/2008 08/02/2009 COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO (Ea accidenl) '"x ALL OWNED ,AUTOS '"x BODILY INJURY $ SCHEDULED AUTOS (Per person) X HIRED AUTOS ;;:Ct;s/i ""'" BODILY INJURY X . \.c - -,; V '. (Per accident) $ - NON-OWNED AUTOS - ft"'" 0'" 200 PROPERTY DAMAGE $ ',:)J () (Per accident) ~RAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO Or;::' :t\i. RECORDS AND OTHER THAN EA ACC $ LEGI~ A Tilit: l.'nu"-..,,, "..r.". AUTO ONLY: AGG $ ~ESSlUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR 0 CLAIMS MADE AGGREGATE $ $ ~ DEDUCTIBLE $ RETENTION $ - $ B WORKERS COMPENSATION AND HEUB5403L51908 08/01/2008 08/01/2009 I y 11',.f,~m.I#;, I IOJ~- EMPLOYERS' LIABILITY 1,000,000 ANY PROPRIETORlPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1,000,000 ~~~I~~V~NS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 OTHER $ $ $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS The City of Clearwater, FL is named as an additional insured per form VCG 205 02 05 under the named insured liability policies with respect to the operatiom ofNextG Networks of NY, Inc., dba NextG Networks East under the registration with the City as a telecommunications service provider. . CERTIFICATE HOLDER CANCELLATION 10 Day Notice for Non-Payment of Premium SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Clearwater DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL l!L.- DAYS WRITTEN 112 S.Osceola Avenue NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Post Office Box IMPOSE NO OBLIGATION OR L1ABIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Clearwater, FL 33756 REPRESENTATIVES. I LOAN #: AUTHORlZEDREPRESENTATlVE ~ L~ ACORD 25 (2001/08) 10 #: @ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) ~ .....1........... ~ ......."v.n.v' ........ . POLICY NUMBER: 7110100050001 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. @VANTAGE FOR GENERAL LIABILITY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM The following schedule lists the coverage extensions provided by this endorsement. Refer to the indMdual provi- sions to determine the extent of your coverage. SCHEDULE OF COVERAGE EXTENSIONS 1. Additional Insured - Broad Form Vendors 2. Additional Insured - by Contract, Agreement or Permit relating to: o Work performed by you o Premises you own, rent, lease or occupy o Equipment you lease 3. Aggregate Umit Per Location 4. Blanket Waiver of Subrogation 5. Bodily Injury Redefined- Mental Anguish 6. Broadened Named Insured 7. Broadened Property Damage o Borrowed Equipment o Customers' Goods o Use of Elevators 8. Broadened Property Damage Rented Premises 9. Coverage Territory - Worldwide 10. Duties in Event of Occurrence, Claim or Suit 11. Expected or Intended Injury (PO) 12. Incidental Medical Malpractice 13. Med~alPayments 14. Mobile Equipment Redefined 15. Newly Acquired or Formed Organizations 16. Non-Owned Aircraft 17. Non-Owned Watercraft 18. Personal and Advertising Injury 19. Product Recall Expense 20. Supplementary Payments Increased Limits 1. ADDITIONAL INSURED - BROAD FORM VENDORS Section 11- Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) (referred to below as vendor) with whom you agreed in a written contract or agreement to provide insurance, but only with respect to "bodily Injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: a. This provision 1. does not apply to: (1) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (2) Any express warranty unauthorized by you; (3) Any physical or chemical change in the product made intentionally by the vendor; (4) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (5) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (6) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; (7) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (8) "Bodily injury~ or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (a) The exceptions contained in Subparagraphs 4. or 6.; or (b) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally un- dertakes to make in the usual course of business, in connection with the disbibution or sale of the prod- ucts. VCG2060206 Includes copyrIght'ld material of Insurance SelVices Office, Inc. CopyrIght 2004, . . Page 1 of7 (9) Any person or organization if the "products-completed operations hazard" is excluded either by the pro- visions of the Coverage Form or by endorsement. b. This insurance does not apply to any insured person or organization, from whom you have acquired such products. or any ingredient, part or container, entering into, accompanying or containing such products. 2. ADDITIONAL INSURED - CONTRACT, AGREEMENT OR PERMIT a. Section II - Who Is An Insured is amended to include as an additional insured any person(s) or organiza- tion(s) with whom you agreed in a written contract, written agreement or permit to provide insurance such as is afforded under this Coverage Part, but only with respect to liability for "bodily injury", "property dam- age" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of "your work" for the additional insured(s) at the location designated in the contract, agreement or permit; or 2. In the maintenance, operation or use of equipment leased to you by such person(s) or organization(s), or 3. In connection with premises you own, rent, lease or occupy. This insurance applies on a primary or primary and non-contributory basis if that is required in writing by the contract, agreement or permit. b. The insurance provided to the additional insured herein is limited. This insurance does not apply: 1. Unless (a) the written contract, agreement or permit is currently in effect or becomes effective during the term of this policy; and (b) the contract or agreement was executed or permit issued prior to the "bodily injury", "property dam- age", or "personal and advertising injury"; 2. To any person or organization included as an insured under the Additional Insured - Broad Form Ven- dors provision of this endorsement; 3. To any person or organization included as an insured by an endorsement issued by us and made part of this Coverage Part; 4. To any person or organization if the "bodily injury", "property damage", or "personal and advertising in- jury" arises out of the rendering of or failure to render any professional architectural, engineering or surveying services by or for you including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings. opinions, reports, surveys. field orders, change orders or drawings and specifications; or (b) Supervisory, inspection, architectural or engineering activities. 5. To any: (a) Lessor of equipment after the equlpment lease expires; or (b) Owners or other interests from whom land has been leased; or (c) Managers or lessors of premises it: (1) The "occurrence" takes place after you cease to be a tenant in that premises; or (2) The "bodily injury", "property damage", "personal and advertising injury" arises out of structural alterations, new construction or demolition operations performed by or on behalf of the man- ager or lessor. 6. To "bodily injury, or "property damage" occurring after: (a) All work on the project (other than service, maintenance or repairs) to be performed by or on be- half of the additional insured at the site of the covered operations has been completed; or (b) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in per- forming operations for a principal as part of the same project. c. Limits of Insurance applicable to the additional insured are those specified in the contract, agreement or permit or in the Declarations of this policy, whichever is less, and fix the most we will pay regardless of the number of: 1. Insureds; Page2of7 Includes copyrighted ~I '" Insurance ServIces OffICe. Iro:. CoovrIaht 2004. VCG 205 02 05 2. Claims made or "suits" brought; or 3. Persons or organizations making claims or bringing "suits". These Limits of Insurance are inclusive of and not in addition to the Umits of Insurance shown in the Decla- rations. 3. AGGREGATE LIMIT PER LOCATION a. Under Section III - Limits of Insurance, the General Aggregate Limit applies separately to each of your "locations" owned by or rented or leased to you. b. Under Section V - Definitions, the following definition is added: "Location" means premises involving the same or connecting lots, or premises whose connection is in- terrupted only by a street, roadway, waterway or right-of-way of a railroad. 4. BLANKET WAIVER OF SUBROGATION Section IV. Transfer of Rights of Recovery Against Others to Us Condition is amended to add the following: We will waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of your ongoing operations done under a written contract or agreement with that person or organization and Included in "your work" or the "products-completed operations hazard", This waiver applies only to persons or organizations with whom you have a written contract, executed prior to the "bodily injury" or "property damage", that requires you to waive your rights of recovery. 5. BODILY INJURY REDEFINED - MENTAL ANGUISH Under Section V the definition of "bodily injury" is replaced by the following: "Bodily injury" means bodily injury, sickness, or disease sustained by a person, including mental anguish or death resulting from any of these at any time. 6. BROADENED NAMED INSURED Section 11- Who Is An Insured Is amended to include as an insured the following: Any organization which is a legally incorporated entity in which you own a financial interest of more than 50 percent of the voting stock on the effective date of this endorsement will be a Named Insured until the 180th day or the end of the policy period, whichever comes first, provided there is no other similar insurance available to that organization. The insurance afforded herein does not apply to any entity which is also an insureCl under another policy or would be an insured under su.ch policy but for its termination or the exhaustion of its limits of insurance. 7. BROADENED PROPERTY DAMAGE - BORROWED EQUIPMENT, CUSTOMERS' GOODS AND USE OF ELEVATORS The insurance for "property damage" liability is subject to the following: a. The Damage To Property exclusion under Section I Coverage A is amended as follows: 1. The exclusion for personaluprope_rtyin t~~ care, custody or control of the insured does not apply to "property damage" to equipment you borrow while af a job-SIte and providecfit is not being used by anyone to perform operations at the time of loss. 2. The exclusions for (a) Property loaned to you; (b) Personal property in the care, custody or control of the insured; and (c) That particular part of any property that must be restored , repaired or replaced because "your work" was incorrectly performed on it do not apply to "property damage" to "customers' goods" while on your premises nor do they apply to "property damage" arising from the use of elevators at premises you own, rent, lease or occupy. Subject to the Each Occurrence Umit, the most we will pay for "property damage" to "Customers' Goods" is $25,000 per "occurrence". b. Under Section V - Definitions, the following definition is added: "Customers' Goods" means goods of your customer on your premises for the purpose of being: 1. Repaired; or 2. Used in your manufacturing process. c. The insurance afforded by this provision is excess over any other valid and collectible property insurance Oncluding any deductible) available to the insured whether such insurance is primary, excess, contingent or VCG 206 02 06 Includes CClp'JI1ghted material of Insurance ServIces Office. Inc. Page 3 of 7 Copyright 2004, .