CERTIFICATE OF LIABILITY INSURANCE (120)��� �
�oR° CERTIFICATE OF LIABILITY INSURANCE
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s
DATE (MM/DD/YYYY)
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THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPaN 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 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).
PRODUCER CONTACT
Marsh Risk & Insurance Services NAME:
1732 North First Street, Suite 400 PHONE Faz
CA License No. 0437153 �� Ex��: (ac No�:
San Jose, CA 95112 en i7'FCC•
696515-Nextf -GAWU-11-12
INSURED
NextG Networks, Inc.
NextG Networks of NY, Inc. dba
NextG Networks East
890 Tasman Drive
Milpitas, CA 95035-7439
A: Zurich American Insurance Company
B: Travelers Property Casualty Co. Of America
16535100
n
COVERAGES "'°""`" � :
CERTIFICATE NUMBER: SEA-002183598-20 REVISION NUMBER:10
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.
ADDLSUBR
TR TYPE OF INSURANCE POLICY EFF POLICY EXP
POLICY NUMBER MM/OD/YYYY MM/DD/YYYY LIMITS
A GENERAL LIAgILITY CPO 6549078-02 08/02I2011 09I01/2012 �e,.� �,.�, ,.,,,�.,,,,.
v
' �VnnMEFCIAL GENERAL LIABILITY
CLAIMS-MADE a OCCUR
GEN'L AGGREGATE LIMIT APpL�ES PER:
POLICY X PRO-
LOC
A AUTOMOBILE LIABILITY
^ ANYAUTO �
ALLOWNED SCHEDULED
AUTOS AUTOS
HIRED AUTOS NON•OWNED
AUTOS
UMBRELLA LIAB OCCUR
EXCESS LIAB CLAIMS-MADE
DED RETENTION 5
B WORKERS COMPENSATION
AND EMPLOYEHS' LIABILITY
ANYPROPRIETORlPARTNER/EXECUTIVE Y�N
OFFICER/MEMBER EXCLUDED? � N / A
(Mandatory in NH)
If yes, describe under
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERALAGGREGATE $
PRODUCTS - COMP/OP AG� $
$
Z COMBINED SINGLE LIMIT
Ea accident
QODILY IfJJURY (Per person) ^�
BODILY INJURY (Per accident) $
PROPERTY DAMAGE �
Per accident
Comp/Coll Deds: g
EACH OCCURRENCE $
AGGREGATE g
$
? X WC STATU• OTH-
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYE $
E.L. DISEASE - POLICY LIMIT $
1,000,000
1,000,000
10,000
1,000,000
2,000,000
2,000,000
�,0�,�0�
100 / 1,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
he City of Clearwater, FL is named as an additional insured per form U-GL-1175 8 Cw (3/2007) under the named insured liability policies with respect to the operations of NextG Networks of NY, Inc., dba NextG
etworks East under the registration with the City as a lelecommunications service provider.
Ciry of Clearwater
112 S. Osceda Avenue
Post Office Box 4748
Clearwater, FL 33758-4748
ACORD 25 (2010/05)
LLA
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 REPRESENTA7IVE
of Marsh Risk 8lnsurance Services
� Rose York J,�� � ���_
O 1988-2010 ACORD CORPORA710N. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Addition�l .Insured — Automati — �
c Uwners, Lessees rDr
Contractars ZIJRICH
Policy No. k;xp, I�utc af 1��t, �tt: C�te of I:nd. :1g�ncy Nu. Addl. prcm, Kr�um 1'rem.
PQ6�49078-0? �9f01l2�i� 8/OZf2UIl
THIS END4I�SEMENT CHAI�tGES THE PCILICY. PLEA�E READ IT CAREFULLY.
Named YnsurQd: NextG Networks, l�rc.
�ddress tinciudin� ZIP �Code): 890 Tasman Drive, PUlilpitas CA 95U35
This enciarsement modi��s insuraz�ce pr�w�ided t�nder tk►�:
Commercial G�aer�! Liability Coverage Part
A. Section Ii — Who Is Aa Insured is a�t�ended to i�clude as an insured any person t�r organiaation who y��u are re-
quired to add as a� additional insured on this policy under a�rTitten contract or ►wriiteri a�reement.
B. The insurance provided to the additianal insured persc>n ac or�aniza�ion applies only to "bodiiy injury'•, "property
damage" or "personal and ad+�Yenising in�ury'• cp�ered under �ECT1QrN 1- Cuverage A- 6odi1�� tnjury pnd Prop-
erty Damage Liabi�ety ar�d Sertion 1- Coverage B- Personal And Advertising Inj�ry Liabitity, but anfy with
r�spect to liabifity for "bodi3}� injury", "property damage" or "p�ecsor�al and advertising injury" causcci, in whole ur in
p�„ by:
1. Your acts or qmissions; or'
2. The acts ar omissio��s af those acting on your behatf; and resulcing direcdy fro�n:
�. Your ongaing operations perforrned for the additianal insured, which is the subject of the rvriiten cbntract or
written a�reement; or
b. "Your work"' campleted as inciuded in the "products-compEeted ap�:rations ha�ard", perfannet� far thz addi-
tional insured, a•hich is [h� subjecE of the wriiten contract or writtcn agreement.
C. Howev�:r, regardless of the provisions af para�raphs A. ar�d B. above:
1. We wiil i�ot extend an}� if�surance coverage to a�ty additional insured person ar or�auiizazion:
a. That is nat provided ta you in this palicy; ar
b. That is any broader co�erage than you are required to pravide to the adciitional insu�ed persdrt or v�ganiza-
tion in the written contract or tivritten a�reement; and
2. We will not provide Limiis of Insurance to any additional insured persan ar or�;aniz�tion that exceed ihe lower
of
a. Th� L'units of Insurance prcrr+i�ied to you in this polic}; ar
b. The Liinits vf Insurance you are required ta pravide in the writtei� contraei or tivritten a�reement.
[neludes u�plri�ht�d ma�eri�l ufii�s�,rancw Serti•icas UtTc�.:�, li�c., ti��itt� its prrmissisr��. U-Cil: 1175-[3 Gl4' (3;2(1Q7)
E'age 1 a1`2
I). 't'hc� insurance pravidul ta th� aciciitiana) insur�d pers�n ar Urga�rtixation �lo�s nnt ap�,ly t�s:
"Badily inJurS'", "Pr�I�en}' damage" or "p�rsorral and advertisin� injuru" arising out af tha rznc3�ring ur failure w
r�ndG.c any� prafessianal archit�ct�ral, �n�;in�ring ar survey�ing s�n�ic�s incl�r.iir,�:
i. Thz preparin�, approving ar failing to prepare oc approve maps, shap drawit�;s, opinians, repncts, suryzys, fteld
orcizrs. chang� arcl�rs or tlrawir�;s ancl spe�i!'ications; anct
2. Su��r+risary, kns�7e;+�tic�n,. archit�.:tural or en�;in+r�.�ring ac:tiviti4s�
E. Tha additional ir�sur�d must sa� to it that:
i• W� are notified as soun as practicable �f an"occurren�e" or ofFense that iva}� result in a c�iny,
2. 1�re ree4ivz writtan rwticz of a claim or "suit" as soc�n as praeticable; and
3. :� request for d�f+:nsc and inclemnity ot'thc: cf�im or "suit" wilf prnmptly b� brau};ht �air�1 any }aoticy isscced by
anather insurer under which the additional insurad may� be an insured in any ca�acity. This provision d�s nat
apply E� inalua.ric� on which th� adtiitiona! inaur�d is � I'�l�m+>�ci lr�urGd, if th�: rvrittc:n cranUract ar u�r�ltwn agr�e-
mant rti*.quirc� that this coa�rag� kx� �araznaz}r an�l nc�n-cantributar�.
�'. For the oo�r�:rag� provided by� thi� �ndars�:mcnt:
i. Thei fc�llotc=in�; paxagraph is added tU I'ar��raph 4.a. c�f the t��hc�' Insuran� �onditinn of 5eetiun 1'V — Con�-
mcrcial General Lis�l�lity Conditions:
'1'his insuraria: is primarv insuranc�: as respects c�ur cor•eragr tc� th� �dclitianal i�sur�d persnn or or�;ar�i-r.ation,
where the �cTitten cuntcaet ur �vriuen agrc�;ment requir�s that this insurancz bz p�im�ry �d non-contributory. In
that event, we will not se�k �anuibution from any ott►�r insurarxce policy available to the additianai insvred on
w�ich th� additianal insured �4rsan or arganz`r.ation is a Nam4d insured.
1. Th� followi,n� naragrapt� i� �dd�:ci ta �'aragraph �.b. of th4 Uth�r Insuranu: Canditian csf Secti�n IV — Ca��n-
m�rciai Generai Liabiiity Co�xlitions:
�ChtS iT1,SUFFiTkCti 1S cYC�Sw Ok�er.
Any of the ather insurance, �►4•hether primary, eYCess, c�ntir,gznt or on an}� other basis, availabi� to an actditic�nal
insureci, irt which thc: additi�nal itisured an auc palii.�; is alsa covc:red as �n atitiitional insuteci bv attac}amet�t of
an endarsemertt to anathzr policy }�ruviding wverage fur the sflme °occurrern;e", claim or "suit"_ This prorisic�n
does n�t appty ta an} policy in which thz additional insured is a Named Insured on such other p�licy ancf x�here
qut pc�licy is ruyuir�d by wcitl�n a�ntract or u�ritien a};n:��zn4nt tc� grovides cav�rag,� tca thx: acE�litir►nat insur�d ar� a
grimary• and non-contributor}� basis.
G ihis czu�orsexn�nt doc:s n�[ apply tca an aciciitiana) inswred which has be�:n a�1�14d io this �tic}� by an enctors�:mc:r�t
shKa�xing th�; adciitiocaal insur�d in a SchL�dule af a�ciciitiorral insuoretls, and which enttc�rs�ment appli�s sptcifically ta
thgt identi�a� additior�al ins�uzd.
An}� proti�isians in this �av�ra�;e Paart not chan�;ed by the te;rms and conditians o£ this enclorse:m4nt �antinu� ta a�ply as
K�itten.
laelu�k� cuUy�igt�tcd nuLLaial of 1►�s��runtc Servicc� U�ice, Iac.. v�iU� it� penni�iw�. ti-Gl.-t E i5 I3 C�i� (3;2r1t�i j
Pagc 2 uY �