CERTIFICATE OF LIABILITY INSURANCE (13) SATE IM7--
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CERTIFICATE OF LIABILITY INSURANCEPage 1 of 2 F03129/201Y3
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 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
cerifficate holder in lieu of such endorsernent(s).
PRODUCER -ONIACT
J_
N
I AMIE,
Kiiiiis of Pennsylvania, Inc. P!AQ1-,,E
888-4b7-2378
c/o 26 Century Blvd. NT 877-945-7378 LA;c NO-
�,-MAtL
P. 0. Box 305191 ADDRESS, celrtlillf-ica ties @%,i-lli-s com
N-a 8 hvillfs, TN 3?2-'0-5191
I N SU R ER A Federal Insurance Company 20281-005
INSURED CROWN' CASTLE INTERNATIONAL CORP, N,,uRE-RrA: Nc-w, insurance Co,
See Attached Rwred Insured List
1220 AuguGta Dr. Suite 500 N'S"UPER C,
Housto9i, TX 77057
I N SU R I R F
COVERAGES CERTIFICATE NUMBER:19589286 REVISION NUMBER:
'J'HIS IS TO CEPT,FY THAT-f HE POLICIES OF INSURANC IA STD BELOW HAVE BEEN ISS JED TO THE NISUI"�ED NAIIAED ABOVE FOR THE POLICY PE,"IOD
INDICATED, NOTOdTHSTANDING ANY REOUIREMENT, TERM OR, CO�,JCATIONI OF ANY CON4TRACT OR OTHER D0CUI`,AENT VAT• RESPECT TO WI-11f THIS
(ERTIFICATE MAT BE ISSUED CIR NAY PERTAIN. s-HE 1t,,1SURANCE AFFOFIDED BY THE POLICIES DESCRIBED HEREIN !S SUBJECT TO AIA, THE TE`I`0AS,
EXCLUSE 01.4E�,'AI'dDCONDI-riONS,'-)F SUCH POLICIES,LINITS SHIDWN MAY HAVE BEEP!I',�EDILJCED P AID DCLAIMS.
INSIR ADD'I L I SUOR Pou-CY EFF POLICY EXP
TYPE OF INSURANCE isar 'YN LHAO'S
, Numr:iER
TA --fOLIC
A GENERAL LIABILITY Y 70211-02-28 4/1/2013 4/1/2014 ._-rACH0CVUMKN--.I'-' Yi 1,,_00010?
0
n-1- a7`t-1 S
X 1.000,000
CLjv!�IS-MAD-` X OCCU5,1 rqED,EXF i4nv m S
5,00'1
P F R',SONAI,&AD V I N i LJR Y 1,000,000
GENE RAL.,.GC-'j-'fEC.,ATE
-RODUCTS-CCAPT'O AGG S 2,000,000
t
X COMBINED SINIGLE
__;J,/!/2013 4/1/2014 1,000,000
A AUTOMOBILE LIABILI-rY Y 7021-02-iZ,�.� accjdpil,�
X ANY A'JTO BOCILY
ALt 01,J,1ED -,O J-IEDDULED BODILY NJUR(W�-,,r acrkJPI'�!j 5
AUTOS ALITOS A---E
a , °.l AUTO'S NON-OWNED
AUT0-
X s UMBRELLALIA13 X OC',CUR, Y 61844671 4/1/2013 4/1/2014 EACH 5,_E€00,000
A G
5,,_.000, 0 ,
EXCFSS LIAR CLAI LIS-rAA13F i i AT E .5 00
DE[-� RETEN�'KJN TA7—'---7-7—H $
A WORKE as COPAPEIiSATI 0 N Y 7171-06-98 4/1/2013 4/112014
X T'Qfe,1,yL.n11ITS- - ER
AND EMPLOYEMS'LIASHATY YiN 6,L EACH 11 000,000
ANY PJ- PRIEIOII PA(iT°,IER,F PC U-NE, N(A
0 FF F,I'M E�L,B--fK E XC L U DE,E),' N L L Di SEALiE -A Er,1,1'11I-C,,VEE S 11 000,000
jMar,d�tory k P-114) I I
1�e{n u E L D�EEASE, ?'Ulvl�T S 1,000,000
DE,1--;(.,'R1PN0N Or OPERATION�',bebw —
DESCRIPTION OF OPERATIONS LOCATIONS i VEHICLES IAftach Acard 101,Additonal Remar*,sSch I mme space is Toqulred)
RE- COUNTRYSIDE #8 4424
See Attached:
CERTIFICATE HOLDER CANCELLATION
SHOLILD ANY OF TH E ABOVE F)!,--SCR[S-ED POLICIES BE CANC--ELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH T�HE POLICY PROVISIONS.
THE CITY OF CLEARIaIATER FLORIDA AUTHORIZED REPRESENTATIVE
ATTN., EARL BARREL, EVGINEERING DEPT.
P0 BOX 4748 R
CLEARWATER, FL 33758-4748
Coll.-4050580 Tpl;1614279 Cert:19589286 (D19138- dt"CORD CORPORATION,All rights reserved
ACORD 25(2010/05) The ACORN name and logo are registered marks of ACORD
AGENCY UST IDS 713115
L #.
ADDITIONAL REMARKS SCHEDULE
Page 2, of 2
NAMED INSURED
AGENCY
willis of Pennsylvania,
See Attached Named Insured List
_ 120 Augusta fir. Suite 50
POLICY NUMBER :Houston, TX 7705 �..',.
See First Page
CARRIER r4AIC CODE
See FFECTIVED TEE See Karst a e
1r
-t I NAC REM h �
THIS ADDITIONAL REMARKS FORM IS o SCHEDULE TO ACORD FORK
FORM NUMBER: 25 FORM TITLE- C I ERTIFICATE"I OF L I 1ABILITY iNSURAINCE
certificate Holder is included as an Additional insured under the General, Li b lit";', Autorvtobile
�ll with respect t t
Liability Umbrella p la n r red b written agreement and �
the liability arising out of the operations performed by or on behalf of the Named Insured.
The General L Automobile Liability, UmLbrella Liability, and
, Workers om.e-satin s o1ici S
include a Wirer of Subrogation in favor �� t� ��r�i�i��tc Holder :gin required
by written
contract: but always subject to the policy terms, conditions and exclusions as permitted by later.
A ;ORD 101 (2008/01) Coll-4050580 TiDl:161 4279 Cert:19589266 @ 2008 ACOR CORP RATION.All rights reserved.
The ACORD name and logo are registered marks of ACORD
Crown Castle International Corp. Consolidated Subsidiaries
WE
Ail-Comrn of Avort.L,L-C. Down Castle NG East Inc.flpff e N WKS r4elmorks of N"'Inc,
Atlantic Coast Communications LLC; Crown Castle NG Netotorkc.,' 1P c (ei=5/a'1 2)lka NexIG Nplwo�ks ric",
AZ-CLEC LLC Crown Castle W3 Wast Inc, 5 a'12)1 ka NlextG PJ1etvvc4 k of Caiff'aria hnc,
CA-CL EC LLC Crown Castle No 1 Pty Ltd(eff 6/14/11 j
CC Castle International LLC Crown Caisfle Operating Companv
CC Finance LLC Crown Castle Operaling LLC
CC Holdings GS V LL C Crown Taal:=Orlando Corp-
CC Site Acquisil ions II LLC Crown Casire PR ILLG
CC TM PA LLC fetf 1 Oi3112012) Crown Castle PT Inc.
CC Towers GI-raranlor LLC Crown Castle Puerto Rico Corp,
CC Towers Holding LLC Crown Castle Seivice L r 2 6!24,2011)
CCG S Holdmgs Co,p, Crown CasTle Solut ons Cm p,
CCPE Acquisitions LLC Crown Castle SoOh LLC
CCTM HiIldli F)qs L1-C:(eff 10/31 120 12) C rovo n,C a s I I e Towers 05 L LC
CCTNII LLC(eft 1 1/30i1='p Croon Castle-,Towers 06-2 LLC
CCT 1`02 Lt C(e ffec I rve, 11 30/12) Crown Castle Towe',rp 09 LLC
CCTMO LLC(eff 10/311"2012) Crown Castle Tnv,,ers LIC,
Coastal Antennae LLC, Crown Castle USA Inc,
CO-GLEG(1 vig/09) Crown Con"imunicaflon LLC' crown In"c'eff 11"111)
(Ua'msi�e Ventura,Inc- Crown Communication New York, Ine.
Coverage Plus Antenna Systems LLC Crown FOolh4e,Systems,Inc
Crown Atl;witrc Cornpanv LLC CTTA FIty Lin-iitcadiOi W13108)
Crown rown Casile AS LLC (eft JW2CIP',1) DC-CLEC LLC
Crown Casile Aflanfic LLC Divarne Ply Lialiled(efte-Fhvi 10126,12)
Crown Castle Augusta LLC FL-CL C LILC
Crown Casile Australia Holdin�p Ply Ltd Global Signal Acrpoistions 11 LLC
Crown Castle Australia Pry Ltd Global Signal Acquisttk)ns III LLC
Crown Castle BP ATT LLC Global Signal Acquisitions IV LLC
Crown Castle CA Corp, Global Signal AccOsitions LLC
Grown Castle is III Corp, Global Signal GP LLC
Crown Castle roT Corripany LLC Glottal Signal Holdings III LLC
Crew,)Castle GT Cori). Global Signal Holdings IV LLC
Crown Castle GT Holding Sub LLC Global Sigrial Opp rarng Partnership,L-P.
Crown Castle International Comp, Global Signal Sewices LLC
Croom Castle linlernalional Co p-do Pi-mr10 Rico GoldenState Tovvers,LLC
Crown Castk'i International LLC GS Savings Inc.
Crown Castle Investment Corp GSPN Intangibles LI-C
Ctown Castle MM Holding Ccinp. High Point rAtanagement Co, LLC:
Crown Castle MM Holding LLC ICB Towers, LLC
Crown Castle MU LLC IL-CLEC LLC
Crown Castle MUPA LLC IN -CLEC LLC
Crown Castle Nevada LLC in SITE Pjbe-r of Virginia, Inc.
Grown Castle NG Acquisitions Corp kell 12,`l 1,'111 InSITE Solutions, LLC
Crown Castle NG Manor lim- ika N %moaks MINic Inc I nterstate Towei-COM M WiCa I!ions LLIC
Crown Ca5flr,-'NG ceniral rnc t elf-5,'311 1'21) h„7 Ni�xrG d 8�olols Inc I ni racoasial City Towers LI-C
JBCM Towers LLC TowerOne NoIlh Covr,,�ntry LLC(eff 3 2,2012,)
KAW Consulting Ply Lt r1(o 6 1;c,_==,'O I TowerOne Partners, LLC(elf&2-2012)
MA-CLEC LLC TowerOne Upper Pattsurove 002,LLC(eft 3/2M12)
MID-CLEr-LLC ToworCno Warrnirister 001, LLC(eff 3/2/20121
Mobile Media Catifornia LLC: TowerOne Warrinaton 00 2, LLC feff 1'2/201.2)
Crown Castle International Corp. Consolidated Subsidiaries
Moble Modia National LLC Towers Finco 11 LLC
Medea,LLC, Tovvers Fmco,III LLC
MW Cell PUT I LLC(ev,1/si'/121, Towers Finco LLC
MW Cpl'TRS 1 LLC trt 1;3V1'.2,) TVHT,LLC
New Patin Networks, Inc, VA-CLEC LLC'
New Path Networks, LLC` WA-CLEC LLC
NextG Netwotks Atlanllc, I rec.(effec t ive ,°'411';1?t 1,VCP Wireless Lease SUbsidory, LLC Ita,ff 1 '-',1€HJ12p
NeAG Ne tworks of Cari fornia, In ( ffeCflve 41l(:i 1 12) WCP WirOess Site,Funding LLC,eff 1 ,1/2012�
Nex-IG Networks of Iffinois, Inc-(effeclive 4/10/12) VVCP Wirpkass Sile Holdco LLC 1"31 2011.)
NextG Networks of NY, fil.,C(efffectivc 41'VX',vr) WCP WrOess Site.Non-RE Fundinq LLC(e-lf
Nex!G Networks,Inc,(et-feclive 4/1 J`12 VVCP Wireless Site Nor-i RE Firfldco 1?311201'22)
NJ-CLEC LLC VVCP Wirelpss Site RE Funding LLC(eff 11i3l';2012)
No-CLEC LLC VVCP Wifeless Site RE Holdco LLC(,eff
NY-CLEC LLC W i reless FLV'16t 1g, LLC(f--41 1 r 1 ;>r7'12')
OH CLEC LLC(eifinctNe 7/2",0111 1) W i rojess Reafty Holdings 11,LLC (Olective 5'19/11)
OP LLC Wireless Revenue Pro e rfi LUC(Off 1131/2012)
IDA- CLEC LLC
Pirinacle San Anlon o L.L.C-
Pmnacle SP.- Louis LLC
Pirinacle Towers Acquisition Holdings LLC
Pinnacle Towers Acquisition LLC
Pinnacle Tow rs Asset Holding LLC Inactive Entities
Pinnacle Towers Canada Inc. Crown Casflf.-a Europe LLC eff,12/912009
Pinnacle Towers M LLC Crown,Castle Mexico, S.A.de C,V,efj 1"1112110
Pinnacle Towers Limited
Pinnacle Towers LLC
Pinnacle Towers V Inc.
Radio Station WGILD LLC
RECC Properties Lirnile/J,,eff W201;06)
SC-CLEC LLC
Shaffer&Associates. I nc
Sio-ra Towers, Inc,
ThUnder Towers LLC
Tower Systprns LLC
Tower Technology Coinpany ol Jacksonvifle LLC
Towcr Vei-itures Ill, LLC
TowerOne 2012.LLC(ef-t 3,21-2012)
Tower One Allentown 001, LLC 3,21,",0 12-)
Tower0ri e Doylestown,LLC leff 312,12012)
TowcrOne Middletown 00 3. -1-C(eft 3/2,'2012)
INSURER CANCELLATION TERMS
_Yf� ------
NAMEDINSURED 0
CROWN CASTLE INTERNATIONAL CORP.
Various
EFFECTmE rjATE SEE PAGE 1
Person or Organization:
Person(s)or organization(s)that you are obligated, pursuant to written contract or agreement between you and
such person or organization,to provide with notice of cancellation for any reason other than non-payment of
premium, provided that, within 10 days of the date the producer or the first named insured receives a copy of the
notice of cancellation,the producer or the first named insured provides us with a spreadsheet containing the
name, address and, if available, e-mail address of the per or organization(s)to whom such notice of
cancellation is to be sent.
All other terms and conditions remain unchanged.
Cancellation Terms:
When we cancel this policy as described in the Cancellation condition for any reason other than non-payment of
premium, we will also send to the person or organization described in the Schedule a notice of at least 3G days in
advance of the cancellation date.
Any failure on our part to deliver such notice will not:
* impose liability of any kind upon us; or
* invalidate the cancellation.
Cancellation Terms Apply to the Following Coverages:
General Liability, Automobile Liability and Workers Compensation
wlll�s 101