HomeMy WebLinkAboutT-Mobile USA, Inc. 5/1-5/1/08
PRODUCER . .
ADn R1Sk servlces,Inc of washington
1420 Fifth Avenue
suite 1200
Seattle WA 98101-4030 USA
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
CONFERS NO RIGHTS uPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
. COVERAGE AFFORDED BY THE POLICIES BELOW.
FAX. 206 749-4860
INSURERS AFFORDING COVERAGE
. PHONE. 206 749-4800
INSURBR A:.
INSURBR B:
Gree~ch Insurance company
National union Fire Ins Co of pittsburgh.
XL specialty Insurance Co
INSURED .
T-Mobile USA, Inc.
its subsidiaries and Affiliates
12920 SE 38th Street
Bellevue WA 98006 USA
INSURBR C:
NAIC #
22322
19445
37885
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INSURBR D:
INSURBR B:
TIm POUClES OF INSURANCE LIS11ID BFLOW HAVE BEEN ISSUED TO 11IB INSURED NAMED ABOVE FOR 11IB POUCY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT. TERM OR CONDmON OF ANY CONTRACT OR 011IBR DOCUMENT WlTII RPSPECT TO WlDCH 1HIS CER11FICATE MAY BB ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORDED BY THE POUClES DBSCRIBBD HERBIN IS SUBJECr TO AIL THE TERMS, EXCLUSIONS AND CONDmONS OF SUCH POUClES.
AGGREGATE IlMlTS SHOWN MAY HAVE BEEN REDUCED BY PAID a.AIMS.
~ TYPE OF INSVRANCE POLICY NUMBER LIMITS
A
~LlABWTY RGD5000064 01
X COMMI!RCIAL OBNBRALUAIlIU'IY
CLAIMS MADB [!] OCCUR
X COntractual Liability Incl.
GBN'LAOORI!OATE UMIT APPLIES PER:
~ POUCY D ~ D LOC
$1,000,000
$1,000,000
$1,000,000 on
....
\0
$2,000,000 co
"
....
$2,000,000 N
N
8
"
on
$1,000,000 ~
i
~
$1,000,000 _
$1,000,000 :I
$1,000,000 iii
~
iE
.-
EACH OCCIJRREN'CB
DAMAGE 10 RBNTBD
PRBMISBS (l!a 0CClIreIlCe)
ODe DeISOD
PERSONAL & ADV INJURY
OBNBRAL AOORI!OATE
CE TERVILLE MN
PRooucrs -COMPIOP AOO
DBSCRIPI10N OPOPBRATlONSILOCATlONSlVBHlc.JlSlllXCUJSIONS ADDED BY BNOORSBMIlNTISPI!CIAL PROVISIONS
AS RESPECTS SITE LEASE AGREEMENT DATED BETWEEN THE CITY OF CENTERVILLE AND APT MINNEAPOLIS, INC. LOCATION: 1875
FOX RUN, CENTERVILLE, ANOKA COUNTY, MINNESOTA (SITE #:A1N004, SITE NAME: CENTERVILLE WT) FOR: SPACE, PERSONAL
PROPERTY AND TELECOMMUNICATIONS EQUIPMENT
A
05/01/07
05/01/07
COMBINBDSINOLB UMIT
(l!a aa:Ident)
05/01/08
05/01/08
RAD 5000066 01
AOS
RAD 5000067 01
IlIA
AuroMOBILE LlABWTY
ANY AUfO
AU.OWNllD Auros
SCHBDULBD Auros
HIRBD Auros
NON OWNllD AUI"OS
A
05/01/07
BACH OCCIJRREN'CB
AGORBOATE
BODn.yINJURY
(PerpelllOll)
BODn.yINJURY
(Per aa:Ident)
PROPERTY DAMAGE
(Per aa:Ident)
AUTO ONLY - EA Aa:IDI!NT
ANY AUfO
OTIIBR TIlAN
AUfOONLY:
EAACJ:.
AOO
B
EXCESSIllMBRELLA LIABWTY
[!] OCCUR D CLAIMS MADB
9834866
~DEDUCl1BLB
DRBTBNrION $25,000
c
RWD
WORKERS COMPENSATION AND
EMPLOYERS'LlABWTY AOS
RWR5ooo124
ANYPROPRlBTOR/PARTNBR/BXIlC\JTIVB AZ IlIA OR WI
OFflCBRIMBMBBR EXCLUDED? '"
If,.., describe UDder SPIlCIAL PROVISIONS
beJow
X
05/01/07
05/01/OS
B.L BACH ACCIDIlNI'
B.L DISBASB-EA BMPLOYIlB
B.L DISBASB-POUCY UMIT
c
0'l1IER
CENTERVILLE, CITY OF
1880 MAIN STREET
CENTERVILLE MN 55038 USA
SHOULD ANY OPTIIB ABOVE DESCRIBBD POUCIBS BB CANCBLLBD BJlIIOlU! TIIB EXPIRATION
DATE THIlIUlOP, TIIB ISSUING INSURIlR WJU. ENDEAVOR 10 MAn.
30 DAYS WRl1TI!N NOTICB 10 TIIB CERTIFICATE HOLDER NAMBD10 TIIB LI!FI'.
Bur PAILllRIl 10 DO SO SHALLIMPOSB NO OBUGATlON OR UAIlIU'IY
OP ANY KIND UPON TIIB INSURER, ITS AGENTS OR RIlPIU!SBNTATIVIlS.
AurHORIZBD Rl!PRl!SI!NTATIVB
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