2019-065-E IT - Open Broadband LLC tower attachment agreement

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DocuSign Envelope ID:3F5DFA23-EAEB-4F98-A868-F9A3E4B04BA7 DATE(MM/DD/YYYY) �--� %,r-K i IrK4A I c Or UKBILITY INSURANCE 5/7/2018 THIS CERTIFICATEIS 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 rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT NAME NUTMEG INS AGENCY INC/PHS (A/c N,Ext): (AI,N.): (888) 443-5112 210775 P: F: (888) 443-6112 E-MAIL r�CC ADDRESS: PO BOX 29611 INSURER(S)AFFORDING COVERAGE NAIC9 CHARLOTTE NC 28229 INSURERA: Turin City Fire Ins Co INSURED INSURER B INSURER C: OPEN BROADBAND LLC INSURER D: PO BOX 723 INSURER E: WAXHAW NC 28173 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. IhSR TITE OF INSURANCE ADDI SUB POLIGYNUAIBER POLICYEFF POLICYEXP LJWIS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s2, 000, 000 CLAIMS-MADE OCCUR DAMAGE TO RENTED s, 000, 000 1 - 1 PREMISES(Ea occurrence) A X General Liao X 76 SBII BB7996 04/17/2018 04/17/2019 MED EXP(Any one person) $1.0, 000 PERSONAL&ADV'INJURY $2, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE s4, 000, 000 POLICY�PRO-R LOC PRODUCTS-COMP/OP AGG $4, 0 0 0, 0 0 0 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) s2, 000, 000 ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED 76 SBII BB7998 04/17/2018 04/17/2019 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $1, 0 0 0, 0 0 0 h` EXCESSLUIB CLAIMS-MADE 76 SBII BB7998 04/17/2018 04/17/2019 AGGREGATE $1, 000, 000 _Dd X RETENTION s10,0 0 0 $ WORSEkSCDAfPEIVSATWN PER OTH- ANDEMPLOYERVLL9B&UT STATUTE I ER ANY PROPRIETORIPARTNER/EXECUTIVEYIN E.L.EACH ACCIDENT $ OFFICERiMEMBER EXCLUDED?_ AVA (Mandatory In NH) ❑ E.L.DISEASE-EA EMPLOYEE$ If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICPMRO 101,Additional Remarks Schedule,may be attached if more space is required) Those usual to the Insured's Operations- Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 attached to this policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. NATIONAL MILLS LLC A�UTIfORIZEDREPRESENTATIVE 710 CATAWBA S T S TE D J ! BELMONT, NC 28012 ©1988 2015 ACORD CORPORATION.All rights reserved ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD I