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COI - Lumen Technologies, Inc. - Expires 2024-06-30® �► R� DATE (MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 08/31/2023 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 have ADDITIONAL INSURED provisions If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CT PRODUCER MARSH USA LLC. CA License #0437153 1301 5th Avenue, Suite 1900 Seattle, WA 98101-2682 Attn: Seattle,certrequest@marsh.com / Fax: 212-948-4326 C N 102197661-S T N D-ALL-23-24 INSURED Lumen Technologies, Inc. and all subsidiaries, Including but not limited to: Qwest Corporation; Embarq Corporation; Level 3 Communications, LLC and CenturyLink Communications, LLC 100 CenturyLink Dr. Monroe, LA 71203 COVERAGES CERTIFICATE NUMBER: CONTA NAME: PHONE FAX INC. No. Extl: rA/C, Not: E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE INSURER A : Greenwich Insurance Company INSURER B : XL Specialty Insurance Co, INSURER C : Allianz Underwriters Ins Co INSURER D : INSURER E : INSURER F : SEA-003796977-06 REVISION NUMBER: 6 or be endorsed. A statement on NAIC # 22322 37885 36420 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INRp WVD POLICY NUMBER IMM/DD/YYYYI (MM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY X X RGD500033311 09/01/2023 09/01/2024 EACH OCCURRENCE $ CLAIMS -MADE X X CONTRACTUAL LIABILITY OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO-LOC JECT OTHER: A AUTOMOBILE LIABILITY X X RAD500033411 X ANY AUTO Auto Physical Damage - Self Insured X OWNED SCHEDULED X AUTOS ONLY AUTOS ONLY HIRED AUTOS ONLY AUTOS B B B B C X UMBRELLA LIAB EXCESS LIAB DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRI ETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Technology E&O incl. Cyber/Privacy Liability X OCCUR x x U5Z000023220 CLAIMS -MADE Y/N N N/A X RWD500032911 (AOS) RWR500033011 (WI) RWE500033111 (WA) RWE500033211 (OH) U5Z000023220 09/01/2023 09/01/2024 09/01/2023 09/01/2024 09/01/2023 09/01/2024 09/01/2023 09/01/2024 09/01/2023 09/01/2024 09/01/2023 09/01/2024 09/01/2023 09/01/2024 DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ COMBINED SINGLE LIMIT $ ( BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY nt) DAMAGE ( I EACH OCCURRENCE IAGGREGATE $ X I STATUTE I I EORH E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ Each Claim/Aggregate Retention 3,000,000 500,000 10,000 3,000,000 15,000,000 15,000,000 2,000,000 10,000,000 10,000,000 1,000,000 1,000,000 1,000,000 10,000,000 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) The City of Gilroy, its officers, officials, and employees are included as Additional Insured as respects their interest in the operations of the Named Insured as required by contract or agreement regarding General Liability and Auto Liability. CERTIFICATE HOLDER City of Gilroy 7351 Rosanna Street Gilroy, CA 95020 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. AUTHORIZED REPRESENTATIVE of Marsh USA LLC ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN102197661 LOC #: Seattle ACQRIJ AGENCY MARSH USA LLC, POLICY NUMBER CARRIER ADDITIONAL REMARKS SCHEDULE NAIC CODE Page 2 of 2 NAMED INSURED Lumen Technologies, Inc. and all subsidiaries, including but not limited to: Qwest Corporation; Embarq Corporation; Level 3 Communications, LLC and CenturyLink Communications, LLC 100 CenturyLink Dr. Monroe, LA 71203 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance GENERAL LIABILITY Automatic Additional Insured's Primary Coverage Additional Insured as respects your interest in the operations of the Named Insured as required by contract or agreement. Coverage provided by the above General Liability policy shall be primary and is limited to liability arising out of Named Insured's ownership and/or operations. Any insurance carried by the additional insured shall not be contributory insurance. Waiver of Transfer of Rights of Recovery Against Others to Us (Waiver of Subrogation) — any person or organization with whom you have entered into a contract or agreement, or by statute, law or code of ordinance. Separation of Insureds Applies. Insurance covers incidents that occur within 50' of railroad property, any railroad exclusions have been deleted per endorsement CG2417. AUTOMOBILE LIABILITY Any person or organization you are required in a written contract, agreement, statute, law or code of ordinances provided the "bodily injury" or "property damage" occurs subsequent to the executive of the contract, agreement, statute, law or code of ordinances. Lessor -Additional Insured and Loss Payee - All Lessors Waiver of Transfer of Rights of Recovery Against Others to Us (Waiver of Subrogation) — Any person or organization with whom you have waived prior to the "accident" or the "loss" under a contract with that person or organization, or under statute, law or code of ordinances. WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY AND EXCESS WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY (OH & WA - SELF -INSURED - $1,000,000 RETENTION) Waiver of Our Right to Recover from others Endorsement — Where required by written agreement signed prior to loss, or required by statute, law or code of ordinances executed prior to loss. EXCESS/UMBRELLA Coverage applies per occurrence. Additional Insured as respects your interest in the operations of the Named Insured as required by contract or agreement. Waiver of Transfer of Rights of Recovery Against Others to Us (Waiver of Subrogation) - Any person or organization with whom you have entered into a contract or agreement, but only to the extent required by such contract or agreement. Separation of Insureds Applies. COMMERCIAL CRIME - FIDELITY BOND Carrier: XL Specialty Insurance Company Policy Number: ELU19204423 Effective Dates: 09/01/2023 - 09/01/2024 Deductible: $2,500,000 Each Occurrence: $15,000,000 U.S. PROPERTY Carrier: Allianz Underwriters Insurance Company Policy Number: U5Z000023220 Effective Dates: 09/01/2023 - 09/01/2024 Limit: $25,000,000 Deductible: $25,000,000 Property Coverage: "All Risk" of Direct Physical Loss or Damage to All Real and Personal Property, including Boiler & Machinery, Earthquake, Flood and Wind - Replacement Cost Basis, and Business Interruption - Actual Loss Sustained. Loss Payee or mortgagee as required by written contract/loan agreement to the the extent of your insurable interest. Waiver of Subrogation - Any person or organization whom you have entered into a contract or agreement, but only to the extent required by such contract or agreement. Other deductibles may apply as per policy terms and conditions. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights i The ACORD name and logo are registered marks of ACORD 0303-01-00-0000824-0002.0001860 Dear Certificate Holder: Tostreamline certificate delivery for our clients and inan effort tosupport our fim/scommitment to ountainabi|itv going forward, we will only be providing renewal certificates of insurance electronically./ |fyou need tocontinue receiving acopy ofthe attached certificate, please send anemail tn USOperatioiis.ei-nail@marsh.com and include the following: —Certificate # (Shown below Insured Name —e.M~ABC-l23456789':01) — E-Mailforfuturedelivery For your convenience, If we do not receive your response, vve will conclude that you no longer require proof of insurance frGITI the named insured and will remove you from c)ur records. Thank you, US Operations, Marsh USA, LLC Ah**lfleM� (9&xa,5hWlel`rmM�