The URL can be used to link to this page

COI - Boldyn Networks US, LLC - Expires 2024-09-30® A�Ra CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ,1„D/2D29 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 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 endorsement(s). PRODUCER Aon Risk Services Northeast, Inc. New York NY Office One Liberty Plaza 165 Broadway, Suite 3201 New York NY 10006 USA CONTACT NAME: PHONE FAX (A/C. No. Ext): (A/C. No.): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Boldyn Networks US LLC 121 Innovation Dr Ste 200 Irvine CA 92617-3094 USA INSURER A: Federal Insurance Company 20281 INSURER B: Chubb Indemnity Insurance CO. 12777 INSURERC: American International Group UK Ltd AA1120187 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570102671505 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE ADDC-SUBR- INSD WVD POLICY NUMBER POLICY tl-I- (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 99511216 11/11/2023 09/30/2024 EACH OCCURRENCE $2,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $2,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY X PRO-X JECT LOC PRODUCTS - COMP/OPAGG $4,000,000 OTHER: A AUTOMOBILE LIABILITY 7355-07-34 11/11/2023 10/01/2024 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X ANY AUTO BODILY INJURY ( Per person) OWNED S SCHEDULED BODILY INJURY (Per accident) A AUTOS ONLY HIRED AUTOS ONLY NON -OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) _ A X UMBRELLA LIAB X OCCUR 56718908 11/11/2023 09/30/2024 EACH OCCURRENCE $9,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $9,000,000 DED RETENTION B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N 2471736479 11/11/2023 02/01/2024 x PER STATUTE OTH- ER ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? N N / A E.L. EACH ACCIDENT S1,000,000 (Mandatory in NH) If describe E.L. DISEASE -EA EMPLOYEE $1,000,000 yes, under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1, 000, 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: AGMT: A01955. The City, and its elected and appointed council members, board members, commissioners, officers and officials are included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. A waiver of Subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the General Liability, Automobile Liability and workers' Compensation policies. CERTIFICATE HOLDER CANCELLATION Holder Identifier : 570102671505 Certificate No City of Gilroy 7351 Rosanna Street Gilroy CA 95020 USA 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 sZa tfinl 000000 03 04 000304 001194 P ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000075032 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Northeast, Inc. NAMED INSURED Boldyn Networks US LLC POLICY NUMBER See Certificate Number: 570102671505 CARRIER See Certificate Number: 570102671505 NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DD/YYYY) LIMITS EXCESS LIABILITY C 32022119 1st XS 11/11/2023 09/29/2024 Aggregate $25,000,000 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000075032 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Northeast, Inc. NAMED INSURED Boldyn Networks US LLC POLICY NUMBER See Certificate Number: 570102671505 CARRIER See Certificate Number: 570102671505 NAIL CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Named Insureds old name: M3 Hilbert Towers, LLC.... New name: Boldyn Networks US VI LLC Old name: MobileComm Site Management LLC New name: Boldyn Networks US V LLC old name: Mobilitie* Operations LLC .. New name: Boldyn Networks uS Operations LLC Old name: Mobilitie Services, LLC .. New name: Boldyn Networks US Services LLC old name: Mobilitie Investments III - C, LLC New name: Boldyn Networks US III LLC old name: Mobilitie Investments III - B, LLC New name: Boldyn Networks US II LLC Old name: Mobilitie Investments IV, LLC New name: Boldyn Networks US IV LLC Old name: Mobilitie Investments III - A, LLC.................. New name: Boldyn Networks US I LLC old name: Mobilitie LLC .. .... New name: Boldyn Networks US LLC old name: Signal Point Systems LLC .. .. .... New name: Boldyn Networks US VII LLC old name: Base Line Integrators LLC.. .. New name: Boldyn Networks US VIII LLC 000000 04 04 000304 001195 P ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. AGENCY CUSTOMER ID: 570000075032 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Northeast, Inc. NAMED INSURED Boldyn Networks US LLC POLICY NUMBER See Certificate Number: 570102671505 CARRIER See Certificate Number: 570102671505 NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Addendum As respects Policy Number 32022119, Aon Commercial Risk (U.S.) is generating and distributing this certificate in an administrative capacity. Aon UK is the broker for the defined policy. ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved.