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AT&T-CS110519
Risk Managemsnt AT &T Ssrvices, Inc. One AT &T Plaza 203 South Akard, Suits 2731 Dallas, TX 75202 May 19, 2011 To Whom It May Concern: Subject: Subsidiaries of AT&T Inc. Certificates of Insurance (COI) Memorandum of Insurance (MOI) To evidence AT &T's obligation to provide proof of insurance, please take a moment to access the website below and review the information to confirm that it satisfies your organization's requirements for information concerning AT &T's insurance program. www.marsh.com/moi?client=D526 If the above Memorandum of Insurance (MOI) satisfies your organization's requirements and the COI is no longer required, please indicate on the front of the Certificate and fax to: 212 -948 -4341. If the COI requires modifications, please contact the AT &T employee responsible for your business relationship and ask that employee to authorize the necessary updates by following the standard request protocol. COI's will only be sent or modified when requested by the AT &T employee responsible for the business relationship. This would also include COI renewals. Should you have any questions as respects to the MCI, please contact Jessica Winterrose at 314.342.7003. Thank you for assisting Subsidiaries of AT &T Inc. Sincerely, AT &T Services, Inc. Risk Management DATE (MM /DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 1 05123/2011 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 OF-PRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. 'ORTANT: 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 certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME: Marsh USA Inc. PHONE FAX 701 Market Street, Suite 1100 A/c No xt : A/c No): St. Louis, MO 63101 E-MA ADDIL RESS: Attn: ATT.CertRequest @marsh.com PRODUCER « 018566 -GAW- CRT -11 -12 INSURER (S) AFFORDING COVERAGE NAIC # INSURED INSURER A: p Old Republic Insurance Co 24147 Subsidiaries of AT &T Inc. INSURER B: One AT &T Plaza 208 South Akard INSURER C : Dallas, TX 75202 INSURER D : INSURER F: COVERAGES CERTIFICATE NUMBER: CHI - 002940745 -02 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. INSR /Y ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDDYYY MMIDDIYYYY MWZY 59229 0610112011 0610112012 EACH OCCURRENCE $ 1,000,000 A I GENERAL LIABILITY DAMAGE TO RENTED 1 000 000 COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: " POLICY n JLOT LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS UMBRELLA LIAB OCCUR EXCESS LIAR CLAIMS -MADE DEDUCTIBLE A, WORKERS COMPENSATION MWC 117072 00 AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR /PARTNER /EXECUTIVE ❑ OFFICER /MEMBER EXCLUDED? N NIA (Mandatory in NH) If ves. describe under 12011 10610112012 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) City of Coppell is included as Additional Insured under the General Liability policy but only with respect to the requirements of the contract between the Certificate Holder and AT &T Inc. and Subsidiaries. TE City of Coppell Attn: Engineering Department 255 Parkway Boulevard Coppell, TX 75019 ACORD 25 (2009/09) TION 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 Inc. Katey E. Jones Ys"� ©1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PREMISES Ea occurrence $ MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 10,000,000 PRODUCTS - COMP /OP AGG $ 1,000,000 1 0610112012 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ EACH OCCURRENCE $ AGGREGATE $ 12011 10610112012 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) City of Coppell is included as Additional Insured under the General Liability policy but only with respect to the requirements of the contract between the Certificate Holder and AT &T Inc. and Subsidiaries. TE City of Coppell Attn: Engineering Department 255 Parkway Boulevard Coppell, TX 75019 ACORD 25 (2009/09) TION 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 Inc. Katey E. Jones Ys"� ©1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDITIONAL INFORMATION PRODUCER Marsh USA Inc. 701 Market Street, Suite 1100 St, Louis, MO 63101 Attn: ATT.CeaRequest @marsh.com 018566 -GAW- CRT -11 -12 INSURED Subsidiaries of AT &T Inc. One AT &T Plaza 208 South Akard Dallas, TX 75202 TEXT CHI - 002940745 -02 INSURERS AFFORDING COVERAGE INSURER G: INSURER H: INSURER I: INSURER J: DATE (MM /DD/YY) 05/23/2011 NAIC # Coverage evidenced applies to Subsidiaries of AT &T Inc., EXCLUDING Pacific Bell Telephone Company, Nevada Bell Telephone Company, Southwestern Bell Telephone Company, Illinois Bell Telephone Company, Indiana Bell Telephone Company, Michigan Bell Telephone Company, The Ohio Bell Telephone Company, Wisconsin Bell, Inc., The Southern New England Telephone Company and BellSouth Telecommunications, WITH THE EXCEPTION OF Nevada Bell Telephone Company Workers' Compensation and the Southern New England Telephone Company Workers' Compensation. <.CR 1 irwA 1 t 11ULUtK City of Coppell Attn: Engineering Department 255 Parkway Boulevard Coppell, TX 75019 of Marsh USA Inc. Katey E. Jones V" Page 2