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HomeMy WebLinkAboutDISH Wireless LLC - Telecommunications Tower Collocation Consent Agreement 2023 01 20 wireless 5701 South Santa Fe Drive Littleton, CO 80120 DATE: �1 TO: L►G1( � GUI � l FROM: Lease Admu istration, Dish Wireless RE: N,L-TOMf- NIWOan -SNr-0-- L To Whom It May Concern, DISH Wireless L.L.C. is pleased to partner with you as we build out our 5G Network! Enclosed you will find: originals of the partially executed Lease originals of the partially executed Memorandum of Lease originals of the partially executed SNDA Once fully executed,please return ONE (1) original of each back to: Dish Wireless Attn: Lease Administration 5701 South Santa Fe Drive Littleton, CO 80120 If you are interested in having your rent paid via Electronic Funds Transfer("EFT")please complete the enclosed EFT request form and return it with a voided check. For questions or concerns that may arise during our tenancy,please email us at 1 andlc�rclrelali�i��u�istt corn. We look forward to a long-term partnership with you! d %W Authorization Agreement **—w s h for Automated Deposits & Dish Wireless L.L.C. Credits I hereby authorize and request DISH Wireless L.L.C. ("Company") to make payment of any amounts owed to me by initiating credit entries to my account at the Bank indicated below("Bank"). hereby authorize and request Bank to accept any credit entries initiated by Company and to credit all such entries to my account without liability for the correctness of the entries. It is understood and agreed that I may terminate this agreement at any time upon three business days prior written notice to Company or Bank. Notification to Company or Bank shall be effective upon receipt. I understand and agree that if an erroneous credit is made to my account,that Company and Bank are authorized to stop payment, reverse the entry or make any adjustments necessary to my account to correct the erroneous entry. DISH SIG Site ID: Landlord Entity Name: Rent Payee Name: (if different from Landlord entity) Address: Signed: Printed Name: Date: Remittance Email Address: Depositor Account Information 1. Attach a voided,pre-printed company check,or letter from banking institution with the following information: • Account Name and Address • Bank Name • Bank Routing Number • Bank Account Number 2. Email completed document to Landlordrelations@Dish.com-or-mail to: Dish Wireless L.L.C. ATTN:Lease Administration 5701 S.Santa Fe Drive Littleton,CO 80120 COMPANYIPERSONAL NAME 1102 101 ADDRESS CITY,STATE 12345 DATE ii i A4_6 VOIDED CHECK HERE $ Sample Bank NOT NEGOTIABLE Bank H.S. SAMPLE --VOID Bank ogion Pit bu trgh,PA DO NOT MEMO CASH! • 043000261, 23" 4567110 TELECOMMUNICATIONS TOWER COLLOCATION CONSENT AGREEMENT (Shore Road Site) THIS COLLOCATION CONSENT AGREEMENT ("Agreement") is entered into by and between the City of Winter Springs, a Florida municipal corporation ("City") and DISH Wireless L.L.C, a Colorado limited liability company authorized to conduct business in Florida ("Dish"). WHEREAS, City is the owner of real property generally located on Shore Road within the City of Winter Springs, more particularly described herein; and WHEREAS, City entered into that certain Lease Agreement with Bell South Mobility, LLC ("Bell South"), dated November 7, 2000, which leased a portion of the City's property to Bell South for the construction and operation of a monopole cell tower; and WHEREAS, Bell South constructed a one hundred sixty-five foot (165') free-standing monopole which is designed with spaces to collocate the antennas of three (3) commercial mobile radio service operators ("ToNver"); and WHEREAS, the Lease Agreement was subsequently assigned to Crown Castle South, LLC ("Crown Castle") effective March 6, 2001; and WHEREAS, the Lease Agreement was amended to provide additional extension terms and make other changes by that First Amendment to Lease Agreement effective March 31, 2016 ("First Amendment"); and WHEREAS, Dish desires to collocate on the Tower and sublease a portion of the ground space of the City's property("Leased Property") from Crown Castle for purposes of operating and maintaining communication equipment and related facilities; and WHEREAS, City desires to consent to the sublease between Dish and Crown Castle and to Dish collocating its communication facilities on the Tower under the terms and conditions of this Agreement. NOW, THEREFORE, in consideration of the mutual promises, covenants, and agreements herein contained, the receipt and sufficiency of which are hereby acknowledged, the parties hereto, intending to be legally bound, hereby agree as follows: 1.0 Recitals. The foregoing recitals are true and correct and hereby incorporated herein by this reference. 2.0 Consent to Collocation. The City hereby consents to Dish collocating its communications and related facilities on the Tower and on the Leased Property. In furtherance of consenting to the collocation, the City also consents to Dish entering into a sublease with Crown Castle for the use of a portion of the Leased Property ("Subleased Parcel") and the Tower. The Subleased Parcel is described as "cell tower site"and is legally described on Exhibit"A"attached Telecommunications Tower Collocation Consent Agreement DISH Wireless L.L.C. Site ID:ORMC000092A D Page 1 of 8 hereto and incorporated herein by this reference. The use of the Subleased Parcel shall be limited to operating and maintaining communications equipment and related facilities in order to effectuate the collocation. City also consents to Dish's use of the non-exclusive access and utility easement to the Leased Property. The easements were granted to Bell South by the City and are legally described under the Lease Agreement. The easements are described as "access and utility easement" and are legally described on Exhibit "A." Dish agrees to fully comply with the terms and conditions of the aforementioned easements and further agrees that Dish shall not in any way overburden the easements or interfere with the City's and any other authorized user's right to use the easements. 3.0 Term. The term of this Agreement shall commence on January 1, 2023 upon full execution of this Agreement by the Parties. The City acknowledges and agrees that Dish shall have the right to sublease the Subleased Parcel and collocate on the Tower for a term that coincides with the Term in the Lease Agreement, as extended by the First Amendment. This Agreement shall automatically renew at the same time as the Lease Agreement unless: (i) Dish has provided the City written notice of its desire not to renew prior to the renewal; (ii) the City has terminated this Agreement pursuant to paragraph 22.0 of this Agreement; (iii) Dish is in breach of this Agreement, in which case, this Agreement may only be renewed if the City agrees to the renewal in writing and Dish cures the breach; or (iv) Dish is in breach of the Sublease Agreement with Crown Castle, in which case, the Agreement may only be renewed if the City and Crown Castle agree to the renewal in writing and Dish cures the breach. 4.0 Termination of Lease Agreement. If the Lease Agreement is terminated by Crown Castle or City and Dish desires to continue occupying and possessing the Subleased Parcel and Tower space, Dish may do so by entering into a written lease agreement with the City which shall require direct payment to the City of all rental proceeds required by the Lease Agreement. 5.0 No Assignment. This Agreement shall not be assigned or transferred, unless the assignment is consented to in writing by the City. 6.0 Third Party Rights. This Agreement is not a third party beneficiary contract and shall not in any respect whatsoever create any rights on behalf of any party not expressly a party to this Agreement. 7.0 Further Assurances. From and after the execution of this Agreement, each of the parties hereto shall fully cooperate with each other and perform any further act(s) and execute and deliver any further documents which may be necessary or desirable in order to carry out the purposes and intentions of this Agreement. 8.0 Severability. If any provision of this Agreement is held to be invalid, void, or unenforceable, the remaining provisions shall nevertheless remain in full force and effect, unless the absence of the invalid, void, or unenforceable provision or provisions causes this Agreement to fail in its essential purposes. 9.0 Governing Law and Venue. This Agreement shall be construed and enforced in accordance with the laws of the State of Florida. The parties further agree that in any dispute between them relating to this Agreement, exclusive jurisdiction shall be in the state circuit courts Telecommunications Tower Collocation Consent Agreement DISH Wireless L.L.C. Site ID:ORMc0000s2A �O Page 2 of 8 located in Seminole County, Florida, and in the federal district court in Orlando, Florida, any objections as to jurisdiction or venue in such courts being expressly waived. 10.0 Attorney's Fees. In the event any litigation or controversy arises out of or in connection with this Agreement between the parties hereto, the prevailing party in such litigation or controversy shall be entitled to recover from the other party or parties all reasonable attorney's fees and paralegal fees, expenses and suit costs, including those associated with any appellate or post-judgment collection proceedings. 11.0 Non-Waiver. No delay or failure by either party to exercise any right under this Agreement, and no partial or single exercise of that right, shall constitute a waiver of that or any other right, unless otherwise expressly provided herein. 12.0 Notices. Any notice, request, instruction, or other document to be given as part of this Agreement shall be in writing and shall be deemed given under the following circumstances: (i) when delivered in person; (ii)three (3) business days after being deposited in the United States Mail, postage prepaid, certified or registered; (iii) the next business day after being deposited with a recognized overnight mail or courier delivery service; or (iv) when transmitted by facsimile or telecopy transmission,with receipt acknowledged upon transmission; and addressed as follows (or to such other person or at such other address, of which any party hereto shall have given written notice as provided herein): To City of Winter Springs: City Manager 1126 East S.R. 434 Winter Springs, Florida 32708 PH: (407) 327-5957 FAX: (407) 327-4753 To Dish: DISH Wireless L.L.C. Attn: Lease Administration 5701 South Santa Fe Drive Littleton, Colorado 80120 DISH Site ID: ORMCO00092A Phone: (303) 703-1352 13.0 Counterparts. This Agreement may be executed in any number of counterparts, each of which when so executed and delivered, shall be an original; but such counterparts shall together constitute but one and the same instrument. 14.0 Public Record. It is hereby specifically agreed that any record, document, computerized information and program, audio or video tape,photograph, or other writing of Dish related to this Agreement, may be deemed to be a Public Record whether in the possession or control of the City or Dish. Said record, document, computerized information and program, audio or video tape, photograph, or other writing of Dish is subject to the provisions of Chapter 119, Telecommunications Tower Collocation Consent Agreement DISH Wireless L.L.C. site ID:ORM0000092A AO Page 3 of 8 �i Florida Statutes, and may not be destroyed without the specific written approval of the City. Upon request by the City, Dish shall promptly supply copies of said public records to the City. All books, cards, registers, receipts, documents, and other papers in connection with this Agreement shall during normal business hours of Dish be open and freely exhibited to the City for the purpose of examination and/or audit. 15.0 Interpretation. The City and Dish have participated in the drafting of all parts of this Agreement. As a result, it is the intent of the parties that no portion of this Agreement shall be interpreted more harshly against either of the parties as the drafter. 16.0 Independent Contractor. Dish shall be considered an independent contractor under this Agreement. 17.0 Entire Agreement. This Agreement represents the entire and integrated Agreement between the parties and supersedes all prior negotiations, representations, or Agreements, either oral or written, and all such matters shall be deemed merged into this Agreement. 18.0 Sovereign Immunity. The City intends to avail itself of the benefits of Section 768.28, Florida Statutes, and any other statutes and common law governing sovereign immunity to the fullest extent possible. Neither this provision nor any other provision of this Agreement shall be construed as a waiver of the City's right to sovereign immunity under Section 768.28, Florida Statutes, or other limitations imposed on the City's potential liability under state or federal law. Dish agrees that City shall not be liable under this Agreement for punitive damages or interest for the period before judgment. Further, City shall not be liable for any claim or judgment, or portion thereof, to any one person for over two hundred thousand dollars ($200,000.00), or any claim or judgment, or portion thereof, which, when totaled with all other claims or judgments paid by the State or its agencies and subdivisions arising out of the same incident or occurrence,exceeds three hundred thousand dollars ($300,000.00). Nothing in this Agreement is intended to inure to the benefit of any third party for the purpose of allowing any claim which would otherwise be barred under the doctrine of sovereign immunity or by operation of law. This paragraph shall survive termination of this Agreement. 19.0 General Liability Insurance. Dish shall purchase and maintain, at its own expense, such general liability insurance and automobile liability insurance to cover claims for damages because of bodily injury or death of any person or property damage arising in any way out of Dish's use of the Subleased Parcel, Tower, or utility and ingress and egress easements. The insurance shall have minimum limits of coverage of $1,000,000.00 per occurrence combined single limit for bodily injury liability and property damage. This shall include, but not be limited to, automobile liability of owned vehicles, hired and non-owned vehicles, and employee non- ownership. All insurance coverage shall be with insurer(s) approved by the City Manager and licensed by the State of Florida to engage in the business of writing of insurance. The City shall be named on the foregoing insurance policies as "additional insured." Dish shall cause its insurance carriers to furnish insurance certificates and endorsements specifying the types and amounts of coverage in effect pursuant hereto,the expiration dates of such policies,and a statement that no insurance under such policies will be canceled without thirty(30) days prior written notice to the City in compliance with other provisions of this Agreement. If the City has any objection Telecommunications Tower Collocation Consent Agreement DISH Wireless L.L.C. Site ID:ORMc0000s2A Page 4 of 8 AO to the coverage afforded by or other provision of the insurance required to be purchased and maintained by Dish in accordance with this paragraph on the basis of its not complying with the Agreement, the City shall notify Dish in writing thereof within thirty (30) days of the date of delivery of such certificates and endorsements to the City. The City, at its discretion, reserves the right to require Dish to obtain reasonable increases in the insurance coverage set forth in this paragraph. Dish shall continuously maintain such insurance during the term of this Agreement in the amounts, type, and quality as required by this paragraph. 20.0 Indemnification and Hold Harmless. Dish shall indemnify and hold harmless the City and its employees, officers, attorneys, agents, and contractors from and against all claims, losses, damages, personal injuries (including but not limited to death), or liability to the person or property (including reasonable attorney's fees through any and all administrative, trial, post judgment and appellate proceedings), directly or indirectly arising from the negligent acts, errors, or omissions, intentional or otherwise, arising out of or resulting from Dish's and its employee's, agent's, and contractor's use and occupancy of the Subleased Parcel,Tower, and utility and ingress and egress easements. This indemnification shall survive the expiration or termination of this Agreement. The indemnification provided above shall obligate Dish to defend at its own expense or to provide for such defense, at the sole option of the City, as the case may be, of any and all claims of liability and all suits and actions of every name and description that may be brought against the City or its employees, officers, and attorneys which may result from Dish's and its employee's, agent's, and contractor's use and occupancy of the Subleased Parcel,Tower, and utility and ingress and egress easements. In all events the City shall be permitted to choose legal counsel of its sole choice, the fees for which shall be subject to and included with this indemnification provided herein, as long as said fees are reasonable. 21.0 Standard of Care. hl using the Subleased Parcel, Tower, and utility and ingress and egress easements, Dish shall use that degree of care and skill ordinarily exercised, under similar circumstances by reputable members of its profession practicing in the same or similar locality. 22.0 Termination. If Dish defaults in fulfilling any of the covenants of this Agreement and such default shall continue for sixty (60) days after Dish's receipt of written notice from the City specifying the nature of said default, or, if the said default so specified shall be of such a nature that the same cannot be reasonably cured or remedied within such sixty(60) days and Dish shall not in good faith commence the curing or remedying of such default within such sixty (60) days and shall not thereafter diligently proceed therewith to completion, then in any one or more of such events this Agreement shall terminate and come to an end as fidly and completely satisfied and Dish shall then quit and surrender the Subleased Parcel and the right to use the utility and ingress and egress easements as provided herein and remove its communications equipment and related facilities as set forth in paragraph 33.0. 23.0 Dish's Signatory. The undersigned person executing this Agreement on behalf of Dish hereby represents and warrants that he/she has the full authority to sign the Agreement on behalf of Dish and to fully bind Dish to the terms and conditions set forth in this Agreement. Telecommunications Tower Collocation Consent Agreement DISH wireless L.L.C. Site ID:ORMC000092A Page 5 of 8 AO 24.0 Not Recordable. The parties understand and agree that neither this Agreement nor any sublease shall be recorded in the public records. 25.0 Hazardous Materials. Dish represents and warrants that its use of the Subleased Parcel, Tower, and the utility and ingress and egress easements will not generate any hazardous substance and that Dish will not in violation of any applicable law or regulation, store or dispose on or near the Subleased Parcel, Tower, and the utility and ingress and egress easements, any hazardous substance. Dish shall indemnify and hold harmless the City and its employees, officers, attorneys, agents, and contractors from and against all claims, losses, damages, personal injuries (including but not limited to death), or liability to the person or property (including reasonable attorney's fees through any and all administrative,trial,post judgment,and appellate proceedings), directly or indirectly arising from the generation, storage, disposal, transportation, or use of Hazardous Materials by Dish and its employees, agents, and contractors on the Subleased Parcel, Tower, and the utility and ingress and egress easements. For purposes of this Agreement, Hazardous Materials shall mean gasoline, petroleum and other petroleum by products, asbestos, explosives,PCBs,radioactive material,or any"hazardous"or"toxic"material, substance,or waste which is defined by those or similar terms or is regulated as such under any statute,law, ordinance, rule, or regulation of any governmental authority having jurisdiction over the Subleased Parcel, Tower, or utility and ingress and egress easements or any portion thereof or its use, including any material, substance, or waste which is defined as: (i) a "hazardous substance" under the Water Pollution Control Act (33 U.S.C. Section 1251 et seq., as amended); (ii) "hazardous waste" under the Resource Conservation and Recovery Act of 1976 (42 U.S.C. Section 6901 et seq., as amended); (iii) a "hazardous substance" or "hazardous waste" under the Comprehensive Environmental Response, Compensation and Liability Act of 1980 (42 U.S.C. Section 9601 et seq., as amended, or any other superfittld law); (iv) a "hazardous chemical" under 29 C.F.R. Part 1910; or (v) a "pollutant" or "contaminant" under 42 U.S.C. Section 9601. This indemnification shall survive the expiration or termination of this Agreement. 26.0 Liens. Dish shall keep the Subleased Parcel and utility and ingress and egress easements free from any liens arising out of any work performed for, materials furnished to, or obligations incurred by or on behalf of Dish. Dish shall also hold the City harmless against any such liens and shall take immediate action to remove any such lien should one be filed against any property owned by the City as a result of work performed or as a result of under this Agreement for or on behalf of Dish. 27.0 Condemnation. If the whole of the Subleased Parcel or utility and ingress and egress easements,or such portion thereof as will make said parcel unusable for the purposes herein subleased, are condemned by any legally constituted authority for any public use or purpose, then in either of said events the term hereby granted shall cease from the time when possession thereof is taken by public authorities, and rental shall be accounted for as between Dish and City as of that date. 28.0 Damage or Destruction. Notwithstanding any other provision of this Agreement, Dish shall bear the risk of loss or damage to its communications equipment and personal property on the Subleased Parcel, Tower, and utility and ingress and egress easements, except to the extent such loss or damage is caused by the negligence or willful misconduct of the City. Under no circumstances under this Agreement will the City be liable to Dish for economic loss, lost profits, Telecommunications Tower Collocation Consent Agreement DISH Wireless L.L.C. Site ID:ORMcoaoos2A A Page 6 of 8 AO loss of business, loss of market share, or any other incidental, punitive, special, or consequential damages of any nature whatsoever even if informed of the possibility of such damages. 29.0 Maintenance. Dish shall be solely responsible for maintaining its communications equipment and personal property in a safe and good condition, working order, and repair. Dish shall be solely responsible for promptly repairing damage to its communications equipment and personal property. Dish shall keep the Subleased Parcel, Tower, and utility and ingress and egress easements free of debris and anything dangerous, noxious, or offensive in nature which would create a hazard or undue vibration, heat, or noise. 30.0 Utilities. Dish shall provide for its own utilities and shall be responsible for paying such utilities. 31.0 Taxes. Dish shall pay any and all taxes and assessments levied upon Dish's communications equipment and personal property used or kept on the Subleased Parcel, Tower, or utilities and ingress and egress easements. 32.0 Rent. Upon the effective date of this Agreement, Dish acknowledges and agrees that Dish shall pay the City one thousand and no/100 dollars ($1,000.00) per month to sublease the Subleased Parcel, plus applicable taxes and assessments. However, the initial lease payment shall be for $3,000.00 to cover the first three months of this Agreement (January, February and March, 2023), and monthly thereafter. Dish shall remit its rental payments directly to the City, and made payable to the City of Winter Springs. Should Dish fail to make the rent payments under the sublease, the City shall have the right to immediately terminate this Agreement and in such case Dish shall also immediately remove its communications and related facilities from the Subleased Property and utility and ingress and egress easements. 33.0 Removal of Equipment. Upon termination of this Agreement, Dish shall, within sixty (60) days, remove all of its communications equipment and related facilities from the Subleased Parcel and utility and ingress and egress easements and restore said property to its original above grade condition,normal wear and tear and loss due to other casualty beyond Dish's control excepted. If such time for removal causes Dish to remain on the Subleased Parcel after termination of this Agreement, Dish shall pay rent directly to the City in the amount of four thousand and no/100 dollars ($4,000.00) per month until such time as the removal of the communications equipment and related facilities are completed. Upon terrilination of this Agreement and removal of Dish's communication equipment and related facilities, Dish shall be released of any liability occurring on the Subleased Property and utility and ingress and egress easements after such termination and removal. 34.0 Modification. Modifications of this Agreement shall only be made in writing signed by both parties. 35.0 Compliance with Laws. Dish shall comply with all local, state, and federal laws and regulations regarding the construction, placement, maintenance, and use of Dish's communications equipment and related facilities. 36.0 Signs. Unless required by law, Dish shall not place any sign(s) on the Subleased Property, Tower, or utility and ingress and egress easements. Telecommunications Tower Collocation Consent Agreement DISH Wireless L.L.C. Site ID:ORMC000092A Page 7 of 8 AO IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the day and year last written below. CITY OF WINTER SPRINGS, a Floridan cipal c oration. ATTEST: OT1 Shawn Boyle, Ci y Manag Date: lO Christian Gowan, City Clerk w • o��Itl;� WITNESS: D + +SS L.L.C., a Colorado L ited 'abi it o By: P int Name: 3e In htX ah( J Print Name:D vid Ma o Title:EVP etwo/rk Devel ment Print Name: tf,( Date: Telecommunications Tower Collocation Consent Agreement DISH Wireless L.L.C. site to:ORMc0000s2A Page 8 of 8 ,�Q Exhibit A LAND QESCRIPMCN. (= TOM s m ' A PARCEL OF UWO =NO A PORTION OF (CT.100. 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AMMAM EAST MGM OF WAY LM CE MCRE USDA, TSENIC'1f:.X-04G SAM EAW' Rt1 'OF WA'1( NO=07°I1,Tr W=.,ADL'ST"C$.OF 20.07 PINT TO THEP4DU OF mD LA1►m5 sTUATE iN mm crr OF wm=mw=4 SmmqQI.E cotwy-Et.QX m,, AI+R;►CONTAM*a.M ACM(9a,MSQCAPE•Mgn(WLAND.MMEOR.IESS Ao DATE(MM/DD/YYYY) AC"RV CERTIFICATE OF LIABILITY INSURANCE 8/1/2023 1 12/19/2022 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). CONTACT PRODUCER Lockton Companies NAME: 8110 E Union Avenue PHONE FAX Suite 100E-MAIL Ext: AIC No Denver CO 80237 ADDRESS: (303)414-6000 INSURERS AFFORDING COVERAGE NAIC# INSURER A:ACE American Insurance Cornpany 22667 INSURED DISH Network Corporation INSURER B: 1033161 DISH Network LLC INSURER C: 9601 S.Meridian Blvd. INSURER D: Englewood,CO 80112 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 19202764 REVISION NUMBER: XXXXXXX 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 ADDLTYPE OF INSURANCE INSD SUER POLICY NUMBER MMIDD/YYYY MM DDPOLICY EFF Y EXP LTR LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A X Y N XSL G47332175 8/1/2022 8/1/2023 DAMAGE TO RENED CLAIMS-MADE [A]OCCUR PREMISES Ea occTurrence $ 300,000 X Standard MED EXP(Any one person) $ XXXXXXX Contractual Liab. PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4 000 000 POLICY❑jE O N LOC PRODUCTS-COMP/OP AGG $ 4 000 000 X OTHER:SIR$500 000 $ AUTOMOBILE LIABILITY NOT APPLICABLE COMBINED SINGLE LIMIT $ Ea accident XXXXXXX ANY AUTO BODILY INJURY(Per person) $ XXXXXXX OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS XXXXXXX HIRED NON-OWNED PROPERTY DAMAGE $ XXXXXXX AUTOS ONLY AUTOS ONLY Per accident $ XXXXXXX UMBRELLA LIAB _ OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS-MADE AGGREGATE $ XXXXXXX DIED RETENTION$ $ XXXXXXX WORKERS COMPENSATION NOT APPLICABLE AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ XXXXXXX OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ XXXXXXX If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ XXXXXXX DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) RE:Property at 411 Shore Rd,Winter Springs-DISH Site ID ORMC000092A City of Winter Springs is included as Additional Insured as respects General Liability if required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 19202764 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Winter SpringsACCORDANCE WITH THE POLICY PROVISIONS. 1126 East State Rd 434 AUTHORIZED REPRESENTATIVE _ rt Winter Springs,FL 32708 ©1988-205 ACORD CORP66VRATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Form W=9 Request for Taxpayer Give Form to the (Rev.October2018) Identification Number and Certification requester. Do not Department of the Treasury send to the IRS. Internal Revenue Service ►Go to www.irs.gov/FormW9 for instructions and the latest information. 1 Name(as shown on your income tax return).Name is required on this line;do not leave this line blank. DISH WIRELESS HOLDING L.L.C. 2 Business name/disregarded entity name,if different from above DISH WIRELESS L.L.C. TIN 35-2576388 M 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check only one of the 4 Exemptions codes apply only to � P Y P ( PP Y Y ro following seven boxes, certain entities,not individuals;see a instructions on page 3): o ElIndividual sole proprietor or ElC Corporation ElS Corporation ElPartnership ElTrust/estate c single-member LLC Exempt payee code(if any) �6 ❑✓ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)► C `p 2Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting 4' y LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is code(if any) another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC that n is disregarded from the owner should check the appropriate box for the tax classification of its owner, w y ❑ Other(see instructions)► (Applies to accounts maintained outside the U.S.) N5 Address(number,street,and apt.or suite no.)See instructions. Requester's name and address(optional) in 9601 S MERIDIAN BLVD 6 City,state,and ZIP code ENGLEWOOD CO 80112 7 List account number(s)here(optionao Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number backup withholding.For individuals,this is generally your social security number(S .However,for a -m - resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later. For other entities,it is your employer identification number(EIN).If you do not have a number,see How to get a TIN, later. or Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and Employer identification number Number To Give the Requester for guidelines on whose number to enter. F R - 3 4 4 6 5 M23 Certification Under penalties of perjury, I certify that; 1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and 2. 1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am no longer subject to backup withholding;and 3.1 am a U.S.citizen or other U.S.person(defined below);and 4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct. Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid, acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions for Part 11,later. Sign Signature of Here U.S.person (= Date 0- 08/22/2022 General Instructions •Form 1099-DIV(dividends,including those from stocks or mutual funds) Section references are to the Internal Revenue Code unless otherwise s Form 1099-MISC(various types of income,prizes,awards,or gross noted. proceeds) Future developments.For the latest information about developments . Form 1099-B(stock or mutual fund sales and certain other related to Form W-9 and its instructions,such as legislation enacted transactions by brokers) after they were published,go to www.irs.gov/FormW9. •Form 1099-S(proceeds from real estate transactions) Purpose of Form •Form 1099-K(merchant card and third party network transactions) An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest), 1098-E(student loan interest), information return with the IRS must obtain your correct taxpayer 1098-T(tuition) identification number(TIN)which may be your social security number • Form 1099-C(canceled debt) (SSN),individual taxpayer identification number(ITIN),adoption .Form 1099-A(acquisition or abandonment of secured property) taxpayer identification number(ATIN),or employer identification number (EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident amount reportable on an information return.Examples of information alien),to provide your correct TIN. returns include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might •Form 1099-INT(interest earned or paid) be subject to backup withholding.See What is backup withholding, later. Cat.No.10231X Form W-9(Rev.10-2018)