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HomeMy WebLinkAboutInsurance Certificate: Charter Communications 1]~l 345-5000 10/31/2012 10:25:30 PM PAGE 2/004 Fax Server .ac RU CERTIFICATE OF LIABILITY INSURANCE DA F 16137/YUt 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 be endorsed. R 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 UUWACT Marsh USA Inc. NAME: 701 Market Street, Suite 1100 PHONE FAX SL Louis, MO 63101-1830 &N-Lo Eat No Attn: s000ls.ceftrEQUesl@nlnlsh.fgfll (fait) 212.948-0811 ADDRESS: INSURERS AFFORDINGC- mRAGE NAIOM 405245-ALL-GAWU-12-13 FCSGI INSURER A; OM Republic Insurance Co 24147 INSURED ' North American Eke Irsuralrce Can an Charter Comnenialions Inc. INSURER e : p Y 29700 12405 Pmversmurt Drive INSURER C St. Louis, MO 63131-3674 INSURER D INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: CHI.003949642-37 REVISION NUMBER:3 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. INSq LTR TYPE OF INSURANCE POUCYNUMSER MWDDY EFF IAWDDtYYY P UMRS A GENERALLJABIUTY MWZY 59975 111012012 11/012013 EACH OCCURRENCE $ 2,000,000 X COMMERCIAL GENERAL LIABILITY 500000 PREMISES Ea oocurren® $ CLAIMSMADE X OCCUR MED EXP(Any -a person) S 10,000 PERSONAL BADV INJURY $ 2,000.000 GENERALAGGREGATE $ 2,000,11(10 GENL AGGREGATE UMIT APPLIES PER: PRODUCTS-COMP/OP qGG $ 2,000,000 X POLICY PRO. LOC IFCT A AUTOMOBILE LIABILITY MWTB 21831 11/012012 111012013 X ANVAUTO aadent 2,000,000 ALL OWNED SCHEDULED EDGILY LV INJURY leer perem) $ AUTOS BOOILY INJURY (PB-xOdanO $ AUTOS X X NON-0VnaED HIRED AUTOS AUTOS PRO PITY DAMAGE ' erarn'tlem $ B X umBRElln uq6 OCCUR H20000042601 11/012012 111012013 EXCESS L" EACH OCCURRENCE $ 5,1X10,000 CWMSdAADE DED RETENTION AGGREGATE $ 5,000,00 A WORKERS COMPENSATION MWC 11810800 11/012012 11/012013 X WC STATU- OTH- $ AND EMPLOYERS' LNBkJTY Y/N RTI OFFI PR CEIVIVEMER OPMUCAPAC UDED?ECImVE N❑ N/A E.L EACH ACCIDENT $ 2,000,000 (Mandorory in NH) Ifylre, Oeavibe urger E.L DISFl,SE FA EMPLOYE $ 2,000.000 DESCRIPTION!OPERATIONSw. E.LDISEASE POLICYUMIT S 2•~•Om DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES (Attach ACORD 101, ACUltic Remarks ScheOUlB, If more apace is requlrm) (See reverse anlAorarached foraddilional information) CERTIFICATE HOLDER CANCELLATION City of Ashland C 20 i East Main Street SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE Ashland, OR 97531 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Morah USA Inc. Manashi Mukherjee -]12tay,tJploh;..~q,µ„tr'nri ACORD 25 ©1988.2010 ACORD CORPORATION. All rights reserved. (2010/05) The ACORD name and logo are registered marks of ACORD 212 345-5000 10/31/2012 10:25:30 PM PAGE 3/004 Fax Server AGENCY CUSTOMER ID: 405245 LOC St. Louis ACORO® ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh USA inc. - Charier Communiations Ina 12405 Pow2rscaurt Dnve POLICY NUMBER SL LOnh, MO 63131-3674 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, ' FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Chaney Communications. Inc. and their. - subsidiaries, associated, affiliated and inter-related companies; - controlled or majority (more than 50%) owned partnerships, limited habdity mmparte r - interest only in (or its subsidaries' interest in) any other partnerships or joint ventures or limited liability Companies; - interest in (or its subsidiaries' interest h) any company or orgaNzaton coming under its active management or control; any entry or Imply required to be insured under any contract oragreemem which may now ebs4 may have previously amled, or may hereafter be created or acquired. American Cable Entertainment Company, LLC Charter Communications, LLC Intedink Communication Partners, LLC Athens Cableveton, Inc. Charter Video Electronics, Inc. Long Beach, LLC Aumble Cable TV Inc. Dalton Cablevision, Inc. Marcus Cable Associates, LLC Cable Equities Colorado, LLC Falcon Cable Media. a CA LP Marcus Cable of Alabama, LLC CC10, LLC Falcon Cable Systems Company II, LP Manors Cable, Inc. CC Michigan, LLC Falcon Cablevision, a CA LP MidAest Cable Communications. Ina CC Systems, LLC Falcon Comm rity Cable. LP Peachtree Cable N, LP CC VIti Operating, LLC Falcon CommunityVen4res I, LP Plattsburgh Cablevison, Inc. Charter Cable Pal LLC Falcon First Cade of New York, Inc. Renaissance Media, LLC Charter Communications Entertainment 1. DST Falcon First Cable of the Southeast, Inc. Rifkin Acquisition Partrlers, LLC Charter Communications Entertainment l,LLC Falcon Telecable, a CA LP Robin Media Group, Inc Charter Communications Entertainment II, LLC Falcon Video Communicatons. LP Scottsboro TV Cable, Inc Charter Communications Operatng, LLC The Helicon Group, LP Tennessee, LLC Charier Communications Properties. LLC Hometown TV, Inc Toga Cable Company, Inc Charter Communm ons V, LLC HPI Acquisition Co., LLC Vista Broadband Communications, LLC Charter Communications VI. LLC ...and any corporation or other business organization other than a joint venture a which the Named Insured shown in the declarations has or acquires dunag the policy period an ownership of more than 50% and which is domlcied wihin the United States of America, its temitodes orpossessions, Puerto Rim or Canada. Entity. Falcon Cable Systems Company It, LP CertiGmte Holder is named as Additional Insured under the General Lability as respems franchise agreement Additional Insured status becomes effective once the contract oragreement is filly exemted. Ordinance 022M dated May 17, 1983. ACORD 101 (2008/01) 02008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 212 345-5000 10/31/2012 10:25:30 PM PAGE 4/004 Fax Server Cassandra Shon \ r ` March USA Inc. \a.d~~j 701 Markat Sira4t- swte noo Si Louis, MO 83voi-1830 +1314 342 2405 cassmcra.shor[CMM;s sh. rn www.imwsh.com October 31, 2012 .Dear Certificate Holder: In order to serve you better, we would like to forward future renewal certificates via facsimile f e- mail. Please clearly indicate your fax number or a-mail address on the front of the enclosed Certificate of Insurance and fax to: Marsh USA fnc. 212-948-0811 fax or Email to` stlouis.certrequestoa marsh.com If the Certificate is no longer required, please indicate on the front of the Certificate and fax or e- mail to the number/address referenced above. Thank you for your assistance. Lassie Short Client Representative Marsh USA Inc. p MARSHta WIFNIVAN