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HomeMy WebLinkAboutInsurance Certificate: Charter Communications (2) 212 345-5000 10/31/2012 10:19:39 PM PAGE 2/004 Fax Server CERTIFICATE OF LIABILITY INSURANCE DATEJ2012 vYY) 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. 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 a . - PRODUCER Marsh USA Im NAME: 701 Market StreeL Suite 1100 PHONE FAA SL Louis, MO 63101-1830 NC i, Ert : A/C No I W N AMMn: sdouis.certrequest@nnarsh.mm (fax) 212.948-0811 ADDRESS: INSURER' I AFFORDING COVERAGE NAIC a 405245-ALL-GAWU-12-13 FTCB y MDF- OMRepublic lrsulance Co INSURER A: 24147 INSURED N/A Charter Communications Inc. INSURER a N/A 12105 PuMerseourt Drive INSURER C SL Louis, MO 63131.3674 INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: CHI4103954149.37 REVISION NUMBER:4 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. Ext, NSR LTR TYPE OF INSURANCE POLICY NUMBER MMIDDDY/WYy MMIDDY LIMBS A GENERAL LIABIUTY MWZY 5W75 111072012 11/012013 2,000,000 X EACH OCCURRENCE S COMMERCIAL GENERAL UABILITY PREMISES Fa odcuDence $ 500000 CLAIMS MADE OCCUR MEDEXP(Mymepenwn) S 10,000 PERSONAL 8 ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE UMIT APPLES PER: X POLCV PRO- Lm PRODUCTS-COMP/OP AGG $ 2,000,000 E A AIITOMOaILE UABIUTr MWTB 21831 111012012 11/072013 aacddcni 2,000,000 ANY AUTO ALLOWNED SCHEDULED BODILY INJURV(Par nwn) $ AUTOS AUTOS BODILY INJURY (Per aa asYdnnt) $ X HIRED AUTOS X NON-OWNED PROPERTY er O~deM~MAGE $ $ UMBRELLA LIAR OCCUR EXCESS LUIB EACH OCCURRENCE $ CI-AIMS-MADE AGGREGATE g OLD RETENTION A WORKERS COMPENSATION MWC118108 (q $ AND EMPLOYERS' UASIUTY 11/0771012 11/012013 X WC 37ATU- OTH- OFFI LEfLMEkSEHEXRCLUOE/EXECImVE YN❑ N/A EL EACH ACCIDENT $ 2, .000 (Mandary in OFYFI ERIMEMBER E E.L. DISEASE - EA EMPLOYE $ 2,000,000 DESCRIPtomCNNH) OFOPERATONSwow E.LDISEASE-POLICYUMIT $ 2.000,000 DESCRIPTON OF OPERATIONS /LOCATONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space IB reRulrad) (See reverse andlor attached for addibmal infomaGon) CERTIFICATE HOLDER CANCELLATION Ciy of Ashland 20 East Main Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 Ashl, OR ast ai 97527 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATiiE of Marsh USA Inc. Manashi Mukherjee -Ma'vwnior,:. .1Y4-.1Xr a~LAty © 1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD L1G ss~-5oo0 10/31/2012 10:19:39 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 US41nC. Charter CgmMoniation5lnC POLICY NUMBER 124 5FbwlY9M DnVe St LOU19, MO 6313L3674 CARRIER Ni CODE EFFECTIVE OAlE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Caltiflcate of Liability Insurance Chi Commuratr s. Inc and (heir. , - subsidiaries. associated. affiliated and inter-related companies; controlled or majority (more than 50%) owned partnerships, limited liability, companies; interest only in (wits subsidamm' interest in) any other partnerships orjoinl ventures or limited liability companies; - interest in (orits subs idiares' interest in) any company or organiraton coming under its active management or control; any entry or party required to be insured underany, contract or agreement witch may now east may have previously edsted, or may hereafter be neared oracquired. American Cable Emeriti Company, LLC Charter Communications, LLC Intertink Communication Partners, LLC Athens Cablevision, Inc Charer Mdeo Electronics, Irc, Long Beach LLC A,usable 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 Marcos Cable, Inc. CC Michigan, LLC Falcon CaNevision, a CA LP Midwest Cable Communications, Inc CC Systems, LLC Falcon Community Cade, LP Peachree Cable TV, LP CC VI40peratig, LLC Falcon CommunityVen4aes 1. LP Plattsburgh Cablevision, Inc Charter Cable Farmers, LLC Falcon First Cade of New York, Inc. Renaissance Media, LLC Charter Communications Entertainment 1, DST Falcon First Cable of the Southeast Inc. Rifldn Acquisiton Partners, LLC Charter Communications Entertainment l,LLC Falcon Teleable, a CA LP Robin Media Group inc. Charter Communications Entertainment ll,LLC Falcon Video Communiations. LP Scottsboro TV Cable, Inc Chaser Communications Operating, LLC The helicon Group, LP Tennessee. LLC Charter Communications Properties, LLC Hometown TV, Inc Tloga Cable Company, Inc. Charter Communications V. LLC FPI Acquisition Co., LLC Vista Broadband Communications, LLC Chester Communications N, LLC ...and any corporation or other business organization other than a joint venture in which the Named Insured shown in the declarations has oracquires doing the policy period an ownership of more than 50% and which is domiciled within the United Slates of Arai its tenAones orpossessiom, Puerto Rico or Canada. Entity. Falcon Teleable, a Catifoma Limited Partnership The Cry of Ashland, its officers, employees and agents are named as Accluoaal Insured under the General L'abiliry policies as their interests mayappear. Additional Insured slalus becomes effective once the Centrad or agreement is fuly, executed. ACORD 101 (2008101) 02008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD clz s45-5o00 10/31/2012 10:19:39 PM PAGE 4/004 Fax Server Cassandra Short D Marsh USA Inc. \`L.d~\~S ~ 7olMarkatStreel- Suite 1 too Si. Louis, MO 631o1-1830 +1 314342 2406 Cass andra.sho ngrnarsh-.COT w .marsh.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 e-mail address on the-front of the enclosed Certificate of Insurance and fax to: Marsh USA Inc. 212-948-0811 fax or Email to: stlouis.certrequest@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. U Cassie Short Client Representative Marsh USA Inc. MARSH & M[t.ENNA N