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HomeMy WebLinkAboutInsurance Certificate: Charter Communications (2) 212 345-5000 10/30/2015 9:56;58 PM PAGE 2/003 Fax Server AGUR°~ CERTIFICATE OF LIABILITY INSURANCE DAmMo' 11 5 16-1 ' 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(s). PRODUCER NAME: Marsh USA Inc. PHONE FAX 701 Market Street, Suite 1100 AC Ext: AC No. St.Louls,MO 63101-1830 ADDRESS: Attn: StLouis.CertRequestramarsh.com Fax:212-948-C811 INSURERS) AFFORDING COVERAGE NAIC# FTCB y MDF- INSURER A:Old Republic Insurance Company 24147 INSURED INSURER B : N/A N/A Charter Communications, Inc. 12405 Powerscourt Drive INSURER C: St. Louis, MO 63131 INSURER D: INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: CHI-OC6004589-53 REVISION NUMBER:5 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 PAI D CLAI MS. IL R TYPE OF INSURANCE POLICY NUMBER II WDD/ YY (MMU/DD/YYYY) Lill A X COMMERCIAL GENERALLIABILI Y 1305715 11/01/2015 11/01,2016 EACH OCCURRENCE $ 2,000,000 CLAIMS MADE OCCUR PREMISES Fa occrrrence $ 500,000 MED EXP (Arty one person) $ 10,000 PERSONAL&AlINJURY $ 22000,000 GENLAGGREGATE UMITAPPUES PER: GENEPALAGGREGATE $ 2,000,000 ECT El LOO PROD UCTS-CCMP/OPAGG $ 2,000,000 X POLICYF-IL PRC- OTHER: $ A AUTOMOBILE LIABILITY MWTB305710 11/0112015 11/01/2016 (Ea accident) LIMIT $ 2,000,000 X ANYAUTO BODILY INJURY(Per person) $ AL ALO ED ~EEDDULED BODILY INJURY (Per accident) $ X HIREDAUTOS LX AUNON-O PROPERTY DAMAGE TOS ED (Peracade[T) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ DED RETENTION $ $ A WORKERS CO1V1PE16ATION M W C 305714 00 11/01/2015 11 /01(2016 X STATUTE ER AND EIVPLOYERS UABIUTY Y/N ANY PROPRIETORPARTNERiEXECUTIVE T N/A E. L EACH ACCIDENT $ 2,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L DISEASE - EA EMPLOYE $ 2,000,000 If es describe under DS~RIPTIONOFOPERATIONS below E.LDISEASE - POLICYJMIT $ 2,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACOFD 101, Additional Remarks Schedule, may be attached if more space is required) (See reverse ai attached br additimal information) CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 East Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland, OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mikherjee Cra * - +~t {e a I © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 212 345-5000 10/30/2015 9:56:58 PM PAGE 3/003 Fax Server AGENCY CUSTOMER ID: 405245 LOC St. Louis Aco ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh USA Inc Charter Carrrurrcations, Inc. 12405 Powerscourt Dive POLICY NUMBER St. Louis, MO 63131 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 Charter Communications, Inc andtheir. subsidiaries, associated, affiliated and inter-related companies; controlled or major ty (more than 50%) owned partnerships, limited liability companies; interest only in (or its subsidiaries' interest in) any other partnerships or joint ventures or limited liability companies; interest in (or its subsidiaries' interest in) any company or organization coming under its active management or control; any entity or parry required to be insured under any contract or agreement which may now exist, may have previously existed, or may hereafter be created or acquired, American Cable Entertainment Company, LLC Charter Communications VI, LLC HPI Acquisition Co., L L.C. Athens Cablevision, Inc. Charter Communications V, LLC Intedink Communication Partners, LLC Ausable Cable TV, Inc. Charter Communications, LLC Long Beach, LLC Cable Equities Colorado, LLC Charter Video Electronics, Inc. Marcus Cable Associates, LL.C. CC 10, LLC Dalton Cablevision, Inc. Marcus Cable of Alabama, LLC, CC Michigan, LLC Falcon Cable Media, a California Limited Partnership Marcus Cable, Inc, CC Systems, LLC Falcon Cable Systems Company II, L P Midwest Cable Communications, Inc. CC VI II Operating, LLC Falcon Cablevision, a California Limited Partnership Peachtree Cable N, L. P. CCO SoCal I, LLC Falcon Community Cable, L. P, Plattsburgh Cablevision, Inc. CCO SoCal II, LLC Falcon Community Ventures I Limited Partnership Renaissance Media, LLC Charter Cable Partners, L LC Falcon First Cable of New York, Inc, Rifkin Acquisition Partners, LLC Charter Communications Entertainment I, LLC Falcon First Cable of the Southeast, Inc, Robin Media Group, Inc. Charter Communications Entertainment 11, LLC Falcon Telecable, a Calrfomia Limited Partnership Scottsboro TV Cable, Inc. Charter Communications Operating, LLC Falcon Video Communications, L P. Tennessee, LLC Charter Communications Properties LLC The Helicon Group, L.P. Tioga Cable Company, Inc, Bresnan Communications, LLC Hometown TV, Inc, Vista Broadband Communications, LLC Bresnan Digital Services, LLC Bresnan Broadband Holdings, LLC Bresnan Microwave of Montana, LLC Bresnan Broadband of Utah, LLC Bresnan Broadband of Colorado, LLC Bresnan Broadband of Montana, LLC Bresnan Broadband of Wyoming, LLC ..and any corporation or other business organization other than a joint venture in which the Named Insured shown in the declarations has or acquires during the policy period an ownership of more than 50°r and which is domiciled within the United States of America, its territories or possessions, Puerto Rico or Canada. Entity: Falcon Telecable, a California Limited Partnership The City of Ashland, its officers, employees and agents are added as Additional Insured to the Commercial General Liability policy but only with respects to the requirements of the written contract or agreement with the Named Insured. Additional Insured status becomes effective once the written contract or agreement isfully executed. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MEN 21? 345-5000 10/30/2015 9:56:58 PM PAGE 1/003 Fax Server ■ ■ ■ %0 ■ Facsimile Transmittal Sheet MARSH An MhK Company From: Rhonda Metech To: City of Ashland Phone: Fax: 541-552-2059 Date: 30-Oct-15 Attention: Time: 09.56 PM Company: CHARTER COMMUNICATIONS Message: The information contained in this./acsimile message is confidential, may be privileged, and is intended far the use of the individual or entity named above. If you, the reader of this message, are not the intended recipient, the agent, or employee responsible for delivering this information to the intended recipient; you are expressly prohibited from copying, disseminating, distributing, or in any other way using any of the information contained in this facsimile message. w M -41 :8 . sf nl op as sva"R