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HomeMy WebLinkAboutInsurance Certificate: Charter Communications 212 345-5000 12/16/2016 7:16:31 PM PAGE 2/005 Fax Server 0 DATE (MNVDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12116/2016 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 CONTACT NAME: Marsh USA Inc. PHONE FAX 701 Market Street, Suite 1100 A/e No Ext : A/C No )7 St. Lou s, MO 63101-1830 E-MAIL Al StLouis CertRecluest(gmarsh com Fax: 212-948-0811 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # FTCB y MDF- INSURER A : Commerce & Industry Insurance Company 19410 INSURED INSURER B : National Union Fire Ins Co Pittsburgh PA 19445 Charter Communications, Inc. 12405 Powerscourt Drive INSURER C : New Hampshire Insurance Company 23841 St. Louis, MO 63131 INSURER D : N/A N/A INSURER E : Insurance Company State Of Pennsylvania 19429 INSURER F COVERAGES CERTIFICATE NUMBER: CHI-006004589-60 REVISION NUMBER:5 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO -HF 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 MA`s 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MWDD/YYYY A X COMMERCIAL GENERAL LIABILITY 3629906 0110112017 0110112018 EACH OCCURRENCE $ 2,000,000 DAMAGE 70 73 nce $ 500,000 CLAIMS-MADE lx] OCCUR PREMISES ( RENTED MED EXP (AnV one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN L AGGREGATE LIMIT APPLIES PER' GENERAL AGGREGATE $ 2,000,000 X POLICY ❑ PRO- ❑ LOC PRODUCTS - COMP/OP AGG $ 2,000,000 JECT OTHER' $ B AUTOMOBILE LIABILITY 1921838 (AOS) 0110112017 01/01!2018 COMBINED SINGLE LIMIT $ 2,000,000 Ea accident B X ANY AUTO 1921839 (MA) 0110112017 0110112018 BODILY INJURY (Per person) $ B ALL OWNED SCHEDULED 1921840 (VA) 0110112017 0110112018 BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS (Per accidentL UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ C WORKERS COMPENSATION 014649697 (AOS) 0110112017 01/0112018 X STATUTE ERH AND EMPLOYERS LIABILITY E Y / N 014649696 WA WI) (WY) 0110112017 01/0112018 2,000.000 (MA) ( ) ( L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EY.ECUTIVE ~ NIA OFFICERYMEMBER EXCLUDED? (Mandatory in II E L. DISEASE - EA EMPLOYEE $ 2,000,000 If Ves, describe under See Additional 2,000,000 DESCRIPTION OF OPERATIONS below Page EL. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) (See reverse andror attached for additional info- nation) 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 Mukherjee'~Ai~7t•:: © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 212 345-5000 12/16/2016 7:16:31 PM PAGE 3/005 Fax Server AGENCY CUSTOMER ID: 405245 LOC St. Louis ACOR© ADDITIONAL REMARKS SCHEDULE Page 2 of 4 AGENCY NAMED INSURED Marsh USA Inc. Charter Communications, Inc. 12405 Powers court Drive POLICY NUMBER St. Louis, MC 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 Workers Compensation Conliii Carrier: New Hampshire Insurance Company Policy Number: 014649698 (MN) Effective Dale: 0110112017 Expiration Dale 01/0112013 Limits: Refer to Workers Comp limits on certificate Carrier: New Hampshire Insurance Comoany Policy Number: 014649699 (AZ) (IL) (i (NC) (Ni (NJ) (PA) (UT) (VA) (VT) Effective Dale: 0110112017 Expiration Dale: 0110112013 Limits: Refer to Workers Comp limits on certifcale Carrier: New Hampshire Insurance Company Policy Number: 01464970C (ME) Effective Dale: 0110112017 Expiration 1 01/01/2013 Limits: Refer to Workers Comp limits on certificate Carrier: New Hampshire Insurance Company Policy Number: 014649701 (CA) Effective Date: 0110112017 Expiration Date 0110112013 Limits: Refer to Workers Comp limits on certifcale Carrier: New Hampshire Insurance Company Policy Number: 014649702 (1 Effective Date: 0110112017 Expiration Dale: 0110112013 Limits: Refer to Workers Comp limits on certificate ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 212 345-5000 12/16/2016 7:16:31 PM PAGE 4/005 Fax Server AGENCY CUSTOMER ID: 405245 LOC St. Louis ACORD ADDITIONAL REMARKS SCHEDULE Page 3 of 4 AGENCY NAMED INSURED Marsh USA Inc. Charter Communications, Inc. 12405 Powerscourt Drive POLICY NUMBER St. Louis, MO 63131 CARRIER NAIC CODE I EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Charier Communications, Inc. and their: subsidiaries, associated, affiliated and inter-related companies, controlled or majority (more than bM,'.) 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 party required to be insured under any contract or agreement which may now exist, may have previous y existed, or may hereafter be created or acquired. American Cable Entertainment Company, Athens Cablevision, LLC, Bresnan Broadband Holdings, LLC, Bresnan Broadband of Colorado, LLC, Bresnan Broadband of Montana, LLC, Bresnan Broadband of Utah, LLC, Bresnan Broadband of Wyoming, LLC, Bresnan Communications, LLC, Bresnan Digital Services, LLC, Bresnan Microwave of MT, LLC, Bright House Networks Information Systems (Alabama), LLC, Bright House Networks Information Systems (California), LLC, Bright House Networks Information Systems (Flo,ida), LLC, Bright House Networks Information Systems (Indiana), LLC, Bright House Networks Info,mat on Systems (Michigan), LLC, Bright House Networks, LLC, Cable Equities Colorado, LLC, CC 10, LLC, CC Michigan, LLC, CC Systems, LLC, CC VIII Fibedink, LLC, CC VIII Operating, LLC, CCO SoCal I, LLC, CCO SoCal II, LLC, Charter Advanced Services (AL), LLC, Charter Advanced Services (CA), LLC, Charter Advanced Services (CO), LLC, Charter Advanced Services (CT), LLC, Charter Advanced Sevices (GA), LLC, Charter Advanced Services (IL), LLC, Charter Advanced Services (LA), LLC, Charter Advanced Services (MA), LLC; Charter Advanced Services (MD), LLC, Charter Advanced Services (MI), LLC, Charter Advanced Services (MN), LLC, Charter Advanced Services (MO), LLC, Charter Advanced Services (MS), LLC, Charter Advanced Services (MT), LLC, Charter Advanced Services (NC) LLC, Charter Advanced Services (NE) LLC, Charter Advanced (NH), LLC Charter Advanced Services (NV), LLC Charter Advanced Services (NY), LLC Charter Advanced Services (OR), LLC Charter Advanced Services (SC), LLC Charter Advanced Services (TN), LLC Charter Advanced Sevices (TX), LLC Charter Advanced Sevices (UT), LLC Charter Advanced Services (VA), LLC Charter Advanced Services (VT), LLC Charte Advanced Services (WA), LLC Charter Advanced Services (WI), LLC Charter Advanced Services (WY), LLC Charter Advanced Services VIII (MI), LLC Charter Advanced Services VIII (MN), LLC Charter Advanced Services VIII (WI), LLC Charter Cable Partners, LLC Charter Communications Entertainment I, LLC Charter Communications Entertainment II, LLC Charter Communications Entertainment VII, LLC Charter Communications Operating, LLC Charley Communications Prooerties LLC Charter Communications A, L.L.C. Charter Communications, LLC Charter Fiberlink - Alabama, LLC Charter Fiberlink - Georgia, LLC Charter Fibedink - III inois, LLC Charter Fiberlink - Maryland II, LLC Charter Fioerlink - Michigan, LLC Charte, Fiberlink - Missouri, LLC Charter Fiberlink - Nebraska, LLC Charter Fiberlink - Pennsylvania, LLC Charter Fiberlink - Tennessee, LLC Charter Fibedink AR-CCVII, LLC Charter Fibedink CA-CCO, I LC Charter Fiberlink CC VIII, I_ LC Charter Fibedink CCO, LLC Charter Fibe•1 ink CT-CCO, LLC Charter Fiberlink I A-CCO, LLC Charter Fibedink MA-CCO, LLC Charter Fibedink MS-CCVI, LLC Charter Fiberlink NC-CCO, LLC Charter Fiberlink NH-CCO, LLC Charter Fibedin< NV-CCVII, LLC Charter Fiberlink NY-CCO, LLC Charter Fibedink OH-CCO, LLC Charter Fioerlink OR-CCVII, LLC Charter Fiberlink SC-CCO, LLC Charter Fiberlink TX-CCO, LLC Charter Filbert ink VA-CCO, LLC Charter Fiberlink VT-CCO, LLC Charter Fiberlink WA-CCVII, LLC Charter Video Electronics, LLC DukeNel Communications I LC Falcon Cable Media, a California I imitec Partnership Falcon Cable Systems Company II, LP. Falcon Cablev Sion, a California Limited Partnersh p Falcon Community Cable, LP. Falcon Community Ventures I Limited Partnership Falcon First Cable of the Southeast, LLC Falcon Tel ecable, a California Limited Partnership Fa con Video Communications, L.P. Hometown T.V., LLC HPI Acquisition Co. LLC Insight Communications Midwest, LLC Insight Communications of Central Ohio, LLC Insight Kentucky Partners II, LP. Interlink Communications Partners, LLC Long Beach LLC Marcus Cable, LLC Marcus Cable Associates, L.L.C. Marcus Cable of Alabama, L.L.C. Midwest Cable Communications, LLC NaviSite LLC Ocearl Time Warner Cable LLC Peachtree Cable TV, L.P. Renaissance Media LLC Rifkin Acquisition Partners, LLC Robin Media Group, LLC Scottsboro TV Cable, LLC The Helicon Group, LP- Time Warner Cable Business LLC Time Warner Cable Enterprises LLC Time Warner Cable Information Services (Alabama), LLC Time Warner Cable Information Services (Arizona), LLC Time Warner Cable Information Services (California), LLC Time Warrior Cable Information Services (Colorado), LLC Time Warner Cable Information Services (Hawa i), LLC Time Warner Cable Information Services (Idaho), LLC Time Warner Cable Information Services (Illinois), LLC T me Warner Cable Information Services (Indiana), LLC Time Warner Cable Information Services (Kansas), LLC Time Warner Cable Information Services (Kentucky), LLC Time Warner Cable Information Services (Maine), LLC Time Warner Cable Information Services (Massachusetts), LLC Time Warner Cable Information Services (Michigan), LLC Time Warner Cable Information Sevices (Missouri), LLC Time Warner Cable Information Services (Nebraska), LLC Time Warne, Cable Information Services (New Hampshire), LLC Time Warner Cable Information Services (New Jersey), LLC Time Warner Cable Information Services (New Mexico), LLC Time Warner Cable Information Services (New York), LLC Time Warner Cable Information Services (North Carolina), LLC Time Warner Cable Information Services (Ohio), LLC Time Warner Cable Information Services (Pennsylvania), LLC Time Warner Cable Information Services (South Carolina), LLC Time Warner Cable Information Services (Tennessee), LLC Time Warner Cable Information Services (Texas), LLC Time Warner Cable Information Services (Virginia), LLC Time Warner Cable Information Services (Washington), LLC Time Warner Cable Information Services (West Virginia), LLC Time Warner Cable Information Services (Wisconsin), LLC Time Warner Cable Internet LLC Time Warner Cable Media LLC Time Warner Cable Midwest LLC Time Warner Cable New York City LLC Time Warner Cable Northeast LLC Time Warner Cable Pacifc West LLC Time Warner Cabe Southeast LLC Time Warner Cable Sports LLC Time Warner Cable Texas LLC TWC Administration LLC TWC Digital Phone LLC TWC News and Local Programming LLC TWC Regional Sports Network I LLC Vista Broadband Communicall ons, 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 507% and which s domiciled within the United Slates of America, Is territories or possessions, Puerto Rico or Canada. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 212 345-5000 12/16/2016 7:16:31 PM PAGE 5/005 Fax Server AGENCY CUSTOMER ID: 405245 LOC St. Louis ACO ADDITIONAL REMARKS SCHEDULE Page 4 of 4 AGENCY NAMED INSURED Marsh USA Inc. Charter Communications, Inc 12405 Powerscourt Drive POLICY NUMBER Sill Loins, 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 Entity: Falcon Telecable, a Cal forna 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 is fully executed. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 212 345-5000 12/16/2016 7:16:31 PM PAGE 1/005 Fax Server ■ ■ ■ ■ ■ ■ Facsimile Transmittal Sheet MARSH An MW Company From: Jennifer Hallford To: City of Ashland Phone: Fax: 541-552-2059 Date: 16-Dec-16 Attention: Time: 05:58 PM Company: CHARTER COMMUNICATIONS Message: The information contained in this facsimile message is confidential, may be privileged, and is intended for 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. R:: R H _ _