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Time Warner-CS090101
ACOROTM CERTIFICATE OF LIABILITY INSURANCE JDATE (MM /DD/YY) PRODUCER 67063 TYPE OF INSURANCE AON RISK SERVICES CENTRAL, INC. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION CHICAGO IL OFFICE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 200 E. RANDOLPH STREET HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 'AICAGO IL 60601 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1/1/2009 INSURERS AFFORDING COVERAGE NAIC # INSURED 1005 INSURER A: New Hampshire Ins. Co. C- NATIVE EXCHANGE III, LP INSURER B: Ins. Co. State of Pennsylvania DBA TIME WARNER CABLE 1565 CHENAULT STREET DALLAS TX 75228 INSURER C: State of Washington Dept of Labor & Ind. MED EXP (Any one person) INSURER D: St. Paul Fire & Marine Ins. Co. PERSONAL & ADV INJURY $ 3,000,000 rnvoown_�� INSURER E: Ohio Bureau of Workers' Compensation 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD' INSR TYPE OF INSURANCE POLICY NUMBER 16506223 POLICY EFFECTIVE DATE (MM /DD/YY) POLICY EXPIRATION DATE (MM /DD/YY) LIMITS A GENERAL LIABILITY 1/1/2009 1/1/2010 EACH OCCURRENCE $ 3,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 3,000,000 GENT AGGREGATE LIMIT APPLIES PER: X POLICY PROJECT I—ILOC GENERAL AGGREGATE $ 6,000,000 PRODUCTS - COMP /OP AGG 5,000,000 A AUTOMOBILE LIABILITY MA - 6506084 1/1/2009 1/1/2010 COMBINED SINGLE LIMIT X ANY AUTO VA - 6506083 Ea accident) $ 5,000,000 ALL OWNED AUTOS AIDS - 6506082 BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY (Per accident) $ NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ D EXCESS /UMBRELLA LIABILITY X OCCUR ❑ CLAIMS MADE QK01201974 1/1/2009 1/1/2010 EACH OCCURRENCE $ 25,000,000 AGGREGATE $ 25,000,000 DEDUCTIBLE $ RETENTION $ A B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes describe under SPECIAL PROVISIONS below OTHER TX - 5455930, FL - 5455932 CA - 9731081, AOS - 5455927 ND,OH,WA,WY - 5455931 EL only) ( Y) WI - 5455931 (Stat. & EL) OR - 5455928, MA - 5455929 1/1/2009 /2010 X A - TORY LI•. +: r° E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE - POLICY LIMIT $ 2,000,000 E C Ohio W/C Monopolistic -WA W/C 20004115 826986 -12 12/1/2008 6/1/2008 12/1/2009 6/1/2009 $ Wyoming (State of WY) 1003627561 7/31/2008 7/31/2009 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS REF: ORDINANCE NO. 93615 THE CITY OF COPPELL IS INCLUDED AS AN ADDITIONAL INSURED AIMA. GtKI1FIGATE HOLDER ("ANIC'M I ATInKl CITY OF COPPELL O. BOX 478 'aPELL TX 75019 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) © ACORD CORPORATION 1988 7800 Crescent Executive Drive Charlotte, NC 28217 Tel 704 - 731 -3000 TIME WARNER CABLE To: Certificate Holders Re: Certificate of Insurance for Time Warner Cable We are providing the attached certificate of insurance due to the separation from our parent company, Time Warner Inc. Time Warner Cable has replaced its corporate policies effective .January 1, 2009, as evidenced in the enclosed certificate of insurance. Should you have any question related to the enclosed certificate(s), please contact Ingrid Bennett (704- 731 -3934, Ing rid. Bennett @twcable.com) or Anne Theisen (704- 731 -3923, Anne.Theisen @twcable.com).