Time Warner-CS081124.�tCORA CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
--
11 /24/2008
PRODUCER
MARSH USA INC.
TWO LOGAN SQUARE
PHILADELPHIA, PA 19103 -2797
Attn: Comcast.Certs @marsh.com Fax: 212 - 948 -0486
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
U5194 - ALL- GAWU -08 -09 COMC IRVING TX
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
COMCAST CABLE OF INDIANA/MICHIGAN/
INSURER A: Discover Property And Casualty Iris CO
36463
TEXAS, INC.
2951 KINWEST PARKWAY
INSURER B: ACE Property And Casualty Ins Co
20699
INSURER c: Fidelity And Guaranty Insurance Co.
35386
IRVING, TX 75063
INSURER D:
INSURER E:
COVERAGES
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.
INS
LTR
ADD'L
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM /DD/YY)
POLICY EXPIRATION
DATE (MM /DD/YY)
LIMITS
A
GENERAL LIABILITY
X li COMMERCIAL GENERAL LIABILITY
����
CLAIMS MADE �_1 OCCUR
D001 Q00054
12/01/08
12/01/09
EACH OCCURRENCE
4 900 OO
DAMAGE T( RENTED
PREMISES Ea occurence
$ 4,900,00
MED EXP (Any one person)
$ 1 0.00
PERSONAL & ADV INJURY
$ 4,900,00
:X$100,000
GENERALAGGREGATE
$ 25,000,00
GENERAL AGGREGATE LIMIT APPLIES PER
PRODUCTS - COMP /OP AG9$
6,000,00
POLICY PRO-
JECT LOC
AUTOMOBILE
LIABILITY
A
X
ANY AUTO
DOO 1 A00357 (AOS)
12/01/08
12/01/09
COMBINED SINGLE LIMIT
(Ea accident)
$ 10,000,00
A
A
ALL OWNED AUTOS
SCHEDULED AUTOS
D001 A00358 (MA)
D001A00359(TX)
12/01/08
12/01/08
12/01/09
12/01 /09
BODILY INJURY
(Per person)
$
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
H ANY AUTO
OTHER THAN EA ACC
$
$
AUTO ONLY:
AGG
B
EXCESS /UMBRELLA LIABILITY
X� OCCUR CLAIMS MADE
XOO G24873304
12/01/08
12/01/09
EACH OCCURRENCE
$ 5,000,00
AGGREGATE
$ 5,000,00
$
DEDUCTIBLE
$
RETENTION $
C
A
C
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED?
SPECIAL PROVISIONS below
D001 WO0433 (AOS)
D001 WO0434 (NJ)
D001W00435(OR,WI)
D001 W00436 (MN)
12/01/08
12/01/08
12/01/08
12/01/08
12/01/09
12/01/09
12/01/09
12/01/09
)( WC STATU- OTH-
E.L. EACH ACCIDENT
$ 2,000,00
E.L. DISEASE - EAEMPLOYE
$ 2,000,00
E.L. DISEASE - POLICY LIMIT
$ 2,000,00
OTHER
i
I
DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS
CITY OF COPPELL IS INCLUDED AS ADDITIONAL INSURED AS RESPECTS THE GENERAL LIABILITY POLICY WHERE REQUIRED BY WRITTEN
CONTRACT WITH THE NAMED INSURED. $100,000 PER OCCURENCE SELF INSURED RETENTION APPLIES ONLY TO THE ABOVE GENERAL
LIABILITY POLICY.
Cr-m I IFICA I t HOLDER CLE- 001951308 -09 CANCELLATION --
CITY OF COPPELL
P.O. BOX 478
COPPELL, TX 75019
ACORD 25 (2001/08)
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
„ EEp
Aof Iaers�SR4Inc seN
Mary Radaszewski
ITS AGENTS OR
Ie
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
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