Time Warner-CS080602ACORD CERTI��CTE0IBILITIUr►NCE
6 /2i2oo 000'oo
PRODUCER
MARSH INC.
57598
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1166 Avenue of the Americas
New York NY 10036 -2774
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY
A ACE American Insurance Company
INSURED
C- NATIVE EXCHANGE III, LP
DBA TIME WARNER CABLE
1005
COMPANY
B Indemnity Insurance Co. of North America
COMPANY
C State of Washington Dept of Labor & Ind.
1565 CHENAULT STREET
DALLAS TX 75228
COMPANY
D National Union Fire Ins Co of Pittsburgh
COVRACES �I
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 CONTRACTOR OTHER DOCUMENT VUTH RESPECT TO V\HICH THIS
CERTIFICATE MAYBE 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 SHOVMI MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMIDD /YY)
POLICY EXPIRATION
DATE (MWDDIYY)
LIMITS
A
GENERAL
LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE T1 OCCUR
HDO G2374109A
6/1/2008
6/1/2009
GENERAL AGGREGATE
$ 20,000,000
X
PRODUCTS - COMP /OP AGG
$ 5,000,000
PERSONAL & ADV INJURY
$ 3,000,000
OWNER'S & CONTRACTOR'S PRor
EACH OCCURRENCE
$ 3,000,000
GEN'L
FIRE DAMAGE (Any one fire)
$ 1,000,000
AGGREGATE LIMIT APPLIES PER:
_
Fx_1 POLICY PROJECT LOC
MED EXP (Any one person)
$ 10,000
AUTOMOBILE
LIABILITY
ANY AUTO
ISAH0824389A
6/1/2008
6/1/2009
COMBINED SINGLE LIMIT
$ 5,000,000
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
A
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
OTHER THAN AUTO ONLY
EACH ACCIDENT
$
AGGREGATE
$
D
EXCESS LIABILITY
X UMBRELLA FORM
BE 5443209
6/1/2008
6/1/2009
EACH OCCURRENCE
$ 25,000,000
AGGREGATE
$ 25,000,000
$
OTHER THAN UMBRELLA FORM
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETOR/ X
PARTNERS /EXECUTIVE INCL
Co. B (TINA): WLR C44344609
(All States except CA & WI)
Co. A (ACE): WLR 044344646 (CA)
SCF 044344683 (WI)
6/1/2008
6/1/2009
0TH -
X C O R S Y LIMITTATU- S ER
T
EL EACH ACCIDENT
$ 2,000,000
EL DISEASE - POLICY LIMIT
$ 2,000,000
OFFICERS ARE: EXCL
EL DISEASE -EA EMPLOYE
$ 2,000,000
OTHER
A
Ohio W /C -Stat. Limit
WCU C44345080
6/1/2008
6/1/2009
EL - EA/DEA/DPL 1,000,000
C
Monopolistic -WA W/C
826986 -12
6/1/2008
6/1/2009
W/C Statutory Limits
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES /SPECIAL ITEMS
REF: ORDINANCE NO. 93615
THE CITY OF COPPELL IS INCLUDED AS AN ADDITIONAL INSURED AIMA.
CER tFICATE -_- LDER
CANCEL IrATiON_
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF COPPELL
P.O. BOX
TX
COPPELL TX 75019
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD
@AORD CORPORATION 1988'