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Time Warner-CS040108Ccomcasts January 8, 2004 Rhonda Brothers Engineering Department City of Coppell 255 Parkway Blvd. Coppell, Tx. 75019 Dear Ms Brothers: Comcast Cable Communications, Inc. 1565 Chenault Dallas, TX 75228 Please find enclosed Comcast's Right -Of -Way Registration Form due by March 1, 2004. Please call me at (214) 320 -7529 if you need any additional information. Cordially, O-U� k-aor Dottie Kelly Permit Coordinator Cc: File 01/08/2004 11:18 CITY OF COPPELL ENGR. DEPT. 4 92143207559 T H It - C i T Y - a p RIGHT-OF-WAY MAINTENANCE USE FEE Ordinance No. 2441 -944, Sec. 6 -14 -3. Registration Form for Service Provider NO.979 P02 Registration expires March 1 of every other year after the calendar year in which the first registration occurs. If registration is not renewed by the expiration date, after written notice from the City, the facilities of the service provider will be deemed to have been legally abandoned Service Provider (include any business name provider operates under or bas operated under for past 5 years) Comcast Cable of Indiana /Michigan/ Texas, Inc. PUC Certificate Number (for certificated t&=mmaanicatioiu providers) City of Coppell License Ordinance No. 2110 -944 Contact Names/Numbers Rick Jaskula 214-370'6238 Dottie Kell 214 - 320 -7529 Contractor(s) Name SEE ATTACHED LIST Contact Information Emergency Contact Local Management Center 877 - 833 -6350 Liability Insurance Carrier Marsh USA Inc. (Sec. 6 -14 -3 (h)) Attach proof of coverage Plans of Record provided to Engineering Dept. for existing facilities Y N For proposed facilities Y N .Forward registration form and fee to Engineering Dept_, City of Coppell, 255 Parkway Blvd. Coppell TX 75019 fl . ... ............. .... ..............:'..: >.:..... For QpFice tES . e Re stratioa-V-.�q*:::of:25t);t;: 116194 -COMCA- CAS -=4 COMO IRVING TX wTOaaaE COMPANY A DISCOVER PROPERTY & CASUALTY INSURANCE COMPANY Ms1aE0 COMCASTCABLEOFINDIANA/MICHIGAN/ COMPANY b U9F60 TEXAS, INC, A 2961 KINMST PARWIAY COMPANY IRMNO, TX 76063 C AMERICAN GUARANTEE A LIABILITY INSURANCECO. 1?/Ot/OA ov pmy $ 10,000,Om D FIDELITY & GUARANTY INS. CD. THIS IS TO CERTIFY TWAT POLICIps aF INaWRANCE DESGIIBlb HEREIN HAVE BEEN 1881,1120 TO THE INSJRED NAMED NEIIEW FOR THE P0. CY MIOO INDCATEO NOmTHSTANOwO ANY REQUREMENT, 7lRM OR CONDITION OF ANY CONTRACT OR OTHER 0OCUMENT WITH RESPECT TO WHICa THE CO. FICATE MAY BE ISSUED OR MAY PERTNN, TwE INSURANCE AFFORDED BY THE POUCEa GEMMED wERNIN IS SUB.ECT TO ALL TWE TERMA CONDITIONa ANp EXCLU ®ONE 0► SUCH POUCE4 AOOREOATE UMTS34OWN MAY HAVE BEEN RSDUCS0lYPAD CLANS. 12191/04 CC LTR TY ►E OF MILMARCE POLICY I�UYIER ►OLIOr t14taTIVt PaLlICY 91FIRATION LAN 173 12101 108 12101104 BODIIYINJIRY� (Par SOo" DATE AMIDO/YY) OATt aYIODM I $ NVERAL LWILRY --�� A X COMMERCALOENERALIABLITY 000Z30010120/03 12/01/p0 (kNERAL AOMraATE $ 24,9OO Om PROpUG►4.OQrIP/OPAtTA S 6,900,000 41LAMSMA01! ICO?JR TOONLY.EAA�pENT S ENVY AL1T0 I DERWNALtADV!NJUIIY 5 1,000,Om OWERIACONTRAC OR'OPROT I EACH O=RRENC! $ 1,9moo0 FIRE AMAOE(M msn $ 1,900000 EICISILMLITV c x UMBRELLA FOIM X 1 IR 12/01/03 1 17/01/04 EACH 0CCU111RENCE S 5,O0QO0o ACaRloATI ^" a e,uQgaoo CITY OF COPPELL IS INCLUDED AS AODITIONAL INSURED AS RESPECTS THE GENERAL LIABILITY POLICY WHERE REQUIRED BY WRITTEN CONTRACT WITH THE NAMED INSURED. $100,000 PER OCCURENCESELF INSURED RETENTION APPLIES ONLY TO THE ABOVE GENERAL LIANUTY POLICY. SMOIRD AN1' OF TM P%IC;M OESMIvEO HM" DE CkWaL® SEFAI!1S, b( ^IyRlpf OATE THEIIEOI, M INALOM APORDINS COIIERA4 VALL &M M/OI T6 MYL ae DAYS MITTEN NOTia TG THE CITY OF COPPELL P,O. BOX 478 CEIRI"Ayt WOLDEA NAMED WREIN. NIA' FAILL10 TO MAIL &M WICI 901L RFOE NOO2I,I0TIeA1 OA COPPELL,TX 75010 uuwrtvCFMyKI ) LpMyMmelueltA.• an�IxeoweRRaenynoeN�soRAe •AtaarAmeaoNTrE m1lA cr Tw aRnF!aTe. RARw uIA _ r. Mary Radowswaki wTOaaaE MED I An m■ v ) a 10,000 A X MIYAUTO 00=00191 (ACS) 1M/03 1?/Ot/OA I �BINEDSNOLELIMIT $ 10,000,Om B A.LC MEDAUrOS 4CHEDULED AUTCS DIX12 00192(MA) 12/01/03 12191/04 9OOILv!NJ11RY (r« PsomiJ -- 6 E HIWzQAUTOS NON- OMNEDAUTOS D002AOO193(TX) 12101 108 12101104 BODIIYINJIRY� (Par SOo" = PRO'IRTY DAMAGE $ WIWE LWILITY TOONLY.EAA�pENT S ENVY AL1T0 �ZCIrNglll THAN AUTO ONLY AN AWDENT $ A00RMATE $ EICISILMLITV c x UMBRELLA FOIM AUC 030471448 12/01/03 1 17/01/04 EACH 0CCU111RENCE S 5,O0QO0o ACaRloATI ^" a e,uQgaoo OTHeRTHAN UMBRELLA FORM $ D p IMPL9V9RILYMILITY Tf1EPROPRIETORf X INCL PARTNPJ13E1D C]71ME OFF!a�esAR!' act 0002MOD24e (ADS) D0021MIMM (NV, OR, WI) MZMM40 (N.1) 12/01/03 12/01/03 12/01/03 12101104 12/01/04 12/01/04 x TQ�Y GI MIT EL EACH ACCIDENT 2,000 QQ E �I�AlI iOLlcxLlMlr S 2,000,000 !L DIMAN-RACH SmPLOYEE $ 2,000,000 CITY OF COPPELL IS INCLUDED AS AODITIONAL INSURED AS RESPECTS THE GENERAL LIABILITY POLICY WHERE REQUIRED BY WRITTEN CONTRACT WITH THE NAMED INSURED. $100,000 PER OCCURENCESELF INSURED RETENTION APPLIES ONLY TO THE ABOVE GENERAL LIANUTY POLICY. SMOIRD AN1' OF TM P%IC;M OESMIvEO HM" DE CkWaL® SEFAI!1S, b( ^IyRlpf OATE THEIIEOI, M INALOM APORDINS COIIERA4 VALL &M M/OI T6 MYL ae DAYS MITTEN NOTia TG THE CITY OF COPPELL P,O. BOX 478 CEIRI"Ayt WOLDEA NAMED WREIN. NIA' FAILL10 TO MAIL &M WICI 901L RFOE NOO2I,I0TIeA1 OA COPPELL,TX 75010 uuwrtvCFMyKI ) LpMyMmelueltA.• an�IxeoweRRaenynoeN�soRAe •AtaarAmeaoNTrE m1lA cr Tw aRnF!aTe. RARw uIA _ r. Mary Radowswaki 01108/2004 _10:04_ 9728303928 COMCAST - .• ... -• • r avvz c .,rQ r-nvr. vi ) rLimnyrax PAGE 0? V N p a0 O co Lo co N � 4m nN M I I� u'> r T c oho r^j �j O) O N (%p ^ C? O < I L9 C? (L a0 m N ° o � I N cMD co 1- c0 LO 'r o co co to co n ^ LO a�� Fx- Fx rx C7 H ° F — � � H O) C N (D 4= 4= a N v a O O (D U �_ _ cc C rL L U O m o 3 _C N y L y C cp m Q V m +L... J D N W m 0 CD r CA m O, f0 m 04 m U'3 O cD LU LL L C m LL: m N C) c 3 (L I- 9 d o N Lo c6 co O m N m N d m v c o ° 0 0 u') coo M n a. `o 8 E 8 8 � N V N N A E .O. .O. U N U cc m d U . 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