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Liability Insurance-Insight Comm
ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) TM 12/20/2012 10:25:02 PM 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 MARSH USA, INC. Contact Name: 1166 Avenue of the Americas Phone No: I Fax No: 704- 731 -1209 New York NY 10036 Producer Email: Producer Customer No: INSURERS AFFORDING COVERAGE NAIC # INSURED INSIGHT COMMUNICATIONS MIDWEST LLC INSURER A: New Hampshire Ins. Co. 23841 A TIME WARNER CABLE COMPANY INSURER B: Insurance Co. of the State PA 19429 810 7TH AVENUE, 41ST FLOOR INSURER C: ACE American Insurance Company 22667 NEW YORK NY 10019 INSURER D: Navigators Insurance Company 42307 INSURER E: National Union Fire Ins Co of Pittsburgh 19445 INSURER F: Commerce & Industry Insurance Company 19410 COVFRAG.F5 ___ CFRTIFICATF Nl1MRFR: 91764 810 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 AMY P.EQU!REMENT, 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSRD WVD POLICY NUMBER (MM /DD /YYYY) (MM /DD/YYYY) LIMITS GENERAL LIABILITY GL 9645279 1/1/2013 1 /1 /2014 EACH OCCURRENCE $ 3,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1,000,000 F CLAIMS -MADE © OCCUR MED EXP (Any one $ 10,000 person) PERSONAL & ADV INJURY $ 3,000,000 GENERAL AGGREGATE $ 20,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 5,000,000 © POLICY ❑ PROJECT ❑ LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT X ANY AUTO CA 5196245 (AOS) 1/1/2013 1 /1 /2014 (Ea accident) $ 5,000,000 CA 5196246 (VA) ALL OWNED AUTOS CA 5196247 (MA) BODILY INJURY $ E ^ (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY $ (Per accident) NON -OWNED AUTOS PROPERTY DAMAGE $ (Per accident) " 1 UMBRELLA LIAB © OCCUR X00 G27048316 1/1/2013 1 /1 /2014 EACH OCCURRENCE $ 25,000,000 C — I EXCESS LIAB 0 CLAIMS -MADE AGGREGATE $ 25,000,000 I DEDUCTION $ RETENTION $ WORKERS COMPENSATION WC 019358808 (AOS), WC 1/1/2013 1 /1 /2014 x II WC STATU n OTH AND EMPLOYERS' LIABILITY Y/N 019358809 (CA), WC 0 i 9358810 (FL), LJ TORY LIMITS Li ER A ANY PROPRIETOR /PARTNER /EXECUTIVE N/A WC 019358812 (MN), WC 019358814 E.L. EACH ACCIDENT $ 2,000,000 OFFICER /MEMBER EXCLUDED? © (ND,WA,WI,WY) Mandatory in NH? WC 019358813 (OR -Ins B) EMPLOYEE DISEASE - EA $ 2,000,000 If yes describe under WC 019358811 (MA -Ins. B) Y E.L. DISEASE - POLICY LIMIT $ 2,000,000 SPECIAL PROVISIONS below OTHER A Excess WC OH ($1M Retention) WC 6636177 1/1/2013 1 /1 /2014 Workers Comp - Statutory 1,000,000 A Excess WC OH ($1M Retention) WC 6636177 1/1/2013 1 /1 /2014 Employers Liability 1,000,000 D Excess Auto Only NY13EXC702201 IV 1/1/2013 1 /1 /2014 Each Occurrence 2,500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: ALL OPERATIONS USUAL AND INCIDENTAL TO THE BUSINESS OF THE INSURED CERTIFICATE HOLDER CANCELLATION CITY OF JEFFERSONVILLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED CITY COUNTY BUILDING BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 500 EAST COURT AVENUE IN ACCORDANCE WITH THE POLICY PROVISIONS. JEFFERSONVILLE IN 47130 AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) 1988 -2010 ACORD CORPORATION. All rights reserved.