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AGENCY CUSTOMER ID:
<br />_ LOC #:
<br />A� ® ADDITIONAL REMARKS SCHEDULE Page _of
<br />AGENCY
<br />NAMEDINSURED
<br />One Federal Street
<br />Charter Communications, Inc.
<br />Boston, MA 02110 USA
<br />400 Atlantic Street
<br />1/1/2018
<br />Stamford, IT 06901
<br />014122390
<br />ICA)
<br />EFFECTIVEDATE: 01/01/2018
<br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
<br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance
<br />City of sanGa Age, Cicy of Santa is aradded as Additional Insured :o the Commercial General Liability policy but
<br />only with respects to the requirementsof the written contract or agreement with the Named Insured. Additional
<br />Insured status becomes effective once the written contract, or agreement is fully executed.
<br />This ie is primary and n - ontributory o any existing i and limited to liability arising cut of
<br />the operations of the named inenred and where required by written contract.
<br />WORKERS COMPENSAT-ON POLICY INFORMATION
<br />Insurer A.11cy Number Effective Date Expiration Date
<br />0 014122396
<br />MA,ND, WA, wi, WYl
<br />1/1/2019
<br />1/1/2019
<br />E 01412239'1
<br />AZ, IL, KY, NC, OR, NJ, PA, DT, VA, on)
<br />1/1/2018
<br />1/1/2015
<br />014122390
<br />ICA)
<br />1/1/2010
<br />1/1/2019
<br />E 01ei22399
<br />AOS)
<br />1/1/2010
<br />1/1/2019
<br />014122400
<br />IPL)
<br />1/1/2018
<br />1/1/2019
<br />E 014122001
<br />IME)
<br />1/1/2010
<br />1/1/3019
<br />E 01412240]
<br />(MN)
<br />1/1/201H
<br />1/1/2019
<br />Charter Communications, Inc. dew Spectrum and Thai,
<br />Subsidiaries, associated, affiliated and inter -related companlea;
<br />- Controllod o majority (more than 504) owned partnerships, limited liability companies,
<br />InceresL only - (Bx subs i diaxlea' funereal in) any other partnerships or jos enures or limited 1iab131ty c ,
<br />- InceresL in Worn Ste Pubs idiaries' interest in) any thousand Or organ nation coming nunder its active management o ontrol1e
<br />- Any entity or party required :o be Insured under any contract or agreement which may now exist, may have previously existed, or may hereafter be created or acquired.
<br />American Cable Entertaimnere Company, Athens Cablevision, LLC, Bresnan Broadband Holdings, LLC, Bresnan Broadband of Colorado, LLC, Bresnan Broadband of Montana, LLC,
<br />Bresnan Broadband of Utah, LLC, Bresnan Broadband of wyon in& LDC, e n Commmnicatiene, LLC, Bresnan Bfgital 3 eLLC, s n Microwave of MT, LLC, Bright Haus.
<br />Act works information .Systems (Alabama), LLC, Bright House Networks Information Systems Kalifornia), LLC, Bright House Networks Information Systems (Florida), LLC, Bright
<br />House Ne Imbrue Information Systeme (Indiana), LLC, Bright aeuse Networks Information Systems (Michigan), LLC, Bright House Networks, LLC, Cable Eouities Colorado. LLC , CC
<br />10, LLC , CC Michigan, ILC , CC Systems, LIC, CC VIII _ibeflink, LLC, CG' Viii Operating, LLC , CCU SoCai I, LLC, CCA SoCal II, LLC, Charter Advanced services (AL), LLC,
<br />Charter Advanced Services (CA), LLC, Charter Advanced Services "(CO), LLC, Charter Advanced Services ICm), LLC, Charter Advanced Services (GA), LLC, Charter Advanced.
<br />Services (11), LLC, Charter Advanced Be ry ices (LI), LLC, Charter Advanced Services (NIA), LLC, Charter Advanced Services (Me), LLC, Charter Advanced Servi a (MI), LLC,
<br />the flax Advanced Services (MN), LLC, Charter Advanced Services (MU), LLC, Charter Advanced Services IMS), LLA, Charter Advanced Services per), LLC, Charter Advanced
<br />Earnings (NC), LLC, Charter Advanced Services (NEC, LLC, Charter Advanced 5 s (NH), LLC, Charter Advanced Services (NV), LLC, Charter Advanced Se loess (NY), LLC,
<br />Chaffer Advanced Services {OR), LLC, Charter Advanced Services (BC), LLC, Charter Advanced Services (IN), LLC, Chaston Advanced Services (TX), LLC , Charter Advanced
<br />Service. (UT), LLC, Charter Advanced Services (VA1, LLC, Charter Advanced Services (VT), LLC, Charter Advanced Services goi, ILC, Charter Advanced Services CBS), LLC,
<br />Clients'
<br />AdV..add 3 5 (We), LLC, Charter Advanced Services VIII IMI), BOB, Charter Advanced Serviie5 VIII dhV, LLC, Charter Advanced Services VIII (WI), LLC. Charter
<br />Cable Partners, LLC, Charter Communication. hd LexLainm.Or I LLC , Charter Communications Entertainment I1, LLC , Charter COmmunicatiena Re Lailei omen VII, LLC , ChouLer
<br />Commoni.Cations Operating, LLC, Charter Commun.ica Lions Properties LLC Charter Comminnuati¢ns VI, A.L.C. , Charter Communications, LLC , Charter Fiberlink - Alabama, ILC ,
<br />Charter Fiberlink - Georgia, LLC Chatter Fl Ifel-i: - Illinois, L.LC Charter Fiberlink - Maryland ii, LLC, Charter Fiberlink - Michigan, LLC, Charter Fiberlink -
<br />Missouri, lLC , Chapter Fiberlink - Nebraska, LLC , Charter Fiberlink -nnsylvania, LLC, Charter Fr
<br />blinkc - Tennessee, LLC Charter FSberlink TH-CCVII, LLC, Charter
<br />k
<br />Fiberlink CA-CCO, LLC , Charter FiberlinCC VIII, LLC, Charter Fiberlink CIO, LLC, Charter Fiberlink CT-CCO, LLC , Charter Fide Ylink LA-CCO, LLC , Charter Fiberlink MA-
<br />CCO, LLC Charter F.iber.1—k MS-CCVI, LLC , Charter Fiberlink NC -CLO, LLC , Charter F.iberlick NH -CCD, LLC, Charter Fiberlink NV-G'CVII, LLC , Charier Giberlink NY -CCC, LLC ,
<br />Chart an F`ibexllnk 041-CCO, LLC' , Charter Fiberlink OR-CCVII, LLC , Charter liberlink SC-CCO, LLC , Charter Fiberlink TK-CCO, LLC , Charter Fiberlink VA-CCO, LLC , Charter
<br />Fiberlink VT-CCO, LLC , Charter Fiberlink WA-CCVII, LLC , Charter video Electronics, LLC, DukeNet Communicaflon. LLC, Falcon Cable Media, a California Limited Partnership,
<br />saloon Cable Systems Company II, L.P.I Falcon Cablevision, a California Limited Partnership , Falcon Community Cable, L.P. Falcon Community Ventures I Limited
<br />Partnership, Falcon Firs, Cable of the Southeast, LLC, Falcon Telecable, a California Limited Partnership , Falcon video Communications, L.R. , Hometown T.V., LLC, H2i
<br />Acquisition Co. LLC, Insight Communications Midwest, LLC, Insight Communications of Central Ohio, LLC, Insight Kentucky Partners II, L.P., Ihrerlink Communications
<br />Partnere, LLC , Long Beach LLC, Rayons Cable, LLC, Marcus Cable Associates, L.L.C. , Marcus Cable of Alabama. L.L.C. , Midwest Cable Communicatiins, LLC, Nav_E lice LLC,
<br />Ocean_c Time Warner Cable LLC, Peachtree Cable TV, L.P. , Rena"Wence Media LLC , Rifkin Acquisition Partners, LOU , Robin Media Group, LLC, Scottsboro TV Cable, LLC, The
<br />Holirin Group,
<br />L e Name, Cable 0u5inced LLq Time
<br />e WarnerrCable Enterprises Lig, iire w
<br />r Cubic
<br />able L.faYmation Services (Alabama)
<br />Alabama) , GLC, Time Warner Cabl
<br />e I
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<br />orma
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<br />o
<br />n
<br />Services ArizoLIC, Time Warner Cable Infermatfov Services , TIC, Time Warner Information Services (Colnradp), LLC, Time Warner Cable Infoxmatlov
<br />Sery i) LLC, e Warner Cable Information Services Inshoi, Time Warner Cable Informaion Services (Illinois),LLC, warner Cable InformerionServices
<br />(Indiana), LLC, Time Warner Cable Information Services LLC, Time Warner Cable Infoxmatlov Services Kentucky), LIT, 2• Warner Cable Infomaton Services
<br />(Maine), L1.C, Time 'garner Cable Information Services (Massachusetts),LLC, T. Wnen¢i Cable Infon Services (MiisLLCTmeCable Ie oriSeY
<br />(Nours), LLC, " e Warner Cable Information vis (Nebraska), LLC. Time Cable Information Services (New Hampshire), LLC, Time Warner Information Services
<br />(New lersey), LLC, Time Warner Cable Information Services (New oLLC, Time Warner Cable Information Services (New Ynrk), LLC, 1Sm. Warner Cable InfiServices
<br />(Month Carolinc). LLC, Time WarnerCable Infoableinn Services (Ohio), one, Time Warner Cable Information Services Penylvansa LLC, Time Warn Cable Information
<br />Services (South Carolina), LLC, Time Warner Cable Ionnrvn Service, (Tenn)ee), LLC, Time Warner Gable Information Services (Texas), Time Warner Cable InfoxmaLinn
<br />Se—ices Virgiiia), LLC, T = Cable WarneratiServices (Wasen, LLC. TIME, Warner Cable Information Services (West Virginia)
<br />, LLe, Lr Cable
<br />IainrdaServices (Wisconsin), LLC, Time Warner Cable Internet LLC, Time Warner Cable Media LLC, Time, WarneI Cable Midwest LLC, Time ax TeNew York City LLC. T1m
<br />.
<br />Warner Cable Northeast LLC, Time Warner Cab Pacific We LLC, Time Wetter Cable SCUCherie LLC, Time Warner Cable Sports LLC, Time Warner Cable The LLI, TWC
<br />ServiceseraLITn LLC, Tec Digital Phos. LLC, TWO Hews and local P)gemming LLC, TBC Reifnal Sports Network I LLC, Vista Broadband Communications, LLCy BN Hobe Security
<br />Services, LLC , TWC Security GLC, Spectrum Security, LLC
<br />.1 afer
<br />any corporation or other business organr zat-M Other Than a joint venture i which the Named I red shown in the declarations has o acquires during the policy
<br />parrot an ownership of mora than 5" and whichis domiciled within the United Staten of America, its territories or possessions, Puerto Aico Or Canada.
<br />ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
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