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DocuSign Envelope ID:7298C647-357F-4210-9C30-5CBOE645E4A1
<br /> AGENCY CUSTOMER ID:
<br /> LOC#:
<br /> A � ADDITIONAL REMARKS SCHEDULE Page of
<br /> AGENCY NAMED INSURED
<br /> One Federal Street Charter Communications, Inc.
<br /> Boston, MA 02110 USA 400 Atlantic Street
<br /> Stamford, CT 06901
<br /> EFFECTIVE DATE: 0 1/0 1/2 0 19
<br /> ADDITIONAL REMARKS
<br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
<br /> FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance
<br /> Certificate Reference: 302775
<br /> WORKERS COMPENSATION POLICY INFORMATION
<br /> Insurer Policy Number Effective Date Expiration Date
<br /> E WC 12716987 (NY) 1/1/2019 1/1/2020
<br /> B WC 14122396 (MA,ND,WA,WI,WY) 1/1/2019 1/1/2020
<br /> B WC 14122397 (AZ, IL,KY,NC,NH,NJ,PA,UT,VA,VT) 1/1/2019 1/1/2020
<br /> F WC 14122398 (CA) 1/1/2019 1/1/2020
<br /> B WC 14122399 (AOS) 1/1/2019 l/l/2020
<br /> G WC 14122400 (FL) 1/1/2019 1/1/2020
<br /> Insurer G: Illinois National Insurance Company
<br /> Charter Communications, Inc. branded Spectrum, Spectrum Business and Spectrum Enterprise and their
<br /> - Subsidiaries, associated, affiliated and inter-related companies;
<br /> Controlled or majority (more than 50%) owned partnerships, limited liability companies;
<br /> Interest only in (or its subsidiaries' interest in) any other partnerships or joint ventures or limited liability companies;
<br /> Interest in (or its subsidiaries' interest in) any company or organization coming under its active management or control;
<br /> - Any entity or party required to be insured under any contract or agreement which may now exist, may have previously existed, or may hereafter be created or acquired.
<br /> Bresnan Broadband Holdings, LLC, Bresnan Broadband of Colorado, LLC, Bresnan Broadband of Montana, LLC, Bresnan Broadband of Utah, LLC, Bresnan Broadband of Wyoming, LLC,
<br /> Bresnan Communications, LLC, Bresnan Digital Services, LLC, Bresnan Microwave of Montana, LLC, Bright House Networks Information Services (Alabama), LLC, Bright House
<br /> Networks Information Services (California), LLC, Bright House Networks Information Services (Florida), LLC, Bright House Networks Information Services (Indiana), LLC,
<br /> Bright House Networks Information Services (Michigan), LLC, Bright House Networks, LLC, Cable Equities Colorado, LLC, CC Michigan, LLC , CC Systems, LLC, CC VIII Fiberlink,
<br /> LLC, CC VIII Operating, LLC , CCO SoCal I, LLC, CCO SoCal II, LLC, Charter Advanced Services (AL), LLC, Charter Advanced Services (CA), LLC, Charter Advanced Services
<br /> (CO), LLC, Charter Advanced Services (CT), LLC, Charter Advanced Services (GA), LLC, Charter Advanced Services (IL), LLC, Charter Advanced Services (LA), LLC, Charter
<br /> Advanced Services (MA), LLC, Charter Advanced Services (MD), LLC, Charter Advanced Services (MI), LLC, Charter Advanced Services (MN), LLC, Charter Advanced Services (MO),
<br /> LLC, Charter Advanced Services (MS), LLC, Charter Advanced Services (MT), LLC, Charter Advanced Services (NC), LLC, Charter Advanced Services (NE), LLC, Charter Advanced
<br /> Services (NH), LLC, Charter Advanced Services (NV), LLC, Charter Advanced Services (NY), LLC, Charter Advanced Services (OR), LLC, Charter Advanced Services (SC), LLC,
<br /> Charter Advanced Services (TN), LLC, Charter Advanced Services (TX), LLC, Charter Advanced Services (UT), LLC, Charter Advanced Services (VA), LLC, Charter Advanced
<br /> Services (VT), LLC, Charter Advanced Services (WA), LLC, Charter Advanced Services (WI), LLC, Charter Advanced Services (WY), LLC, Charter Advanced Services VIII (MI), LLC,
<br /> Charter Advanced Services VIII (MN), LLC, Charter Advanced Services VIII (WI), LLC, Charter Cable Partners, LLC , Charter Communications Entertainment I, LLC , Charter
<br /> Communications Entertainment II, LLC , Charter Communications Entertainment VII, LLC, Charter Communications Operating, LLC, Charter Communications Properties LLC, Charter
<br /> Communications VI, L.L.C., Charter Communications, LLC , Charter Fiberlink - Alabama, LLC, Charter Fiberlink - Georgia, LLC, Charter Fiberlink - Illinois, LLC, Charter
<br /> Fiberlink - Maryland II, LLC, Charter Fiberlink - Michigan, LLC, Charter Fiberlink - Missouri, LLC, Charter Fiberlink - Nebraska, LLC, Charter Fiberlink - Pennsylvania,
<br /> LLC, Charter Fiberlink - Tennessee, LLC, Charter Fiberlink AR-CCVII, LLC, Charter Fiberlink CA-CCO, LLC , Charter Fiberlink CC VIII, LLC, Charter Fiberlink CCO, LLC ,
<br /> Charter Fiberlink CT-CCO, LLC, Charter Fiberlink LA-CCO, LLC, Charter Fiberlink MA-CCO, LLC , Charter Fiberlink MS-CCVI, LLC, Charter Fiberlink NC-CCO, LLC , Charter
<br /> Fiberlink NH-CCO, LLC, Charter Fiberlink NV-CCVII, LLC, Charter Fiberlink NY-CCO, LLC, Charter Fiberlink OH-CCO, LLC, Charter Fiberlink OR-CCVII, LLC, Charter Fiberlink SC-
<br /> CCO, LLC , Charter Fiberlink TX-CCO, LLC , Charter Fiberlink VA-CCO, LLC, Charter Fiberlink VT-CCO, LLC , Charter Fiberlink WA-CCVII, LLC, Charter Video Electronics, LLC
<br /> , DukeNet Communications, LLC , Falcon Cable Media, a California Limited Partnership , Falcon Cable Systems Company II, L.P., Falcon Cablevision, a California Limited
<br /> Partnership , Falcon Community Cable, L.P., Falcon Community Ventures I Limited Partnership, Falcon First Cable of the Southeast, LLC , Falcon Telecable, a California
<br /> Limited Partnership , Falcon Video Communications, L.P., Hometown T.V., LLC , HPI Acquisition Co. LLC, Insight Communications Midwest, LLC, Insight Communications of
<br /> Central Ohio, LLC, Insight Kentucky Partners II, L.P., Interlink Communications Partners, LLC, Long Beach LLC, Marcus Cable Associates, L.L.C., Marcus Cable of Alabama,
<br /> L.L.C., Midwest Cable Communications, LLC , NaviSite LLC , Oceanic Time Warner Cable LLC , Renaissance Media LLC, Rifkin Acquisition Partners, LLC, Robin Media Group, LLC,
<br /> Scottsboro TV Cable, LLC , Spectrum Gulf Coast, LLC, Spectrum Mid-America, LLC , Spectrum Pacific West, LLC, Spectrum Security, LLC, Spectrum Southeast, LLC The Helicon
<br /> Group, L.P., Time Warner Cable Enterprises LLC, Time Warner Cable Information Services (Alabama), LLC, Time Warner Cable Information Services (Arizona), LLC Time Warner
<br /> Cable Information Services (California), LLC, Time Warner Cable Information Services (Colorado), LLC, Time Warner Cable Information Services (Hawaii), LLC, Time Warner
<br /> Cable Information Services (Idaho), LLC, Time Warner Cable Information Services (Illinois), LLC, Time Warner Cable Information Services (Indiana), LLC, Time Warner Cable
<br /> Information Services (Kansas), LLC, Time Warner Cable Information Services (Kentucky), LLC , Time Warner Cable Information Services (Maine), LLC, Time Warner Cable
<br /> Information Services (Massachusetts), LLC, Time Warner Cable Information Services (Michigan), LLC, Time Warner Cable Information Services (Missouri), LLC, Time Warner Cable
<br /> Information Services (Nebraska), LLC, Time Warner Cable Information Services (New Hampshire), LLC, Time Warner Cable Information Services (New Jersey), LLC, Time Warner
<br /> Cable Information Services (New Mexico), LLC, Time Warner Cable Information Services (New York), LLC , Time Warner Cable Information Services (North Carolina), LLC, Time
<br /> Warner Cable Information Services (Ohio), LLC, Time Warner Cable Information Services (Pennsylvania), LLC , Time Warner Cable Information Services (South Carolina), LLC,
<br /> Time Warner Cable Information Services (Tennessee), LLC, Time Warner Cable Information Services (Texas), LLC , Time Warner Cable Information Services (Virginia), LLC, Time
<br /> Warner Cable Information Services (Washington), LLC, Time Warner Cable Information Services (West Virginia), LLC, Time Warner Cable Information Services (Wisconsin), LLC,
<br /> Time Warner Cable Internet LLC , Time Warner Cable Media LLC , Time Warner Cable New York City LLC, Time Warner Cable Northeast LLC, Time Warner Cable Sports LLC , TWC
<br /> Administration LLC, TWC Digital Phone LLC, TWC Digital Phone LLC, TWC News and Local Programming LLC, TWC Regional Sports Network I LLC
<br /> ..and any corporation or other business organization other than a joint venture in which the Named Insured shown in the declarations has or acquires during the policy
<br /> period an ownership of more than 50% and which is domiciled within the United States of America, its territories or possessions, Puerto Rico or Canada.
<br /> ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
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