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DocuSign Envelope ID: EOC82D46-2F84-44EB-8OF9-4B562DB4309E
<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: 01/01/2 0 2 0
<br /> ADDITIONAL REMARKS
<br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
<br /> FORM NUMBER: 25 FORMTITLE: Certificate of Liability Insurance
<br /> Certificate Reference: 310163
<br /> WORKERS COMPENSATION POLICY INFORMATION
<br /> Insurer Policy Number Effective Date Expiration Date
<br /> D WC 12716987 (NY) 1/l/2020 1/1/2021
<br /> E WC 14122396 (MA,WA,WI,WY) 1/1/2020 1/1/2021
<br /> E WC 14122397 (AZ, IL,KY,NC,NH,NJ,PA,UT,VA,VT) l/1/2020 1/1/2021
<br /> F WC 14122398 (CA) 1/1/2020 1/1/2021
<br /> E WC 14122399 (AOS) 1/l/2020 1/l/2021
<br /> G WC 14122400 (FL) 1/l/2020 1/l/2021
<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 Digital Services, LLC, Bresnan Microwave of Montana, LLC, Bright House Networks Information Services (Alabama), LLC, Bright House Networks Information Services
<br /> (California), LLC, Bright House Networks Information Services (Florida), LLC, Bright House Networks Information Services (Indiana), LLC, Bright House Networks Information
<br /> Services (Michigan), LLC, Bright House Networks, LLC, CC Systems, LLC, CCH II, LLC (CCHII), Charter Advanced Services VIII (MN), LLC, Charter Communications Entertainment
<br /> I, LLC , Charter Communications Holding Company, LLC, Charter Communications Holdings, LLC, Charter Communications Operating, LLC, Charter Communications VI, L.L.C.,
<br /> Charter Communications VII, LLC, Charter Communications, Inc., Charter Communications, LLC , Charter Fiberlink - Alabama, LLC, Charter Fiberlink - Georgia, LLC, Charter
<br /> Fiberlink - Illinois, LLC, Charter Fiberlink - Maryland II, LLC, Charter Fiberlink - Michigan, LLC, Charter Fiberlink - Missouri, LLC, Charter Fiberlink - Nebraska, LLC,
<br /> Charter Fiberlink - Tennessee, LLC, Charter Fiberlink CC VIII, LLC, Charter Fiberlink CCO, LLC , Charter Fiberlink CT-CCO, LLC, Charter Fiberlink LA-CCO, LLC, Charter
<br /> Fiberlink MA-CCO, LLC , Charter Fiberlink MS-CCVI, LLC, Charter Fiberlink NC-CCO, LLC , Charter Fiberlink NH-CCO, LLC, Charter Fiberlink NV-CCVII, LLC, Charter Fiberlink
<br /> NY-CCO, LLC, Charter Fiberlink OR-CCVII, LLC, Charter Fiberlink SC-CCO, LLC , Charter Fiberlink TX-CCO, LLC , Charter Fiberlink VA-CCO, LLC, Charter Fiberlink VT-CCO, LLC ,
<br /> Charter Fiberlink WA-CCVII, LLC, Charter Gateway, LLC, Charter Helicon, LLC, Coaxial Communications of Central Ohio LLC, DukeNet Communications, LLC , Falcon Cable
<br /> Communications, LLC, Insight Blocker LLC, Insight Communications Company LLC, Marcus Cable Associates, L.L.C., Spectrum Advanced Services, LLC, Spectrum Captive Holdings,
<br /> LLC, Spectrum Gulf Coast, LLC, Spectrum Management Holding Company, LLC, Spectrum Mid-America, LLC, Spectrum Mobile LLC, Spectrum New York Metro, LLC, Spectrum NLP, LLC,
<br /> Spectrum Northeast, LLC, Spectrum Oceanic, LLC, Spectrum Pacific West, LLC, Spectrum Reach, LLC, Spectrum RSN, LLC, Spectrum Security, LLC, Spectrum Southeast, LLC,
<br /> Spectrum Stamford, LLC, Spectrum TV Essentials, LLC, The Helicon Group, L.P., Time Warner Cable Business, LLC, Time Warner Cable Enterprises LLC, Time Warner Cable
<br /> Information Services (Alabama), LLC, Time Warner Cable Information Services (Arizona), LLC , Time Warner Cable Information Services (California), LLC, Time Warner Cable
<br /> Information Services (Colorado), LLC, Time Warner Cable Information Services (Hawaii), LLC, Time Warner Cable Information Services (Idaho), LLC, Time Warner Cable
<br /> Information Services (Illinois), LLC, Time Warner Cable Information Services (Indiana), LLC, Time Warner Cable Information Services (Kansas), LLC, Time Warner Cable
<br /> Information Services (Kentucky), LLC , Time Warner Cable Information Services (Maine), LLC, Time Warner Cable Information Services (Massachusetts), LLC, Time Warner Cable
<br /> Information Services (Michigan), LLC, Time Warner Cable Information Services (Missouri), LLC, Time Warner Cable Information Services (Nebraska), LLC, Time Warner Cable
<br /> Information Services (New Hampshire), LLC, Time Warner Cable Information Services (New Jersey), LLC, Time Warner Cable Information Services (New Mexico), LLC, Time Warner
<br /> Cable Information Services (New York), LLC , Time Warner Cable Information Services (North Carolina), LLC, Time Warner Cable Information Services (Ohio), LLC, Time Warner
<br /> Cable Information Services (Pennsylvania), LLC Time Warner Cable Information Services (South Carolina), LLC, Time Warner Cable Information Services (Tennessee), LLC, Time
<br /> Warner Cable Information Services (Texas), LLC , Time Warner Cable Information Services (Virginia), LLC, Time Warner Cable Information Services (Washington), LLC, Time
<br /> Warner Cable Information Services (West Virginia), LLC, Time Warner Cable Information Services (Wisconsin), LLC, Time Warner Cable, LLC, TWC Administration LLC, TWC Sports
<br /> Newco 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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