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ACORD,. CERTIFICATE OF LIABILITY INSURANCE 09/30/2007 09/28/2006
PRODUCER Lockton Companies THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
P ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
444 W.47th Street,Suite 900 HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Kansas City Mo 64112-1906 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
(816)960-9000 INSURERS AFFORDING COVERAGE
INSURED US CABLE OF COASTAL-TEXAS L.P. INSURER A HARTFORD FIRE
4333 dba US CABLE OF WEST TEXAS INSURER B:
28 WEST GRAND AVENUE INSURER c• FIREMAN'S FUND
MONTVALE NJ 07645 INSURFR D• COMMERCE&INDUSTRY(AIG-ST.LOUIS)
I INSURFR E• INS.CO OF STATE PA(AIG-ST.LOUIS)
THIS CERTIFCATE OF INSURANCE DOES NOT COVERAGES USCAB03 ZH NSURER SI I CONSTITUTE
AU HORIZED REPRESENTATIIVECONTRACT
R PRODUC R AND THE CERTIFICATE HO)DFR
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT, 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR POLICY EFFECTIVE I POLICY EXPIRATION
L_Tit TYPE OF INSURANCE POLICY NUMBER DATE IMM/DDIYY) DATE IMM/DDNYI UMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY 37UUNAK0159 09/30/2006 09/30/2007 FIRE DAMAGE(Any one fire) $ 300,000
CLAIMS MADE X OCCUR MED EXP(Any one person) $ 10,000
PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000
PRO-
POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
A X ANY AUTO 37UENAK0228(AOS) 09/30/2006 09/30/2007 (Es accident)
$ 1,000,000
ALL OWNED AUTOS
BODILY INJURY $ XXXXXXX
SCHEDULED AUTOS (Per person)
X HIRED AUTOS
BODILY INJURY $ XXXXXXX
X NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $ XXXXXXX
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ XXXXXXX
ANY AUTO NOT APPLICABLE OTHER THAN EA ACC $ XXXXXXX
AUTO ONLY: AGG $ XXXXXXX
EXCESS LIABILITY EACH OCCURRENCE $ 5,000,000
C X I OCCUR CLAIMS MADE SU077503688 09/30/2006 09/30/2007 AGGREGATE $ 5,000,000
IIII UMBRELLA $ XXXXXXX
DEDUCTIBLE ` I FORM $ XXXXXXX
RETENTION $ $ XXXXXXX
D WORKERS COMPENSATION AND TBD(AOS) 09/30/2006 09/30/2007 X Wcsuru- I Pr-
EMPLOYERS TORY LIMIT$ FR
EMPLOVERS'LIABILtT1' E.L.EACH ACCIDENT $ 1,000,000
E TBD(NJ) 09/30/2006 09/30/2007 E.L.DISEASE-EA EMPLOYEE $ 1,000,000
E.L.DISEASE-POLICY LIMIT $ 1,000,000
A OTHER 37UUNAK0159 09/30/2006 09/30/2007 ALL RISK FORM.$10,000 DED.
REAL&PERSONAL PROPERTY
DESCRIPTION OF OPERATONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER IS AN ADDITIONAL INSURED UNDER THE ABOVE CAPTIONED POLICY.
CERTIFICATE HOLDER I ADDITIONAL INSURED;INSURER LETTER: CANCELLATION
1003184 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
WELD COUNTY DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
ATTN:BILL HAWKINS
P.O.BOX 758 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
GREELEY CO 80632 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ar
bYn.nuuvir.471n t/5
ACORD 25-S(7/977) For questions regarding this certificate,contact the number listed in the'Produce' above and specify theclient cods'USCABW'. ®A OR
T�ORATION 1988
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ago y&,98720
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