CERTIFICATE OF LIABILITY INSURANCEClient#: 64416 14KNOLOGYINC
DATE (MMIDDIYYYY)
ACORDTM CERTIFICATE OF LIABILITY INSURANCE s�z2i2o�2
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 CONTACT
NAME:
J. Smith Lanier & Co.-Atlanta PHONE 770 476-1770 F� 770 476-3651
AIC No, Ext : A/C, No :
11330 Lakefield Drive E-MAIL
Bldg 1, Suite 100 ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
Duluth, GA 30097 . Twin City Fire Insurance Co 29459
INSURED
Knology, Inc.
1241 O G Skinner Drive
West Point, GA 31833
INSURER A . •
iNSUReR a: Continental Casualty Company 20443
INSURER C :
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR 7ypE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LIMITS
LTR INSR VWD POLICY NUMBER MMIDD MM/DD
A GENERALLIABILITY 20ECSMG3421 06/01/2012 06/01/201 EACHOCCURRENCE $�,�0�,0��
X COMMERCIAL GENERAL LIABILITY PREMISES Ea oNcu ence $ 300,000
CLAIMS-MADE � OCCUR MED EXP (Any one person) $
PERSONAL & ADV INJURY $ �,OOO,OOO
GENERALAGGREGATE $Z,OOO�OOO
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $Z,OOO,OOO
POLICY PR� LOC $
JECT
A AUTOMOBILELIABILITY 20UENMG3422 6/01/2012 06/01/201 EaaBctleD[SINGLELIMIT $,�,000�000
X ANY AUTO BODILY INJURY (Per person) $
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS $
X HIRED AUTOS X AON SWNED Pper�a cRdentDAMAGE
$
B �( UMBRELLA LIAB X OCCUR L4018241272 6101/2012 06/01/201 EACH OCCURRENCE $� � ��� ��0
EXCESS LIAB CLAIMS-MADE AGGREGATE $�O OOO OOO
DED X RETENTION $� O OOO $
A WORKERSCOMPENSATION 20WNMG3420 6/01/2012 06/01/201 X W RYLIMIT ERH
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y� N E.L. EACH P.CCIDENT $rJOO�OOO
OFFICER/MEMBER EXCLUDED? � N / A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $rJOO OOO
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $rJOO,OOO
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
City of Clearwater is named as additional insured as per written contract, but only with respects to the
general liability insurance and subject to the provisions and limitations of the policy. MAY 2 5 2��2
OFFICIAL R�CORDS AN�
LE6'I�LATNE SRVCS DEPi
HOLDE
Clt of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
P.O. Box 4748 ACCORDANCE WITH THE POLICY PROVISIONS.
Clearwater, FL 33756-0000
AUTHORIZED REPRESENTATIVE
O 19 8- 010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S1555783/M1555654 LXA