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Greater Salina Community Foundation CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 5/2/2012 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). CONTACT Brenda Smith PRODUCER NAME: FAX PHONE (800)563-1871 Assurance Partners (785)825-5098 (A/C, No): (A/C, No, Ext): E-MAIL bsmith@yourassurance.com 2090 S. Ohio ADDRESS: PRODUCER 00002505 P.O. Box 1213 CUSTOMER ID #: Salina KS 67402-1213 INSURER(S)AFFORDINGCOVERAGE NAIC# AMCO Insurance Company 19100 INSURED INSURER A : INSURER B : Greater Salina Community Foundation INSURER C : PO Box 2876 INSURER D : INSURER E : Salina KS 67402-2876 INSURER F : 12-13 renewal COVERAGES CERTIFICATENUMBER:REVISIONNUMBER: 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. ADDLSUBR INSR POLICY EFF POLICY EXP TYPE OF INSURANCE LIMITS POLICY NUMBER (MM/DD/YYYY)(MM/DD/YYYY) LTR INSRWVD 1,000,000 GENERAL LIABILITY EACHOCCURRENCE$ DAMAGE TO RENTED X 300,000 COMMERCIAL GENERAL LIABILITY$ PREMISES(Eaoccurrence) 6/14/20126/14/2013 A 5,000 X ACP7220659405 CLAIMS-MADE OCCUR MEDEXP(Anyoneperson)$ 1,000,000 PERSONAL&ADVINJURY$ 2,000,000 GENERAL AGGREGATE$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:PRODUCTS - COMP/OP AGG$ PRO- X $ POLICY LOC JECT COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $ (Eaaccident) ANY AUTO BODILYINJURY(Perperson)$ ALL OWNED AUTOS BODILYINJURY(Peraccident)$ SCHEDULEDAUTOS PROPERTY DAMAGE $ (Peraccident) HIRED AUTOS $ NON-OWNED AUTOS $ UMBRELLA LIAB EACHOCCURRENCE$ OCCUR EXCESS LIAB CLAIMS-MADE AGGREGATE$ $ DEDUCTIBLE $ RETENTION$ WC STATU-OTH- WORKERS COMPENSATION A X TORY LIMITS ER AND EMPLOYERS' LIABILITY Y / N 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACHACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? 6/14/20126/14/2013 ACP7220659405 100,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ Ifyes,describeunder 500,000 E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION coi@salina.orgcoi@salina.orgcoi@salina.org (785)309-5738(785)309-5738(785)309-5738 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Salina City of Salina City of Salina 300 W Ash 300 W Ash 300 W Ash AUTHORIZED REPRESENTATIVE Salina, KS 67401Salina, KS 67401Salina, KS 67401 ACORD25(2009/09)©1988-2009ACORDCORPORATION.Allrightsreserved. TheACORDnameandlogoareregisteredmarksofACORD INS025 (200909)