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Insurance Certificate PHILADELPHIA INDEMNITY INSURANCE COMPANY 1-877-438-7459 ONE BALA PLAZA, SUITE 100 BALA CYNWYD PA 19004 NOTICE OF NONRENEWAL OF INSURANCE Named Insured&Mailing Address: Producer:0004487 SAINT FRANCIS COMMUNITY SERVICES, I ASSURANCE PARTNERS,LLC 509 E ELM ST PO BOX 1213 SALINA KS 67401 SALINA KS 67402 Reference: N/A Policy No.: PHPK2005479 Type of Policy: ME :MENTAL HEALTH PACKAGE Date of Expiration: 07/01/2020; 12:01 A.M. Local Time at the mailing address of the Named Insured. We will not renew this policy when it expires. Your insurance will cease on the Expiration Date shown above. The reason for nonrenewal is due to change in underwriting parameters. This policy provides auto liability coverage. You should contact your agent or any agent concerning your possible eligibility for replacement coverage through another insurer or the Kansas Automobile Insurance Plan. Kansas law requires that financial security, for every motor vehicle covered by this policy, is required to be maintained continuously throughout the registration period. Operating any such motor vehicle without maintaining continuous financial security is a class B misdemeanor and shall be subject to a fine of not less than $300 and not more than $1,000. The registration for any such motor vehicle for which continuous financial security is not provided is subject to suspension, and the driver's license of the owner is subject to suspension. This policy provides fire and extended coverage insurance on your property. You should contact your agent or any agent concerning coverage through another insurer or your possible coverage through the Kansas All-Industry Placement Facility. Date Mailed: 15th ay of April, 2020 Other Party of Interest MIALA CITY OF SALINA DEPARTMENT OF FINANCE ADMINISTRATION ATTN: SHANDI WICKS 300 W ASH ST- PO BOX 736 DONNA KENNEDY SALINA KS 67402 KSCN36NONE APP FORM#CN9697101112KS91999 04152020MYNY ODEN 3.0.20.02a Copy for Other Interests Page 1 of 1 0000297-0000518 a`o�ito® CERTIFICATE OF LIABILITY INSURANCE DATEIMMID19YY) 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(les) 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 TRUSS NAME: Certificate Department 9200 Ward Parkway ,EAM"co No Enc 816-708-4600 1 FAX No):816-708-4600 Suite 500 ADDRESS; Certificates@TrussAdvantage.com Kansas City MO 64114 INSURER(S)AFFORDING COVERAGE NAICa INSURER A:Philadelphia Indemnity Co. I 18058 INSUREDS INSURER B:United Wisconsin Insurance Co 29157 Saint Francis Ministries, Inc • 509 E Elm Street INSURER C:Philadelphia Insurance Co. 1 23850 Salina KS 67401 INSURER D: INSURER E: I INSURER F: COVERAGES CERTIFICATE NUMBER:326711660 REVISION NUMBER: - —THIS IS-TO'CERTIFY-TFIATTHE POLICIES OF INSURANCE LISTED BELOW HAVFBEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT%MTH 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. /LTRI TYPE OF INSURANCE !N�DISrwn I POLICY NUMBER I(MM/DDYEFF IYYYY)I IMWDD(EXP VYYYI LIMITS C I X I COMMERCIAL GENERAL LIABILITY Y PHPK2005479 7/1/2019 7112020 EACH OCCURRENCE 5 1000.000 I CLAIMS MADE n OCCUR DAMAGE TO RENTED PREMISES(Ea°minence) 51000000 MED EXP(Any one person) 15 20.000 PERSONAL 8 ADV INJURY 51000.000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 153.030.000 . X 1 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG 53.000.000 OTHER: 15 A 1 AUTOMOBILE LIABILITY PHPK2005465 7/12019 7/12020 COMaBIINEEDt,SINGLE LIMIT 1 51000000 X (Ea I ANY AUTO BODILY INJURY(Per person) 15 ALL OWNED SCHEDULED1,1 BODILY INJURY Per attidem $ AUTOS ❑AUTOS ( )I HIRED AUTOS NON-OWNED PROPERTY DAMAGE 13 AUTOS (Per accident) I5 A X UMBRELLA UAB X OCCUR PHUB683928 7112019 7112020 EACH OCCURRENCE 155.000.000 EXCESS UAB CLAIMS-MADE AGGREGATE 55.000.000 I DED I X I RETENTIONS to rYYl 5 B WORKERS COMPENSATION 0400175B1c 7/12019 7/1/av20 X I STATUTE I 10R I AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER7EXECUTIVE ri E.L.EACH ACCIDENT 5500.000 OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) EL.DISEASE-EA EMPLOYEE 5500,000 __ It yes.dasaibe under — - -- — - - - - - - - - - DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT S 500.000 C Professional1labAty PHPK2005479 7/1/2019 7/1/2020 Ea.InccdenuAgg 51M153M DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Re:Agreement between City of Salina and Saint Francis Community Services,Inc.for the provision of substance abuse prevention and treatment programming for the period of 4/19/2013 through 12/31/2017.Certificate holder is additional insured as respects General Liability if required by written contract or agreement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Salina ACCORDANCE WITH THE POLICY PROVISIONS. Dept. of Finance&Administration 300 West Ash AUTHORIZEDORI�ZEREPRESENTATIVE�� S Box 736 t"rT - Sallina KS 67402-0736 I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD TE AC® CERTIFICATE OF LIABILITY INSURANCE DA 6m2016 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 TRUSS NAME: Certificate Department PHNE 9200 Ward Parkway IINc_tEat1:816.708.4600 I JC,No):913-491-6379 Suite 500 ADDRESS: Certificates@TwssAdvantage.com Kansas City, MO 64114 INSURER(S)AFFORDING COVERAGE NAIL It INSURER A: Philadelphia Indemnity Co. 18058 INSURED 30326 INSURER a:United Wisconsin Insurance Co 29157 Saint Francis Community Services, Inc. 509 E Elm Street INSURER C: Salina KS 67401 INSURERD: INSURER E: INSURER F: —COVERAGES---- -- -CERTIFICATE-NUMBER: 1876099005 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. LTR R I TYPE OF INSURANCE I Nsp ISWyp I POLICY NUMBER I(MM/DDY/YYYY)EFF I I M/DDYIYYYYf I LIMITS A X I COMMERCIAL GENERAL LIABILITY Y : PHPKISe0348 7/12018 7/12019 I EACH OCCURRENCE I S 1.000.000 CLAIMS-MADE X OCCUR I DAMAGE TO RENTED PREMISES fEa oornnence) I S1,000,000 I I MED EXP(Any one person) I$20,000 J PERSONAL 8 ADV INJURY I S 1.000,000 G�ERI_AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 3,000,000 I POLICY JE LOC PRODUCTS-COMP/OP AGG 53,000,000 OTHER: _ I I S A I AUTOMOBILE LIABILITY PHPK1839982 7/1/2018 7/12019 COMBINED 1 SINGLE LIMIT I $ (Ea000000 I X ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-0WNEO PROPERTY DAMAGE S _HIRED AUTOS AUTOS (Per accident) I I I I S A I X UMBRELLA LIAR X OCCUR PHURe35186 7/1/2018 7112019 EACH OCCURRENCE S4,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000 I DED I X I RETENTIONS 101X10 I S B WORKERS COMPENSATION 0400160276 7/120161112019 X I STATITIE I I OR AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIEE.L.EACH ACCIDENT S 500,000 OFFICER/MEMBER EXCLUDED?_-__- N N/A _ -�— — — (Matary in NH) - and EL DISEASE-EA EMPLOYEE S 500.000 If yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I S 500.000 A Professional Liabity PHPK1840348 7/12018 1/12019 Per Incidem 1,000,000 Aggregate 3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:Agreement between City of Salina and Saint Francis Community Services, Inc.for the provision of substance abuse prevention and treatment programming for the period of 4/19/2013 through 12/31/2017.Certificate holder is additional insured as respects General Liability if required by written contract or agreement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Salina ACCORDANCE WITH THE POLICY PROVISIONS. Dept. of Finance&Administration 300 West Ash P 0 Box 736 AUTHORIZEDZEREPRESENTATIVE Salina KS 67402-0736 114,1) 1 T ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD PHILADELPHIA INDEMNITY INSURANCE COMPANY 1-877-438-7459 ONE BALA PLAZA, SUITE 100 BALA CYNWYD PA 19004 REINSTATEMENT NOTICE Named Insured 8 Mailing Address: Producer.0001588 SAINT FRANCIS COMMUNITY SERVICES, I TRUSS,LLC 509 E ELM ST 4551 WEST 107TH STREET P.O. BOX 1340 THIRD FLOOR SALINA KS 67401 OVERLAND PARK KS 66207 Policy No.: PHPK1672892 Type of Policy: PACKAGE You recently received a notice advising this policy was being cancelled effective 10/25/2017 . This notice is to advise that the policy is being reinstated without lapse in coverage. _ Date Mailed: 19th day of October, 2017 Other Party of Interest CITY OF SALINAADMINISTRATION DEPARTMENT OF FINANCE keS ATTN: SHANDI WICKS 300 W ASH ST-PO BOX 736 MISSY LYNCH SALINA KS 67402 KSCT19 FORM#CT969897KS51995 10192017SN ODEN 30.17.03a Copy for Other Interests Page 1 off1 1 0001171-0002394 • PHILADELPHIA INDEMNITY INSURANCE COMPANY • 1-877-438-7459 ONE BALA PLAZA, SUITE 100 • BALA CYNWYD PA 19004 NOTICE OF CANCELLATION OF INSURANCE Named Insured 8 Mailing Address: Producer:0001588 SAINT FRANCIS COMMUNITY SERVICES, I TRUSS,LLC 509 E ELM ST 4551 WEST 107TH STREET P.O. BOX 1340 THIRD FLOOR SALINA KS 67401 OVERLAND PARK KS 66207 • Reference: N/A • Policy No.: PHPK1672892 Type of Policy: PACKAGE Date of Cancellation: 10/25/2017; 12:01 A.M. Local Time at the mailing address of the Named Insured. We are cancelling this policy. Your insurance will cease on the Date of Cancellation shown above. • The reason for cancellation is NONPAYMENT OF PREMIUM $ 28818.83. Your interest in this policy as an "insured"or other party of interest is being cancelled effective 10/25/2017; 12:01 A.M. Local Time at the mailing address of the named insured. • • • • • • • • • r • Date Mailed: 11th day of October, 2017 Other Party of Interest ��,���///$$$jjj///(((���(//_���J/J���///� � CITY-OF3 f SNS 001 f5lfff hee V CITY OF SALINA DEPARTMENT OF FINANCE ` a ADMINISTRATION ATTN: SHANDI WICKS 300 W ASH ST- PO BOX 736 MISSY LYNCH SALINA KS 67402 — KSCC19NONPMNT FORM#CC9697KS51995 10102017MYNY Page 1 of 1 ODEN 3 o.17_08a Copy for Other Interests ACGREP CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 7/18/2016 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 ACT Certificate Department TRUSS PHONE 813. . FAX 913-491-6379 4551 W. 107th St.,Third Floor (A/C.No Est). 3418998 (A/C.No): E-MAIL Certificates TrussAdvanta e.com Overland Park KS 66207 ADDRESS: g INSURER(S)AFFORDING COVERAGE _ NAIC# INSURERA:Philadelphia Insurance Co. 23850 INSURED 30326 INSURER B:United Wisconsin Insurance Co 29157 Saint Francis Community Services, Inc. INSURER C: 509 E Elm Street Salina KS 67401 INSURER D: INSURER E: INSURER F: COVERAGES— _—__ CERTIFICATE.NUMBER: 140716044.7_ _ 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP W LIMITS LTR INSD VD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYYI A X I COMMERCIAL GENERAL LIABILITY Y PHPK1519315 7/1/2016 7/1/2017 EACH OCCURRENCE $1,000,000 DAMAGE CLAIMS-MADE X OCCUR PREM SESO(Ea occu RENTED $1,000,000 MED EXP(Any one person) $20,000 PERSONAL 8 ADV INJURY $1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $3,000,000 OTHER: S A AUTOMOBILE LIABILITY PHPK1519300 7/1/2016 7/1/2017 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) I$ ALL OWNED SCHEDULED BODILY INJURY(Per accident)!$ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) A X I UMBRELLA LIAB X OCCUR PHUB547805 7/1/2016 7/1/2017 EACH OCCURRENCE $2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE . $2,000,000 DED X RETENTION$10,000 $ B WORKERS COMPENSATION 0400144703 7/1/2016 7/1/2017 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE -- E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory.in.NH) - —--._.__ _ .— _— —___—__-�-- --EA—DISEASE--.:EA:EMPLOYEE-5500,000 ——-— If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 A Professional Liability PHPK1519315 7/1/2016 7/1/2017 Per Incident 1,000,000 Aggregate 3,000,000 • DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:Agreement between City of Salina and Saint Francis Community Services, Inc.for the provision of substance abuse prevention and treatment programming for the period of 4/19/2013 through 12/31/2017. Certificate holder is additional insured as respects General Liability if required by written contract or agreement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Salina THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Dept. of Finance&Administration ACCORDANCE WITH THE POLICY PROVISIONS. 300 West Ash P 0 Box 736 AUTHORIZED REPRESENTATIVE Salina KS 67402-0736 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Client#: 22818 SAINFRA ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 7/01/2015 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: IMA, Inc.-Wichita Division PHONE 316 267-9221 FAX 316 266-6254 PO Box 2992 E--MA Lo,Ext): (A/C,No): Wichita, KS 67201 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC 316 267-9221 INSURERA:Philadelphia Indemnity Ins. Co. 18058 INSURED INSURER B:United Wisconsin Insurance Co. 29157 Saint Francis Community Services, Inc. 509 E Elm Street INSURER C Salina, KS 67401-2353 INSURER D: INSURER E: I 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 LTR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A GENERAL LIABILITY PHPK1359485 07/01/2015 07/01/2016 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO occurrence) $1,000,000 X CLAIMS-MADE OCCUR MED EXP(Any one person) $20000 X Retro Date: 7/5/1989 PERSONAL 8 ADV INJURY S1,000,000 GENERAL AGGREGATE 53,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 53,000,000 -1 POLICY n PECOT- n LOC 5 A AUTOMOBILE LIABILITY PHPKI359428 07/01/2015 07/01/2016 COMBINED SINGLE LIMIT(Eaaccident) 31,000,000 _ X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS _ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) A x UMBRELLA LIAB IOCCUR PHUB505801 07/01/2015.07/01/2016 EACH OCCURRENCE s2,000,000 EXCESS LIAB X CLAIMS-MADE AGGREGATE $2,000,000 DED X RETENTION 51 0,000 $ B WORKERS COMPENSATION 0400144703 07/01/2015 07/01/201d X I TORY LIMITS EORH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT 5500,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE POLICY LIMIT s500,000 A Professional PHPK1359485 07/01/2015 07/01/2016 Retro Date: 7/5/1989 Liability See Below for Coverages and Deductibles DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Professional Liability-Claims Made; Each Incident$1,000,000; Aggregate $3,000,000. Abuse or Molestation: Each Person/Sublimit$1,000,000; Aggregate/Sublimit$1,000,000. Re:Agreement between City of Salina and Saint Francis Community Services, Inc.for the provision of substance abuse prevention and treatment programming for the period of 4/19/2013 through 12/31/2017. (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION City of Salina, Dept.of Finance SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN and Administration ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Shandi Wicks 300 West Ash; P 0 Box 736 AUTHORIZED REPRESENTATIVE Salina, KS 67402-0736 ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 2 The ACORD name and logo are registered marks of ACORD #S1153817/M1153102 SLF2 • DESCRIPTIONS (Continued from Page 1) - Certificate Holder is included as Additional Insured on the General Liability policy if required by written contract or agreement subject to the policy terms and conditions. SAGITTA 25.3(2010/05) 2 of 2 #S1153817/M1153102 Client#:22818 SAINFRA ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6127/2014 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:. • IMA,Inc.-Wichita Division PHONE 316 267-9221 FAX 316 266-6254 LAIC,No,Est): FAX No): PO Box 2992 - • E-MAIL• Wichita, KS 67201 ADDRESS: 316 267-9221 INSURER(S)AFFORDING COVERAGE NAIL# INSURER A:Philadelphia Indemnity Ins.Co. 18058 INSURED INSURER B:United Wisconsin Insurance Co. 29157 - Saint Francis Community Services,Inc. 509 E Elm Street INSURER c: INSURER D: Salina, KS 67401-2353 • 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) A GENERALLIABILITY PHPK1196878 07/01/2014 07/01/2015 EACH OCCURRENCE $1,000,000 XI COMMERCIAL GENERAL LIABILITY PRAEMSE (EaENccTrence) $1,000,000 X CLAIMS-MADE OCCUR MED EXP(Any one person) $20,000 X Retro Date:7/5/1989 PERSONAL 8.ADV INJURY $1,000,000 • . - •. - - . GENERAL AGGREGATE $3,000,000. GENt AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $3,000,000 7 POLICY n E Q LOC. $• AUTOMOBILE UABILUTY COMBINED SINGLE LIMIT A _ PHPK1196869._ , 07/01/2014 07/01/2015(Eaacddent) $1,000,000 X ANY AUTO. - - BODILY INJURY(Per person) $ - ALL OWNED SCHEDULED . • • BODILY INJURY(Per accident) $ AUTOS • AUTOS- - - . •X HIRED AUTOS X NON-OWNED _ PROPERTY DAMAGE $ _ _ AUTOS (Per accident) _ l $ A XI UMBRELLA UAB _ OCCUR PHUB464967 07/01/2014 07/01/2015 EACH OCCURRENCE $2,000,000 EXCESS LIAB X CLAIMS-MADE AGGREGATE $2,000,000 DED X RETENTION$10,000 $ B WORKERS COMPENSATION 0400137600 07/01/2014 07/01/2015 X WY T AMTS OR - AND EMPLOYERS'LIABILITY _ -- ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below . ._ _ _-_El.DISEASE_POLICY.LIMIT_.s500,000_ _ _ ___-_ A Professional PHPK1196878 07/01/2014 07/01/201 Retro Date:7/5/1989 Liability See Below for Coverages and Deductibles DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Professional Liability-Claims Made; Each Incident$1,000,000;Aggregate$3,000,000. Abuse or Molestation: Each Person/Sublimit$1,000,000;Aggregate/Sublimit$1,000,000. Re:Agreement between City of Salina and Saint Francis Community Services, Inc.for the provision of substance abuse prevention and treatment programming for the period of 4/19/2013 through 12/31/2015. Certificate Holder is included as Additional Insured on the General Liability policy if required by written contract or agreement subject to the policy terms and conditions. • CERTIFICATE HOLDER CANCELLATION City of Salina, Dept.of Finance SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN and Administration ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Shandi Wicks 300 West Ash; P 0 Box 736 AUTHORIZED REPRESENTATIVE Salina, KS 67402-0736 •I D-s,6.gra.k. 10. 134,-..eth ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1041991/M1041981 SNW