Loading...
Insurance (Sparrowhawk-Alsop Sand) .--"---- ALSOSAN-01 TLT2 A R O DATE CERTIFICATE OF LIABILITY INSURANCE 12/18/2014 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(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 Ileu of such endorsement(s). PRODUCER CONTACT NAME: Signature Select LLC-Kansas City Branch PxoNE 813 982-3660 FAX 9983 W 110th Street lac,xo war( I (Arc,No):(913)982-3495 Suite 600 ADDRESS: Overland Park,KS 66210 INSURER(S)AFFORDING COVERAGE NAICft _ INSURER A:EMCASCO Insurance Company 21407 INSURED INSURER B:Employers Mutual Casualty Company 21415 Sparrowhawk Land,LLC INSURER C: 105 Industrial Rd INSURERO: Concordia,KS 66901 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. ADDL SUER POLICY EFF POLICY EXP UNITS ILTR TYPE OF INSURANCE MED W D POLICY NUMBER IMMIDDNYYYI IMMIDDRYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X 4E18630514 12/31/2014 12/31/2015 DAMA4t IO REmEO 100,000 CLAIMS-MADE OCCUR PREMISES IEa asumnRl $ MED EXP(Any one person) $ 5,000 PERSONAL S ADV INJURY $ 1,000,000 GE NI AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY © PR0. X LOC PRODUCTS-COMP/OP AGG S 2,000,000 JECT OTHER: S AUTOMOBILE WBWTY COMBIINEEDI SINGLE LIMIT $ 1000000 A X A ys.uso 4E8630514 12/31/2014 12/31(2015 BODILY INJURY(Per Parson) S ALL OWNED SCHEDULED BODILY INJURY(Per acadent) Sr AUTOS AUTOS-O EO W—FR6PEY DAMAGE X HIRED AUTOS AUT S (Per accident) S $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S. 4,000,000 B EXCESS LIAR CLAIMS-MADE 4J8630514 12/31/2014 12/31/2015 AGGREGATE $ DED I X RETENTIONS 10,000 $ 4,000,000 WORKERS COMPENSATOR PER IOTH- AND EMPLOYERS'UAMU Y STATUTE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE Yr'I N/A 4H8630514 12/31/2014 12/31/2015 EL EACH ACCIDENT $ 500,004 (Manda�En NH)E%CLUOEOY EL.DISEASE-EA EMPLOYEE $ 600,004 N Yes RJP11W under EL DISEASE-POLICYLIMIT $ 600,000 DESCRIPTOR OF OPERATIONS below DESCRIPTOR OF OPERATIONSI LOCATIONS/VENICLES (ACORD 101,Ad01NOnal Remarks Schedule,may be attached Irmo a space Is required) RE:Stone Lake Devemopment City of Salina 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 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Salina THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Mike Schrage 300 W Ash St Salina,KS 67401 AUTHORIZED REPRESENTATIVE �� , 1 aw�. 1Yr/S./I�.. ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ALSOSAN-01 TLT2 A DATE IMMMDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 12/18/2014 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 pollcy(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 NAME: Signature Select LLC-Kansas City Branch E PHONE Fi11.(913)982-3660 FAX No(913)982-3495 9383 W 110th Street ADDRESS: Suite 600 ADDRESS: Overland Park,KS 66210 INSURER(S)AFFORDING COVERAGE NAIL INSURER A:EMCASCO Insurance Company 21407 INSURED INSURER B:Employers Mutual Casualty Company 21415 Alsop Sand Co.,Inc. INSURER C: 105 Industrial Rd INSURER O: Concordia,KS 66901 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. TYPE OF INSURANCE ADD!.SUMS POLICY EFF POLICY FXP INSR INSD WD POLICY NUMBER IMMIDD/YYYYI IMM/DOIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 X 4D8630514 12/31/2014 12/31/2015 DNNAGETOREN'Tenon E 100,000 CLAIMS-MADE OCCUR MED EXP 5m) MED EXP(Anyore person) $ 5,000 PERSONAL B ADV INJURY S 1.000,000 I GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 2,000,000 POLICY X JECT X LOG PRODUCTS.COMP/OP AGG S 2,000,000 S OT COMBINED SINGLE LIMIT f 1,000,000 AUTOMOBILE LIABILITY COMBINED student A X ANY AUTO 4E8630514 12/31(2014 12/31/2015 BODILY INJURY(Per Person) S ALL OWNED —SCHEDULED BODILY INJURY(Per scdclanl) $ AUTOS ON PROPERTY DAMAGE S X HIRED AUTOS X N AUTOS-0KNED (Per accident) S X UMBRELLA UAB X OCCUR EACH OCCURRENCE S 4,000,000 B EXCESS MB CLAIMSNPDE 4.18630514 12/31/2014 12/31/2015 AGGREGATE S DED I X RETENTIONS 10,000 $ 4,000,000 PER OTH- WORKERS IDEMPLCOMPENSATION STATUTE ER . AND EMPLOYERS'UABIUTY Y/N 4H8630514 12/31/2014 1213112015 EL EACH ALLIDENT E 600,000 A ANY PRLPRIMBER EXCLUDED/ ❑ N/A Manlndaa�En NH)E%CWOEO? EL DISEASE-EA EMPLOYEE S 600,000 DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS I LOCATORS/VEHICLES(ACORD 101.Additional Remarks Schedule.may be attached It more space Is required) RE:Stone Lake Devemopment City of Salina 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 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. Attn:Mike Schrage 300 W Ash St Salina,KS 67401 AUTHORIZED DIREPRESENTATIV��E�� i ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ALSOSAN-01 LXC ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE 12/19/DDIYYYY) 1 2/1 91201 3 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: Signature Select LLC-Kansas City Branch PHONE 913 982-3660 3658 FAX 913 982-3495 9393 W 110th Street (A/C,No,Ext):( ) (A/c,No):( ) Suite 600 A Overland Park,KS 66210 ADD DREDRE SS: INSURER(S)AFFORDING COVERAGE NAIC S INSURER A:EMCASCO Insurance Company 21407 INSURED INSURER B:Employers Mutual Casualty Company 21415 Sparrowhawk Land,LLC INSURER C: 105 Industrial Rd INSURER D: Concordia,KS 66901 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 I A S POUCY EFF POLICY EXP NSR WVD POUCY NUMBER (MMIDD/YYYY) (MMIDDlYYYY) LIMITS GENERAL UABIUTY EACH OCCURRENCE S 1,000,000 A X COMMERCIAL GENERAL LIABILITY 4D8630514 12/31/2013 12/31/2014 DAMAGE TO RENTED 100 000 PREMISES(Ea occurrence) S CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 5 2,000,000 —I POLICY n ECT I ^ I Loc $ AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT 1 000 000 (Ea accident) 5 , , A X ANY AUTO 4E8630514 12/31/2013 12/31/2014 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS _ AUTOS X HIRED AUTOS X NON-0WNED PROPERTY DAMAGE S AUTOS (Per accident) S X UMBRELLA UAB X OCCUR EACH OCCURRENCE 5 4,000,000 B EXCESSUAB CLAIMS-MADE 4J8630514 12/31/2013 12/31/2014 AGGREGATE S 4,000,000 DED X RETENTIONS 10,000 S WORKERS COMPENSATION X VnC STATU- IOTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER Y/N A ANY PROPRIETOR/PARTNER/EXECUTIVE 4H8630514 12/31/2013 12/31/2014 E.L.EACH ACCIDENT S 500,000 OFFICER/MEMBER EXCLUDED? © N I A _. _(Mandatory in NH)___ _ _ _ _ _E.L..DISEASE-EA.EMPLOYEE-S .—.500,000_____ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 5 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) RE:Stone Lake Devemopment City of Salina 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 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Salina THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ci Ctn of Salina Schrage ACCORDANCE WITH THE POLICY PROVISIONS. 300 W Ash St Salina,KS 67401 AUTHORIZED REPRESENTAT��IVE�--- • ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD