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Insurance Certificate ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM,DDITYYY) kr....../- 10/29/2014 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 Emily White NAME: y Assurance Partners l CNIJoFxt)_ (800)563-1871 tac.Not (755)825-5095 201 E Iron St. ADDRES S:ewhite@yourassurance.com P.O. Box 1213 INSURER(S)AFFORDING COVERAGE NAIC k Salina KS 67402-1213 INsuRERAAdmiral Insurance Company 24856a INSURED INSURERBNationwide Mutual Insurance Co 23787 North Central Regional Planning Commission INSURERcl:artford Underwriters Ins. Co. 30104 PO Box 565 INSURER D:Landmark American Ins. Co. INSURER E: Beloit KS 67420-0565 _INSURERF: COVERAGES CERTIFICATE NUMBER:14/15 All Lines 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 INSR SUBR POLICY NUMBER (MM/DDY/YYYY) (MMIDDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 50,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A CLAIMS-MADE X OCCUR FEIECC1095601 11/3/2014 11/3/2015 MEDEXP(Anyoneperson) S 5,000 PERSONAL&ADVINJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEI'tL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 5 2,000,000 1 POLICY n TECOT- P1 LOC $ AUTOMOBILE COMBINED SINGLE LIMIT UTOMOBILE LIABILITY {Ea accident) $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) S B ALL OWNED SCHEDULED ACP7260122072 11/3/2014 11/3/2015 AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PPe�accidentDAMAGE $ _ AUTOS PIP-Additional $ 27,500 UMBRELLA LIAB _ OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ C WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE N E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER In NH)EXCLUDED? 37WECHD1137 11/3/2014 11/3/2015 E.L.DISEASE-EA EMPLOYEE $ 500,000 (Mandatory In NH) If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 D LHR742052 11/3/2014 11/3/2015 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION coi@salina.org 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. PO Box 736 Salina, KS 67402-0736 AUTHORIZED REPRESENTATIVE Emily White/EMILYW C--,-1 ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 onions)ns The.A/:flPfl name.and Innn are renic}crcrl markc of ArfRrl