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Insurance Certificate Client#: 39960 MAYESPEI _- DATE(MMIDD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 3/31/2014 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 (A/C,No,Ext): (A/C,No): PO Box 2992 E-MAIL ADDRESS: Wichita, KS 67201 INSURER(S)AFFORDING COVERAGE NAIC# 316 267-9221 INSURER A:American Fire and Casualty Co. 24066 INSURED INSURER B:Ohio Casualty Insurance Company 24074 Mayer Specialty Services, LLC INSURER C Nationwide Mutual Insurance Co. 23787 PO Box 469 INSURER D:West American.Insurance Company 44393 831 Industrial Rd INSURER E: Goddard,KS 67052-0469 • 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 W LIMITS LTR INSR VD POLICY NUMBER (MMIDD/YYYY) (MM/DDIYYYY) A GENERAL LIABILITY BLA56027103 04/01/2014 04/01/2015 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED $1 00O 000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) , , CLAIMS-MADE X OCCUR MED EXP(Any one person) $5 000 PERSONAL&ADV INJURY 51,000,000 _ GENERAL AGGREGATE 52,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 52,000,000 7 POLICY n JET• LOC $ D. AUTOMOBILE LIABILITY BAW56027103 04/01/2014 0410112015 Ea COMBINED accident)SINGLE LIMIT 5 1,000,000 { � X ANY AUTO • BODILY INJURY(Per person) $ — ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ _ AUTOS _ AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS (Per accident) $ B X UMBRELLA LIAB X OCCUR US056027103* 04/01/2014 04/01/2015 EACH OCCURRENCE $2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DED X RETENTION$10,000 $ 1 C WORKERS COMPENSATION ACPWC3016600144 04/01/2014 04/01/2015 X WC STAIMTU- OTH- AND EMPLOYERS'LIABILITY TORY LITS ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 ' OFFICER/MEMBER EXCLUDED? y N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under -' - "DESCRIPTION OF OPERATIONS below - — E.L.DISEASE'-POLICY LIMIT Si,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Workers Compensation Information: Proprietors/Partners/Executive Officers/Members Excluded,subject to the policy terms and conditions. *Umbrella Liability does not include the Workers Compensation/Employers Liability coverage. RE: Project#11-2898-Sanitary Sewer Cleaning and Inspection CERTIFICATE HOLDER CANCELLATION City of Salina SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 736 ACCORDANCE WITH THE POLICY PROVISIONS. Salina, KS 67402 AUTHORIZED REPRESENTATIVE T/ �1 ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1011160/M1011068 SKB1 Client#: 39960 MAYESPEI D/YYYY) (MM/D ACORD,. CERTIFICATE OF LIABILITY INSURANCE 3 DATE M/D14 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 (A/C,NoExq: (A/C,No): ADDRESS: Wichita, KS 67201 INSURER(S)AFFORDING COVERAGE NAIC# 316 267-9221 American Fire and Casualty Co. 24066 INSURER A: Y INSURED INSURER B:Ohio Casualty Insurance Company 24074 Mayer Specialty Services, LLC INSURER C Nationwide Mutual Insurance Co. 23787 PO Box 469 INSURER D:West American Insurance Company 44393 831 Industrial Rd INSURER E: Goddard, KS 67052-0469 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 SUER POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A GENERAL LIABILITY BLA56027103 04/01/2014 04/01/2015 EACH OCCURRENCE $1,000,000 DAMARETO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) 51,000,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 5 000 PERSONAL 8 ADV INJURY S 1,000,000 • GENERAL AGGREGATE $2,000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S2,000,000 7 POLICY n Tn. LOC D AUTOMOBILE LIABILITY BAW56027103 04/01/2014 04/01/2015 Ea COMBIaccident)NED SINGLE LIMIT j1,000,000 ( _ 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) _ B x UMBRELLA LIAB X OCCUR US056027103* 04/01/2014 04/01/2015 EACH OCCURRENCE $2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE s2,000,000 DED X RETENTION 510,000 S C WORKERS COMPENSATION ACPWC3016600144 04/01/2014 04/01/2015 X TOORYIIMITS ERH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT S1,000,000 OFFICER/MEMBER EXCLUDED? y N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under --- DESCRIPTION'OF'OPERATIONS below — - I E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) Workers Compensation Information: Proprietors/Partners/Executive Officers/Members Excluded,subject to the policy terms and conditions. *Umbrella Liability does not include the Workers Compensation/Employers Liability coverage. RE: Project#10-2382-Sanitary Sewer Manhole Rehabilitation CERTIFICATE HOLDER CANCELLATION City of Salina SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 736 ACCORDANCE WITH THE POLICY PROVISIONS. Salina, KS 67402 AUTHORIZED REPRESENTATIVE � ©1988-2010 ACORD CORPORATION.All rights reserved. • ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1011161/M1011068 SKB1 Client#: 39960 MAYESPEI ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYI)3131/2014 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 PO Box 2992 E-MAI�o,Ext): (A/C,No): ADDRESS: Wichita, KS 67201 INSURER(S)AFFORDING COVERAGE NAIC# 316 267-9221 American Fire and Casualty Co. 24066 INSURER A: Y INSURED INSURER B:Ohio Casualty Insurance Company 24074 Mayer Specialty Services, LLC INSURER C Nationwide Mutual Insurance Co. 23787 PO Box 469 INSURER D:West American Insurance Company 44393 831 Industrial Rd INSURER E Goddard,KS 67052-0469 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 GENERAL LIABILITY BLA56027103 04/01/2014 04/01/2015 EACH OCCURRENCE 51,000,000 X COMMERCIAL GENERA L LIABILITY PREMISESO(EaEocccu RENTED 51,000,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $15,000 PERSONAL 8 ADV INJURY 51,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 52,000,000 7 POLICY n 78,7 LOC D AUTOMOBILE LIABILITY BAW56027103 04/01/2014 04/01/2015 Ea OMBIaccideNED nt)SI 3S NGLE LIMIT 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) $ B x UMBRELLA LIAB X OCCUR US056027103* 04/01/2014 04/01/2015 EACH OCCURRENCE s2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE s2,000,000 DED X RETENTION SI 0,000 $ `+ WORKERS COMPENSATION ACPWC3016600144 04/01/2014 04/01/2015 X TORYLI U- IOTRH- AND EMPLOYERS'LIABILITY TORY LIMITS Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT 51,000,000 OFFICER/MEMBER EXCLUDED? Y N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE 51,000,000 ___ .If yes,.descdbe.under_ _ — DESCRIPTION OF OPERATIONS below E.L.DISEASE=POLICY'LIMIT -$1;000;000- _ _ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Workers Compensation Information: Proprietors/Partners/Executive Officers/Members Excluded,subject to the policy terms and conditions. *Umbrella Liability does not include the Workers Compensation/Employers Liability coverage. RE: Project#13-2965-Manhole and Wastewater Pump Station Rehabilitaion Certificate Holder, its agents, representative,officer officials, and employees are included as Additional (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION City of Salina SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Shandi Wicks ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 736 Salina, KS 67402-0736 AUTHORIZED REPRESENTATIVE,' ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 2 The ACORD name and logo are registered marks of ACORD #S1011162/M1011068 SKB1 • DESCRIPTIONS:(Continued from Page 1) Insured on the General Liability policy if required by written contract or agreement subject to the policy terms and conditions. A Waiver of Subrogation is provided in favor of Certificate Holder on the General Liability and Automobile Liability Policies if required by written contract or agreement,subject to the policy terms and conditions. SAGITTA 25.3(2010/05) 2 of 2 #S1011162/M1011068