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Insurance Certificate - Utilities
�.....1 DNAENTE-01 AJANSEN ACORO DATE(MM/DD/YYYY) ‘..----- CERTIFICATE OF LIABILITY INSURANCE 2/22/2021 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 have ADDITIONAL INSURED provisions or 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 Andrea Finlay Fee Insurance Group,Inc. (A//c00,,"No,Ext);(620)259-8812I FAX No):(620)662-5415 2920 N.Plum St Hutchinson,KS 67502 ADDRESS:certs@feeinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Cincinnati Casualty Company (The) 28665 INSURED INSURER B:Accident Fund Insurance Company of America 10166 DNA Enterprises,Inc. INSURER c:Evanston Insurance Company 35378 DBA ServiceMaster of Salina 522 Reynolds St. INSURER D: Salina, KS 67401 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 NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD IMM/DD/YYYYI (MM/DD/YYYYl A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR ECP/EBA 040 59 68 10/7/2020 10/7/2021 DAMAGE ISES(TOEa RENTEDoccurrence) $ 1,000,000 PREM MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY 'N LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A COMBINED SINGLE LIMIT 1,000,000 AUTOMOBILE LIABILITY (Ea accident) $ X ANY AUTO ECP/EBA 040 59 68 10/7/2020 10/7/2021 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY _ AUTOSBODILYBODILY INJURY(Per accident) $ AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE (Per accident) $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB ^ CLAIMS-MADE ECP/EBA 040 59 68 10/7/2020 10/7/2021 AGGREGATE $ 1,000,000 DED RETENTION$ $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N WCV 6174800 10/7/2020 10/7/2021 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory m NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Pollution Liability CPLMOL105439 2/4/2021 2/4/2022 Agg&Each Condition 1,000,000 A Sexual Midconduct ECP/EBA 040 59 68 10/7/2020 10/7/2021 Agg&Per Claim 1,000,000 / DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 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:Director of Utilities PO Box 736 Salina,KS 67402-0736 AUTHORIZED REPRESENTATIVE I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DNAENTE-01 AFINLAY '4C-4SP/ZO CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY) 91/27/227/2019 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 have ADDITIONAL INSURED provisions or 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 NAMEACT Andrea Finlay Fee Insurance Group,Inc. PHONE FAX P.O.Box 976 (A/c,No,Ext):(620)259-8812 (A/C,No):(620)662-5415 1 N.Main,Suite 700 E-MAIL andrea@feeinsurance.com Hutchinson,KS 67501 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Cincinnati Casualty Companies 28665 INSURED INSURER B:Accident Fund Insurance Company of America 10166 DNA Enterprises,Inc. INSURER C:Evanston Insurance Company 35378 DBA ServiceMaster of Salina 522 Reynolds St. INSURER D: Salina,KS 67401 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 NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYYI (MM/DDIYYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR ECP/EBA 040 59 68 10/7/2019 10/7/2020 DAMAGE TO RENTED 1,000,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 PRO- 2,000,000 POLICY JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) _ $ X ANY AUTO ECP/EBA 040 59 68 10/7/2019 10/7/2020 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ UNON-OWNED PROPERTY)DAMAGE ONLY UUOONLY Per accident) A X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE ECP/EBA 040 59 68 10/7/2019 10/7/2020 AGGREGATE $ 1,000,000 DED RETENTION$ $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN WCV 6174800 10/7/2019 10/7/2020 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E .DISEASE-EA EMPLOYEE $ 1,000,400 If yes.describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Pollution CPLMOL100106 2/4/2019 2/4/2020 Pollution Liability 1,000,000 A General Liability ECP/EBA 040 59 68 10/7/2019 10/7/2020 Sexual Misconduct 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Salina THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Director of Utilities PO Box 736 Salina,KS 67402-0736 �n � AUTHORIZEDTREPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD /"N DNAENTE-01 AFINLAY A�— a CERTIFICATE OF LIABILITY INSURANCE DATE OMYYY) 2/4/2019 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 have ADDITIONAL INSURED provisions or 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 INAMEpCT Andrea Finlay Fee Insurance Group,Inc.. PHONE FAX P.O.Box 976 I IA/C,No,Ea):(620)259$812 I/A/C,No): 1 N.Main,Suite 700 EDAAIDRESS;andrea eeinsurance.com AD Hutchinson,KS 67501 i INSURER(5)AFFORDING COVERAGE NAIC II I INSURER A:Cincinnati Casualty Companies 28665 INSURED I INSURER e:Accident Fund Insurance Company of America 10166 _ DNA Enterprises,Inc. INSURER C:Evanston Insurance Company 35378 DBA ServiceMaster of Salina 522 Reynolds St. I INSURER 0: Salina,KS 67401 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. II TRRI TYPE OF INSURANCE INSD INNDI POUCY NUMBER I POUCYEFF POLICY EXP IMMNDr(YFF I(MMIDDYYYYYI I UMITS A X I COMMERCIAL GENERAL LIABIUTY I EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE I X I OCCUR ECP/EBA 040 59 68 10!7/2018 10/7/2019 REM_ISES1Ea DC tTOOcel 5 1,000,000 I MED EXP(My one person) 5 10,000 PERSONAL S ADV INJURY 5 1,000,000 I GENII AGGREGATE LIMITpAPPLIES PER: - GENERAL AGGREGATE S 2,000,000 POLICY I I JECT- • ' LOC I PRODUCTS-COMP/OP AGG 5 2,000,000 IOTHER: 1 I I S COED A IAUTOMt.OBILE LIABIUTY _ (Ea acct epi!SINGLE LIMIT 5 1,000,000 X I ANY AUTO : ECP/EBA 040 59 68 1017/2018 10/7/2019 1 BODILY INJURY Per I A OSONLY I I AUTOSULED (Per 5 I IEE�� Ih U� WNEp I BODILY INJURY(Per accident) 5 AUTOS ONLY I AUTO ONLY [PROPERTY)DAMAGE 5 I I I—I t. I $ A I X I UMBRELLA LIAB I I OCCUR EACH OCCURRENCE S 1,000,000 II EXCESSUAB I I CLAIMS-MADE ECP/EBA 040 59 68 1017/2018 1017/2019 AGGREGATE s 1,000,000 I DED I I RETENTION 5 I I 5 _— B /AND EMPLOYERS'YERS'LI COMPENSATION I -- I X I $TATIJTE I I gr - AND EMPLOYERS LIABILITY _ WCV.6174800– - 10/7/2018.._101712019 ,,.�L _1,000,000 YIN ANY PROPRIETOR/PARTNER/EXECUTIVEEXCLU —'-" . E.L.EACH ACCIDENT 3— oFandatoMEMBERE%CLUDED't I I NIA I 1,000,000 IIy .d describe In NH) E.L.DISEASE-EA EMPLOYEE5 B ° ON OFO 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 15 C Pollution ICPLMOL100106 2/412019 2/412020 Pollution Liability 1,000,000 A General Liability 'ECP/EBA 040 59 68 10/7/2018 1017/2019 Sexual Misconduct 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Salina THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Atm:Director of Utilities PO Box 736 Salina,KS 67402-0736 AUTHORIZED REPRESENTATIVE ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 10/4/2017 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 PRODUCER Michelle Nelson NAME: FAX PHONE (620)662-2381(620)662-5415 Fee Insurance Group, Inc (A/C, No): (A/C, No, Ext): E-MAIL michelle@feeinsurance.com Suite 700 1st National Center ADDRESS: PO Box 976 INSURER(S)AFFORDINGCOVERAGE NAIC# Hutchinson KS 67504-0976 The Cincinnati Casualty Company INSURER A : INSURED Cincinnati Insurance Company 10677 INSURER B : DNA Enterprises, Inc., DBA: dba ServiceMaster of INSURER C : 522 Reynolds St. INSURER D : INSURER E : Salina KS 67401 INSURER F : 17-18 Liab 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 LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY X 1,000,000 EACHOCCURRENCE$ DAMAGE TO RENTED 1,000,000 CLAIMS-MADE OCCUR$ A X PREMISES(Eaoccurrence) ECP/EBA 040 59 68 10/7/2017 10/7/2018 10,000 MEDEXP(Anyone person)$ 1,000,000 PERSONAL&ADVINJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- X 2,000,000 POLICY LOC PRODUCTS - COMP/OP AGG$ JECT Employee Benefit Liab Cov$ 1,000,000 OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY$ 1,000,000 (Eaaccident) BODILYINJURY(Perperson)$ X ANY AUTO A ALLOWNED SCHEDULED BODILYINJURY(Peraccident)$ ECP/EBA 040 59 68 10/7/2017 10/7/2018 AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS (Peraccident) AUTOS $ 1,000,000 Uninsured motorist combined UMBRELLA LIAB X EACHOCCURRENCE$ OCCUR 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE$ 1,000,000 A 10/7/2017 ECP/EBA 040 59 68 10/7/2018 $ DED RETENTION$ PER OTH- WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACHACCIDENT$ 500,000 N / A OFFICER/MEMBER EXCLUDED? 10/7/2017 B EWC 040 59 69 10/7/2018 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ 500,000 If yes,describeunder E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below 500,000 A Sexual Misconduct ECP/EBA 040 59 68 10/7/2017 10/7/2018 Limit$1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION martha.tasker@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. Attn: Director of Utilities PO Box 736 AUTHORIZED REPRESENTATIVE Salina, KS 67402-0736 M Nelson/MICHEL ©1988-2014ACORD CORPORATION.Allrights reserved. ACORD25(2014/01)TheACORD nameand logoare registeredmarks ofACORD INS025 (201401) ACORD CERTIFICATE CERTIFICATE OF LIABILITY INSURANCE ioisi ol4 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 Anna Martin NAME: Assurance Partners HO No.E�t) (800)563-1871 AJCC, No):(785)825-5098 201 E Iron St. • ADDRESS:amartin@yourassurance.com P.O. Box 1213 INSURER(S)AFFORDING COVERAGE NAIC# Salina KS 67402-1213 INSURER A:Smployers Mutual Casualty Co. 2141. 5a INSURED INSURER B: ServiceMaster of Salina, Inc. , DBA: INSURERC: 522 Reynolds INSURER D: INSURER E: Salina KS 67401-2034 INSURERF: COVERAGES CERTIFICATE NUMBER:14/15 BA & WC 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 (MM/DD/YYYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY n PED n LOC $ AUTOMOBILE LIABIUTY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 A X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED — SCHEDULED 2X7232014 10/7/2014 10/7/2015 BODILY INJURY(Per accident) $ AUTOS AUTOS X X NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ — EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N X TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? NIA 2X7232014 10/7/2014 10/7/2015 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION martha.tasker@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. Attn: Director of Utilities PD BOX 736 AUTHORIZED REPRESENTATIVE Salina, KS 67402-0736 Anna Martin/ANNAVE 14 ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025r2nlnnsrnl Tho arno 1 n2mo nnrf Innn nro ronicfororl m=rtrc of Ar:non • A`°R°® CERTIFICATE OF LIABILITY INSURANCE 9A20'oD;YY) 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 April McCullough NAME: P 9 Assurance Partners _�912N1DEaU. (800)563-1871 IIAIc .NO1:(7851825-5099 FAX 2090 S Ohio aOORIE$5:amccullough@ycurassurance.com PO Box 1213 PRODUCER 00003493 SLSIDMFR ID it Salina KS 67402-1213 INSURER(S)AFFORDING COVERAGE I NAIC0 INSURED INSURER A:Empl OyerS Mutual Casualty Co. I21415a INSURER B: I ServiceMaster of Salina, Inc. INSURER C: I 522 Reynolds INSURERD: I INSURER E: I Salina KS 67401-2034 INSURER F: I COVERAGES CERTIFICATE NUMBER:13/14 Auto a we REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MI TYPE OF INSURANCE INSRISWYDI POUCY NUMBER IIMSVDDDYIYYYY)IIMWDDIIYYYY)I LIMITS GENERAL UABIUTY EACH OCCURRENCE 5 S COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED I PREMISES(Ea occurrence) I OCCUR MED EXP(My one person) 5 PERSONAL 8.ADV INJURY I5 GENERAL AGGREGATE I$ GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/P AGG 15 I POLICY ri PR0. n I S [MIT LOC AUTOMOBILE UABIUTY I COMBINED SINGLE LIMIT 1$ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) 15 A ALL OWNED AUTOS 2X7232014 10/7/2013 10/7/2014 BODILY INJURY(Per accident)15 SCHEDULED AUTOS PROPERTY DAMAGE 5 X HIRED AUTOS (Per accident) X NON-OWNED AUTOS 5 $ UMBRELLA UAB 1 I OCCUR EACH OCCURRENCE I$ EXCESS UAB I CLAIMS-MADE AGGREGATE 13 DEDUCTIBLE I$ RETENTION 5 I5 A WORKERS COMPENSATION x I VvC STATU- I IOTH- AND EMPLOYERS'UABIUTY YIN TORYIIMITS ER ANY PROPRIETORIPARTNERIEXECUTIVE pi NIA E.L EACH ACCIDENT I5 500,000 OFFICERRAEMBER EXCLUDED? I I i %7232019 110/7/2013 110/7/2014 E.L.DISEASE-EA EMPLOYES 500,000 (Mandatory In NH) 11 e5,desoIDeui & E.L.DISEASE-POLICY LIMIT I5 500,000 DESCRIPTION OF OPERATIONS Debi I III I I DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,U more space Is required) CERTIFICATE HOLDER CANCELLATION • . martha.tasker @sal ina.org 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 Attn: Director of Utilities AUTHORIZED REPRESENTATIVE PO Box 736 Salina, KS 67402-0736 Lemon Bailey/LBAILE °—"�—' �� ACORD 25(2009109) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(2ooms) The ACORD name and logo are registered marks of ACORD