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Insurance Certificate (generic) ..+1 Page 1 of 1 ACC)Ra CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4b.---- 04/16/2020 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 Willis Towers Watson Certificate Center Willis Towers Watson Midwest, Inc. fka Willis of Illinois, Inc. NAME: (A/C.No. Ext1: 1-877-945-7378 (A/C,No ): 1-888-d67-2378 c/o 26 Century Blvd P.O. Box 305191 E-MAIL ADDRESS: certificates@willis.com Nashville, TN 372305191 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Beazley Insurance Company Inc 37540 INSURED R.N. Lochner, Inc. INSURERS 225 Nest Washington, Suite 1200 INSURER C: Chicago, IL 60606 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:W16210235 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 I 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 TYPE OF INSURANCE INSD WVD (MM DCDNYYY) (I POLICY EXP XYPY)i EACH OCCURRENCE COMMERCIAL GENERAL LIABILITY INSR Ab�L$u8� POLICY NUMBER UMI JI CLAIMS-MADE OCCUR , DAMAGE TO RENTED I$ PREMISES(Ea pcxurrencel__$ r I MED EXP(Any one person) i$ PERSONAL&ADV INJURY $ PRO- L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $$ POLICY L_ JECT LOC PRODUCTS•COMPrOP AGG `$ OTHER; $ AUTOMOBILE UABIUTY . COMBINED SINGLE LIMIT LEa accident) 'ANY AUTO BODILY INJURY(Per person) I$ OWNED I—I SCHEDULED BODILY INJURY AUTOS ONLY AUTOS (Per actident)I$ HIRED I NON-OWNED I PROPERTY DAMAGE AUTOS ONLY i AUTOS ONLY ! I;(Per accident) $ UMBRELLA LIABOCCUR EACH OCCURRENCE $ EXCESS UAB ! 1 CLAIMS-MADE 'AGGREGATE 1$ DED ; RETENTION$ $ WORKERS COMPENSATION - PER !0TH- I AND EMPLOYERS'LIABILITY YIN i I STATUTE - 1 ER AN YPROPRI ETOR/PA RTN ER/EX ECUT I V E E.L.EACH ACCIDENT I$ OFFICERNEMBEREXCLUDED? N/A 1 (Mandatory in NH) LE •L.DISEASE-EA EMPLOYEE'$ II yes,describe under I DESCRIPTION OF OPERATIONS below ;E.L.DISEASE•POLICY LIMIT I$ A ,Professional Liability V2AZA4200101 105/01/2020 05/01/20211Per Claim :$1,000,000 Aggregate 181,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached U 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 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE City of Salina 300 W Ash St �/��,�� Salina, KS 67402-0736 9[.+ .v,/i<) ®1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 19510574 BATCH: 1651302 2 of 2 2602 Client#: 39357 HWLOC ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4/29/2014 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).If Waiver of Subrogation is applicable,it only applies to the extent allowed by law. PRODUCER I CONTACT Salina Rivera NAME: Construction -Remegi Team I PHONE 312 595-8105 FAX 312-595-6381 (A/C,No,Ext): (A/C,No): Mesirow Insurance Services ADDRESS: srivera @mesirowfinancial:com 353 N.Clark Street INSURER(S)AFFORDING COVERAGE NAIL# Chicago, IL 60654 INSURER A:Travelers Indemnity Co.of Amer 25666 • INSURED INSURER B:St.Paul Fire&Marine Insuranc 24767 H.W. Lochner, Inc. INSURER C:Phoenix Insurance Company 125623 225 W.Washington, 12th Floor Charter Oak Fire Insurance Com 25615 Chicago, IL 60606 INSURERD: P 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 LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A GENERAL LIABILITY P6608451B877TIA14 05/01/2014 05/01/2011 EACH OCCURRENCE S1,000,000 X COMMERCIAL GENERAL LIABILITY I DAMAGE TO RENTED 51,000,000 ' CLAIMS-MADE X OCCUR MED EXP(Any one person) $5,000 • • PERSONAL&ADV INJURY $1,000,000 • GENERAL AGGREGATE 52,000,000 • GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 52,000,000 POLICY n PECOT- LOC IT • AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT D P8108451B877C0F14 05/01'2014 05/01'2019 Ea accident X1,000,000 • - 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 $ XDrive Oth Car X 'Physical Dam 1,000 Comp $1,000 Coll . B X UMBRELLALIAB IX OCCUR ZUP10P6385414NF 05/01/2014 05/01/201 •EACH OCCURRENCE . x10,000,000 EXCESS LIAR I CLAIMS-MADE - AGGREGATE $10,000,000 - DED X RETENTION s10000 s • • C WORKERS COMPENSATION PNUB8976P38714 05/01/2014 05/01/2015 X WCSTATU- OTH- • AND EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N .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 51,000,000 • . -A-leased/Rehted - - --——-P6608451 B87-7-T!A?- • —05/01/2014 05/01/20i –$150,000-Limit---------- - . Equipment . $500 Deductible • DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) • . Lochner Project#: 000007111.The following are included as Additional Insureds on the General Liability • Policy per written contract: City of Salina, Kansas. - CERTIFICATE HOLDER CANCELLATION City of Salina, Kansas SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN- PO Box 736 ACCORDANCE WITH THE POLICY PROVISIONS. Salina, KS 67402 - S -- t„�r AUTHORIZED REPRESENTATIVE t raj '- "i-.% - -' f,,.}. .^ i. :, a- _ �:#y ...'_,• `" " - ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25 2010/05 ( ) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1552807/M1551949 s SLR F ,� tr-N-. ,, ,'" .rt _ .- ;.x-edt71 .[rr. LM ,. �^.-�c o._,.4 j,ire— .x$, ! - -r .?:" ..- =:4=w- - _ +y;te-,, iz-- ` -�;0 1°,;,.•'67:7;.;�` .,==n7. _ - ".y,4_ - - .