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Insurance Certificate � ® MI DATE(MDD/YYYY) A CC CERTIFICATE OF LIABILITY INSURANCE 09124/2015 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 MARSH USA,INC. NAME: 445 SOUTH STREET (A/c No.Extl: FAX No): MORRISTOWN,NJ 07960-6454 E-MAIL • ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# 100129-6-7BA-SBT1-15/16 240 HARTL INSURER A:HDI-Geriing America Insurance Company 41343 INSURED INSURER B:The Travelers Indemnity Company 25658 SIEMENS INDUSTRY,INC. BUILDING TECHNOLOGIES INSURER C:Travelers Property Casualty Co.of America 25674 1000 DEERFIELD PARKWAY INSURER D: BUFFALO GROVE,IL 60089 INSURER E: _INSURER F: COVERAGES CERTIFICATE NUMBER: NYC-007205998-12 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 INSD W , VD POUCY NUMBER (MM/DD/YYYYuMM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY GLD1110107 10/01/2015 10/01/2016 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) ! $ 1,000,000 1 MED EXP(Any one person) $ 100,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000 PRO POLICY X JECT LOC PRODUCTS-COMP/OP AGG $ INCL OTHER: $ C AUTOMOBILE LIABILITY • TC2JCAP7440L34A15 10/01/2015 10/01/2016 COMBINED SINGLE LIMIT -$ - 2,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ N/A X ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ N/A AUTOS AUTOS X HIRED AUTOS X NON-OWNED AUTOS PROPERTY DAMAGE (Per accident) $ N/A $ A X UMBRELLA LIAB X OCCUR CUD1110207 10/01/2015 10/01/2016 EACH OCCURRENCE $ 1,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION$ $ C WORKERS COMPENSATION TC2JUB7440L27115(AOS) • 10/01/2015 10/01/2016 X PER I OTH- AND EMPLOYERS'UABIUTY STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N TRKUB7440L28315(AZ,MA,OR&WI) 10/01/2015 10/01/2016 E.L.EACH ACCIDENT $ 1,000,000 C OFFICER/MEMBER EXCLUDED? © N/A (Mandatory in NH) TWXJUB7440L33815(OH&WA) 10/01/2015 10/01/2016 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under '""$500K LIMIT I$500K SIR"'" 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION CITY OF SALINA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN:SHANDI WICKS THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O.BOX 736 ACCORDANCE WITH THE POLICY PROVISIONS. 300 WEST ASH STREET,SUITE 206 SALINA,KS 67402 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee -.31lauaes1.= �.N4,u tc-"aa-c.i- ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ® ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ��. 0912612014 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 MARSH USA,INC. PH PHONE FAX 445 SOUTH STREET IA/C.No.Extl: (A/C,No): MORRISTOWN,NJ 07960-6454 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# 100129-6-7BA-SBT1-14/15 240 Knapp INSURER A: HDI-Geriing America Insurance Company 41343 INSURED INSURER B:The Travelers Indemnity Company 25658 SIEMENS INDUSTRY,INC.INCLUDING BUILDING TECHNOLOGIES DIVISION INSURER C:The Charter Oak Fire Insurance Company 25615 1000 DEERFIELD PARKWAY INSURER D:Travelers Property Casualty Co.of America 25674 BUFFALO GROVE,IL 60089-4513 INSURER E: _INSURER F: - COVERAGES CERTIFICATE NUMBER: NYC-006046173-14 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 WPOLICY IMITS LTR INSR VD POCY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A GENERAL LIABILITY GLD1110106 10/01/2014 10/01/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE X COMMERCIAL GENERAL LIABILITY PREMISES O(EaEoccurrrence) $ 1,000,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 100,000 PERSONAL 8 ADV INJURY _ $ 1,000,000 GENERAL AGGREGATE $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ INCL POLICY PRO- n LOC $ D AUTOMOBILE LIABIUTY TC2JCAP7440L34A14 10/01/2014 10/01/2015 COMBINED SINGLE LIMIT 2,000,000 (Ea accident) — ._ _— $ --- - X ANY AUTO — BODILY INJURY(Per person) $ N/A X ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ N/A AUTOS AUTOS PROPERTY DAMAGE $ N/A X NON-OWNED HIRED AUTOS X (Per accident)AUTOS -- $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION TC20UB7440L27114(AOS) 10/01/2014 10/01/2015 X WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS FR B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N TRKUB7440L28314(AZ,MA,OR 8 WI) 10101/2014 10/01/2015 E.L.EACH ACCIDENT $ 1,000,000 D OFFICER/MEMBER EXCLUDED? N N/A(Mandatory in NH) TWXJUB7440L33814(OH&WA) E.L.DISEASE-EA EMPLOYEE $10/01/2014 10/01/2015 1,000,000 If yes,describe under '""$500K LIMIT/$500K SIR"' 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) RE:44OP-070047 CERTIFICATE HOLDER CANCELLATION CITY OF SALINA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE GUARANTEED AUTOMATIC WATER METER PERFORMANCE CONTRACT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN:MARTHA TASKER ACCORDANCE WITH THE POLICY PROVISIONS. 300 WEST ASH SALINA,KS 67401-2335 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee –.PeL.0.uvos-.+ .44 u)-4-e.d. I - ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD