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Insurance Certificate
EBUF!)NN0EE0ZZZZ* 1802603131 DFSUJGJDBUF!PG!MJBCJMJUZ!JOTVSBODF UIJT!DFSUJGJDBUF!JT!JTTVFE!BT!B!NBUUFS!PG!JOGPSNBUJPO!POMZ!BOE!DPOGFST!OP!SJHIUT!VQPO!UIF!DFSUJGJDBUF!IPMEFS/!UIJT DFSUJGJDBUF!EPFT!OPU!BGGJSNBUJWFMZ!PS!OFHBUJWFMZ!BNFOE-!FYUFOE!PS!BMUFS!UIF!DPWFSBHF!BGGPSEFE!CZ!UIF!QPMJDJFT CFMPX/!!UIJT!DFSUJGJDBUF!PG!JOTVSBODF!EPFT!OPU!DPOTUJUVUF!B!DPOUSBDU!CFUXFFO!UIF!JTTVJOH!JOTVSFS)T*-!BVUIPSJ\[FE SFQSFTFOUBUJWF!PS!QSPEVDFS-!BOE!UIF!DFSUJGJDBUF!IPMEFS/ JNQPSUBOU;!!Jg!uif!dfsujgjdbuf!ipmefs!jt!bo!BEEJUJPOBM!JOTVSFE-!uif!qpmjdz)jft*!nvtu!ibwf!BEEJUJPOBM!JOTVSFE!qspwjtjpot!ps!cf!foepstfe/ Jg!TVCSPHBUJPO!JT!XBJWFE-!tvckfdu!up!uif!ufsnt!boe!dpoejujpot!pg!uif!qpmjdz-!dfsubjo!qpmjdjft!nbz!sfrvjsf!bo!foepstfnfou/!!B!tubufnfou!po uijt!dfsujgjdbuf!epft!opu!dpogfs!sjhiut!up!uif!dfsujgjdbuf!ipmefs!jo!mjfv!pg!tvdi!foepstfnfou)t*/ DPOUBDU 2.977.685.7393 QSPEVDFS Bvesfz!NdOfjmm OBNF; Ipmnft!Nvsqiz!'!Bttpdjbuft-!MMD GBY QIPOF 911.638.:15: )B0D-!Op*; )B0D-!Op-!Fyu*; F.NBJM BEESFTT; 2939!Xbmovu!Tsffu Tvjuf!811 JOTVSFS)T*!BGGPSEJOH!DPWFSBHFOBJD!$ Lbotbt!Djuz-!NP!75219 USBWFMFST!JOE!DP!PG!BNFS36777 JOTVSFS!B!; JOTVSFE QIPFOJY!JOT!DP 36734 JOTVSFS!C!; Tdixbc.Fbupo-!QB USBWFMFST!QSPQ!DBT!DP!PG!BNFS 36785 JOTVSFS!D!; YM!TQFDJBMUZ!JOT!DP48996 JOTVSFS!E!; 6521!Mfehf!Tupof!Esjwf Tvjuf!211 JOTVSFS!F!; Nboibuubo-!LT!77614 JOTVSFS!G!; 6:8:6364 DPWFSBHFTDFSUJGJDBUF!OVNCFS;SFWJTJPO!OVNCFS; UIJT!JT!UP!DFSUJGZ!UIBU!UIF!QPMJDJFT!PG!JOTVSBODF!MJTUFE!CFMPX!IBWF!CFFO!JTTVFE!UP!UIF!JOTVSFE!OBNFE!BCPWF!GPS!UIF!QPMJDZ!QFSJPE JOEJDBUFE/!!OPUXJUITUBOEJOH!BOZ!SFRVJSFNFOU-!UFSN!PS!DPOEJUJPO!PG!BOZ!DPOUSBDU!PS!PUIFS!EPDVNFOU!XJUI!SFTQFDU!UP!XIJDI!UIJT DFSUJGJDBUF!NBZ!CF!JTTVFE!PS!NBZ!QFSUBJO-!UIF!JOTVSBODF!BGGPSEFE!CZ!UIF!QPMJDJFT!EFTDSJCFE!IFSFJO!JT!TVCKFDU!UP!BMM!UIF!UFSNT- FYDMVTJPOT!BOE!DPOEJUJPOT!PG!TVDI!QPMJDJFT/!MJNJUT!TIPXO!NBZ!IBWF!CFFO!SFEVDFE!CZ!QBJE!DMBJNT/ BEEMTVCS JOTSQPMJDZ!FGGQPMJDZ!FYQ UZQF!PG!JOTVSBODFMJNJUT QPMJDZ!OVNCFS MUS)NN0EE0ZZZZ*)NN0EE0ZZZZ* JOTEXWE DPNNFSDJBM!HFOFSBM!MJBCJMJUZ BY7917I51:74B2:22012031 2201202:2-111-111 FBDI!PDDVSSFODF% EBNBHF!UP!SFOUFE Y 2-111-111 DMBJNT.NBEFPDDVS% QSFNJTFT!)Fb!pddvssfodf* 6-111 NFE!FYQ!)Boz!pof!qfstpo*% 2-111-111 QFSTPOBM!'!BEW!JOKVSZ% 3-111-111 HFO(M!BHHSFHBUF!MJNJU!BQQMJFT!QFS;HFOFSBM!BHHSFHBUF% QSP. 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Y Y 3-111-111 QPMJDZ MPD QSPEVDUT!.!DPNQ0PQ!BHH% KFDU % PUIFS; DPNCJOFE!TJOHMF!MJNJU C CB2G912481 22012031 2201202: BVUPNPCJMF!MJBCJMJUZ% 2-111-111 )Fb!bddjefou* Y CPEJMZ!JOKVSZ!)Qfs!qfstpo*% BOZ!BVUP BMM!PXOFETDIFEVMFE CPEJMZ!JOKVSZ!)Qfs!bddjefou*% BVUPTBVUPT OPO.PXOFE QSPQFSUZ!EBNBHF Y% Y IJSFE!BVUPT )Qfs!bddjefou* BVUPT % VNCSFMMB!MJBC Y Y DVQ2G915655 22012031 4-111-111 D 2201202: FBDI!PDDVSSFODF% PDDVS FYDFTT!MJBC 4-111-111 DMBJNT.NBEF BHHSFHBUF% Y 21-111 % EFE SFUFOUJPO% QFS PUI. XPSLFST!DPNQFOTBUJPO Y D VC9K7:58992:58H2304202:23042031 TUBUVUFFS BOE!FNQMPZFST(!MJBCJMJUZ Z!0!O 2-111-111 BOZ!QSPQSJFUPS0QBSUOFS0FYFDVUJWF F/M/!FBDI!BDDJEFOU% O O!0!B PGGJDFS0NFNCFS!FYDMVEFE@ 2-111-111 )Nboebupsz!jo!OI* F/M/!EJTFBTF!.!FB!FNQMPZFF% Jg!zft-!eftdsjcf!voefs 2-111-111 F/M/!EJTFBTF!.!QPMJDZ!MJNJU% EFTDSJQUJPO!PG!PQFSBUJPOT!cfmpx EFTDSJQUJPO!PG!PQFSBUJPOT!0!MPDBUJPOT!0!WFIJDMFT!!)BDPSE!212-!Beejujpobm!Sfnbslt!Tdifevmf-!nbz!cf!buubdife!jg!npsf!tqbdf!jt!sfrvjsfe* Dfsujgjdbuf!ipmefs!jt!jodmvefe!bt!bo!beejujpobm!jotvsfe!po!uif!Hfofsbm!'!Bvup!Mjbcjmjuz!qpmjdjft!jg!sfrvjsfe!cz!xsjuufo dpousbdu!ps!bhsffnfou!tvckfdu!up!qpmjdz!ufsnt!boe!dpoejujpot/!!B!xbjwfs!pg!tvcsphbujpo!jt!qspwjefe!jo!gbwps!pg!Dfsujgdbu Ipmefs!po!uif!Xpslfst!Dpnqfotbujpo-!Hfofsbm!'!Bvup!Mjbcjmjuz!qpmjdjft!jg!sfrvjsfe!cz!xsjuufo!dpousbdu!ps!bhsffnfou tvckfdu!up!qpmjdz!ufsnt!boe!dpoejujpot/!!Uif!Hfofsbm!'!Bvup!Mjbcjmjuz!qpmjdjft!bsf!qsjnbsz!boe!opo.dpousjcvupsz tvckfdu!up!qpmjdz!ufsnt!boe!dpoejujpot/ DFSUJGJDBUF!IPMEFS DBODFMMBUJPO TIPVME!BOZ!PG!UIF!BCPWF!EFTDSJCFE!QPMJDJFT!CF!DBODFMMFE!CFGPSF Djuz!pg!Tbmjob-!Vujmjuft!Efqbsunfou UIF!FYQJSBUJPO!EBUF!UIFSFPG-!OPUJDF!XJMM!CF!EFMJWFSFE!JO BDDPSEBODF!XJUI!UIF!QPMJDZ!QSPWJTJPOT/ 411!Xftu!Bti-!Qp!Cpy!847 BVUIPSJ\[FE!SFQSFTFOUBUJWF Tbmjob-!LT!78513 VTB ª!2:99.3125!BDPSE!DPSQPSBUJPO/!!Bmm!sjhiut!sftfswfe/ BDPSE!36!)3125012*Uif!BDPSE!obnf!boe!mphp!bsf!sfhjtufsfe!nbslt!pg!BDPSE mzoofdpy 68:46946 DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12/22/2018 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 CA#0H64724 1-913-982-3650 PRODUCER Lynne Cox NAME: IMA, Inc. (NE Kansas Division) FAX PHONE 913-982-3495 (A/C, No): (A/C, No, Ext): E-MAIL lynne.cox@imacorp.com ADDRESS: 51 Corporate Woods INSURER(S) AFFORDING COVERAGENAIC # 9393 W. 110th Street, Suite 600 Overland Park, KS 66210 PHOENIX INS CO 25623 INSURER A : INSURED TRAVELERS IND CO OF AMER 25666 INSURER B : Schwab-Eaton, PA TRAVELERS INDEMNITY CO. 25666 INSURER C : TRAVELERS PROP CAS CO OF AMER25674 INSURER D : 1125 Garden Way INSURER E : Manhattan, KS 66502 INSURER F : 54909689 COVERAGESCERTIFICATE 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. ADDLSUBR INSR POLICY EFFPOLICY EXP TYPE OF INSURANCE LIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY AX 6806H40963A184711/01/19 11/01/18 1,000,000 EACH OCCURRENCE$ DAMAGE TO RENTED X 1,000,000 CLAIMS-MADEOCCUR$ PREMISES (Ea occurrence) 10,000 MED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- X X 2,000,000 POLICY LOC PRODUCTS - COMP/OP AGG$ JECT $ OTHER: COMBINED SINGLE LIMIT B BA1F801370 11/01/19 11/01/18 AUTOMOBILE LIABILITY$ 1,000,000 (Ea accident) X BODILY INJURY (Per person)$ ANY AUTO ALL OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOSAUTOS NON-OWNED PROPERTY DAMAGE X$ X HIRED AUTOS (Per accident) AUTOS $ UMBRELLA LIAB X X CUP001F804544 11/01/19 3,000,000 C 11/01/18 EACH OCCURRENCE$ OCCUR EXCESS LIAB 3,000,000 CLAIMS-MADE AGGREGATE$ X 10,000 $ DED RETENTION$ PER OTH- WORKERS COMPENSATION X D UB8J6947881847G12/31/18 12/31/19 STATUTEER AND EMPLOYERS' LIABILITY Y / N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N N / A OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is included as an additional insured on the General & Auto Liability policies if required by written contract or agreement subject to policy terms and conditions. A waiver of subrogation is provided in favor of Certifcat Holder on the Workers Compensation, General & Auto Liability policies if required by written contract or agreement subject to policy terms and conditions. The General & Auto Liability policies are primary and non-contributory subject to policy terms and conditions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Salina, Utilites Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 300 West Ash, Po Box 736 AUTHORIZED REPRESENTATIVE Salina, KS 67402 USA © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01)The ACORD name and logo are registered marks of ACORD lynnecox 54909689 DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12/22/2017 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 CA#0H64724 1-913-982-3650 PRODUCER Lynne Cox NAME: IMA, Inc. (NE Kansas Division) FAX PHONE 913-982-3495 (A/C, No): (A/C, No, Ext): E-MAIL lynne.cox@imacorp.com ADDRESS: 51 Corporate Woods INSURER(S) AFFORDING COVERAGENAIC # 9393 W. 110th Street, Suite 600 Overland Park, KS 66210 PHOENIX INS CO 25623 INSURER A : INSURED TRAVELERS IND CO OF AMER 25666 INSURER B : Schwab-Eaton, PA TRAVELERS INDEMNITY CO. 25666 INSURER C : TRAVELERS PROP CAS CO OF AMER25674 INSURER D : 1125 Garden Way INSURER E : Manhattan, KS 66502 INSURER F : 51688429 COVERAGESCERTIFICATE 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. ADDLSUBR INSR POLICY EFFPOLICY EXP TYPE OF INSURANCE LIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY AX 6806H40963A174711/01/18 11/01/17 1,000,000 EACH OCCURRENCE$ DAMAGE TO RENTED X 1,000,000 CLAIMS-MADEOCCUR$ PREMISES (Ea occurrence) 10,000 MED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- X X 2,000,000 POLICY LOC PRODUCTS - COMP/OP AGG$ JECT $ OTHER: COMBINED SINGLE LIMIT B BA1F801370 11/01/18 11/01/17 AUTOMOBILE LIABILITY$ 1,000,000 (Ea accident) X BODILY INJURY (Per person)$ ANY AUTO ALL OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOSAUTOS NON-OWNED PROPERTY DAMAGE X$ X HIRED AUTOS (Per accident) AUTOS $ UMBRELLA LIAB X X CUP001F804544 11/01/18 5,000,000 C 11/01/17 EACH OCCURRENCE$ OCCUR EXCESS LIAB 5,000,000 CLAIMS-MADE AGGREGATE$ X 10,000 $ DED RETENTION$ PER OTH- WORKERS COMPENSATION X D UB8J6947881747G12/31/17 12/31/18 STATUTEER AND EMPLOYERS' LIABILITY Y / N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N N / A OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is included as an additional insured on the General & Auto Liability policies if required by written contract or agreement subject to policy terms and conditions. A waiver of subrogation is provided in favor of Certifcat Holder on the Workers Compensation, General & Auto Liability policies if required by written contract or agreement subject to policy terms and conditions. The General & Auto Liability policies are primary and non-contributory subject to policy terms and conditions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Salina, Utilites Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 300 West Ash, Po Box 736 AUTHORIZED REPRESENTATIVE Salina, KS 67402 USA © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01)The ACORD name and logo are registered marks of ACORD schappel 51688429 A�® CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDDNYYY) 10/27/2017 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). PRODUCER CAS/0E64724 1-913-982-3650 CONTACT NAME: Lynne Cox IMA, Inc. (NE Kansas Division) PHONE FAX 913-982-3495 WC No FSU; WC,NO): E-MAIL 1 e.cox®ima co Com 51 Corporate Woods ADDRESS: Ynn P 9393 W. 110th Street, Suite 600 INSURER(S)AFFORDING COVERAGE NAIL. Overland Park, KS 66210INSURER A: PHOENIX INS CO 125623 INSUREDINSURER e: TRAVELERS IND CO OF AMER 25666 Schwab-Eaton, PA INSURER C r TRAVELERS INDEMNITY CO. 125666 1125 Garden Way INSURER D: Travel ere Indemnity Co. of Connecticut 131194 INSURER E: I Manhattan, KS 66502 INSURER F: I COVERAGES CERTIFICATE NUMBER: 51255070 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. 7LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. rLTR I TYPE OF INSURANCE I NSD IS%WD I POLICY NUMBER I(MM/ODYryyyy)EFF I IMMJDDYIYYYYI I LIMITS A X I COMMERCIAL GENERAL LIABILITY 680006840963A 11/01/17 11/01/18 EACH OCCURRENCE Is 1,000,000 NTED I CLAIMS-MADE X OCCUR DAMAGE TO sRoccurrence) I 1,000,000 PREMISES IERoNTVrter,de) S MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 I GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JET K LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: S B AUTOMOBILELIABILITY ANY AUTO BA1P801370 11/01/17 11/01/18 COMBINED SINGLE LIMIT S: 1,000,000 (Ea accident) X BODILY INJURY(Per person) ALL OWNED SCHEDULED BODILY INJURY(Per amide/It) AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOSX AUTOS (Per accident) S I S C IX UMBRELLA LIAR X OCCUR CUP00117804544 11/01/17 11/01/18 EACH OCCURRENCE IS 3.000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 3,000,000 I DED I X I RETENTIONS 10,000 S WORKERS COMPENSATIONPER OTH- D XEUB4342T02816 12/31/16 12/31/17 I XI STATUTE I IER AND EMPLOYERS'LIABILITY ANY PROPRIETORARTNERIEXECUTNE IPY/N E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED] N❑ NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEd s 1,000,000 It yes.describe under DESCRIPTION OF OPERATIONS bNpwE.L.DISEASE-POLICY LIMIT I$ 1,000,000 DESCRIPTION OF OPERATIONS(LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule.may be attached if more space is required) Certificate holder is included as an additional insured on the General & Auto Liability policies if required by written contract or agreement subject to policy terms and conditions. A waiver of subrogation is provided in favor of Certifcat Holder on the Workers Compensation, General & Auto Liability policies if required by written contract or agreement subject to policy terms and conditions. The General & Auto Liability policies are primary and non-contributory subject to policy terms and conditions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Salina, Utilites Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 300 West Ash, Po Box 736 AUTHORIZED REPRESENTATIVE Salina, KS 67402 USA I C.1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD lynnecox 51255070 DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12/24/2016 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 CA#0H647241-913-982-3650 PRODUCER NAME: IMA, Inc. (NE Kansas Division) FAX PHONE 913-982-3495 (A/C, No): (A/C, No, Ext): E-MAIL ADDRESS: 51 Corporate Woods INSURER(S) AFFORDING COVERAGENAIC # 9393 W. 110th Street, Suite 600 Overland Park, KS 66210 PHOENIX INS CO25623 INSURER A : INSURED TRAVELERS IND CO OF AMER 25666 INSURER B : Schwab-Eaton, PA TRAVELERS INDEMNITY CO. 25666 INSURER C : Travelers Indemnity Co. of Connecticut31194 INSURER D : 1125 Garden Way INSURER E : Manhattan, KS 66502 INSURER F : 48749020 COVERAGESCERTIFICATE 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. ADDLSUBR INSRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY AX6806H40963A164711/01/17 11/01/161,000,000 EACH OCCURRENCE$ DAMAGE TO RENTED X 1,000,000 CLAIMS-MADEOCCUR$ PREMISES (Ea occurrence) 10,000 MED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- XX 2,000,000 POLICYLOCPRODUCTS - COMP/OP AGG$ JECT $ OTHER: COMBINED SINGLE LIMIT BBA1F80137011/01/17 11/01/16 AUTOMOBILE LIABILITY$ 1,000,000 (Ea accident) X BODILY INJURY (Per person)$ ANY AUTO ALL OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOSAUTOS NON-OWNED PROPERTY DAMAGE X$ X HIRED AUTOS (Per accident) AUTOS $ UMBRELLA LIAB X XCUP1F804544164711/01/173,000,000 C11/01/16 EACH OCCURRENCE$ OCCUR EXCESS LIAB 3,000,000 CLAIMS-MADEAGGREGATE$ X10,000 $ DEDRETENTION$ PEROTH- WORKERS COMPENSATION X DXEUB4342T0281612/31/1612/31/17 STATUTEER AND EMPLOYERS' LIABILITY Y / N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N N / A OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is included as an additional insured on the General & Auto Liability policies if required by written contract or agreement subject to policy terms and conditions. A waiver of subrogation is provided in favor of Certifcat Holder on the Workers Compensation, General & Auto Liability policies if required by written contract or agreement subject to policy terms and conditions. The General & Auto Liability policies are primary and non-contributory subject to policy terms and conditions. CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Salina, Utilites Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 300 West Ash, Po Box 736 AUTHORIZED REPRESENTATIVE Salina, KS 67402 USA © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01)The ACORD name and logo are registered marks of ACORD lynnecox 48749020 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/29/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND C CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND O BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONT REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, bject to the terms and conditions of the policy, certain policies may reqconfer rights to the certificate holder in lieu of such endorsement(s). CA#0H647241-913-982-3650 CONTACT PRODUCER NAME: IMA, Inc. (NE Kansas Division) FAX PHONE (A/C, No): (A/C, No, Ext): E-MAIL 51 Corporate Woods ADDRESS: 9393 W. 110th Street, Suite 600 INSURER(S) AFFORDING COVERAGENAIC # Overland Park, KS 66210 PHOENIX INS CO25623 INSURER A : INSURED TRAVELERS IND CO OF AMER25666 INSURER B : Schwab-Eaton, PA TRAVELERS IND CO25658 INSURER C : TRAVELERS CAS & SURETY CO OF AMER31194 1125 Garden Way INSURER D : INSURER E : Manhattan, KS 66502 INSURER F : COVERAGESCERTIFICATE NUMBER:REVISION NUMBER: 42548716 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION O CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAV ADDLSUBR INSRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSRWVD A6801F79981811/01/15 GENERAL LIABILITY 11/01/141,000,000 EACH OCCURRENCE$ DAMAGE TO RENTED X 1,000,000 COMMERCIAL GENERAL LIABILITY$ PREMISES (Ea occurrence) X 10,000 CLAIMS-MADEOCCURMED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 2,000,000 GENERAL AGGREGATE$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:PRODUCTS - COMP/OP AGG$ PRO- X $ POLICYLOC JECT 11/01/1411/01/15 COMBINED SINGLE LIMIT BBA1F801370 AUTOMOBILE LIABILITY 1,000,000 (Ea accident)$ X BODILY INJURY (Per person)$ ANY AUTO ALL OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOSAUTOS NON-OWNEDPROPERTY DAMAGE X $ X HIRED AUTOS (Per accident) AUTOS $ CX XCUP001F80454411/01/1411/01/15 UMBRELLA LIAB 3,000,000 EACH OCCURRENCE$ OCCUR 3,000,000 EXCESS LIAB CLAIMS-MADEAGGREGATE$ X10,000 $ DEDRETENTION$ WC STATU-OTH- WORKERS COMPENSATION 12/31/15X DXAUB4342T02814 12/31/14 TORY LIMITSER AND EMPLOYERS' LIABILITY Y / N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N N / A OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD Certificate holder is included as an additional insured on the G contract or agreement subject to policy terms and conditions. A Holder on the Workers Compensation, General & Auto Liability pol subject to policy terms and conditions. The General & Auto Liab subject to policy terms and conditions. CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Salina, Utilites Department ACCORDANCE WITH THE POLICY PROVISIONS. 300 West Ash, Po Box 736 AUTHORIZED REPRESENTATIVE Salina, KS 67402 USA © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05)The ACORD name and logo are registered marks of ACORD jstewart0921 42548716 A °RD CERTIFICATE OF LIABILITY INSURANCE DATE(MEDD 10/30/20"YYY)14 • 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 CA#0H64724 1-913-982-3650 CONTACT IMA, Inc. (NE Kansas Division) NAME PHONE FAX IA/C,No.Ext): (A/C,No): 51 Corporate Woods ADDRIESS: 9393 W. 110th Street, Suite 600 Overland Park, KS 66210 INSURER(S)AFFORDINGCOVERAGE NAIC# INSURERA: PHOENIX INS CO 25623 INSURED INSURERB: TRAVELERS IND CO OF AMER 25666 Schwab-Eaton, PA INSURERC: TRAVELERS IND CO 25658 1125 Garden Way INSURERD: HARTFORD ACCIDENT & IND CO 22357 Manhattan, KS 66502 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 42009412 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. ILTR I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER I(MM/DDYIYYYY)I(MMIDD//YYYY) LIMITS A GENERAL LIABILITY 6801F799818 11/01/141 11/01/15 EACH OCCURRENCE $ 1,000,000 g DAMAGE TO RENTED ) 1,000,000 COMMERCIAL GENERAL LIABILITY PREMISES(Ea omurence CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: _PRODUCTS-COMP/OP AGG $ 2,000,000 —1 POLICY I I JE 1 LOC $ B AUTOMOBILE LIABILITY BA1F801370 11/01/14 11/01/15 COMBINED SINGLE LIMIT 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS - AUTOS X NON-OWNED PROPERTY DAMAGE HIRED AUTOS % AUTOS - (Per accident) C X UMBRELLA LIAB X OCCUR CUP001F804544 11/01/14 11/01/15 EACH OCCURRENCE $ 3,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 3,000,000 DED X RETENTION$10,000 $ D WORKERS COMPENSATION 37WECBT9523 12/31/13 12/31/14 X TORYLLIMITS OER - AND EMPLOYERS'LIABILITY Y/N N ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate holder is included as an additional insured on the General & Auto Liability policies if required by written contract or agreement subject to policy terms and conditions. A waiver of subrogation is provided in favor of Certifca- Holder on the Workers Compensation, General & Auto Liability policies if required by written contract or agreement subject to policy terms and conditions. The General & Auto Liability policies are primary and non-contributory subject to policy terms and conditions. CERTIFICATE HOLDER CANCELLATION • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Salina, Utilites Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 300 West Ash, PO Box 736 AUTHORIZED REPRESENTATIVE Salina, KS 67402 USA ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD stephspradling . .. . 42009412 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/30/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND C CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND O BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONT REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, bject to the terms and conditions of the policy, certain policies may reqconfer rights to the certificate holder in lieu of such endorsement(s). CONTACT CA#0H647241-913-982-3650 PRODUCER NAME: IMA, Inc. (NE Kansas Division) FAX PHONE 913-982-3495 (A/C, No): (A/C, No, Ext): E-MAIL 51 Corporate Woods ADDRESS: 9393 W. 110th Street, Suite 600 INSURER(S) AFFORDING COVERAGENAIC # Overland Park, KS 66210 PHOENIX INS CO25623 INSURER A : TRAVELERS IND CO OF AMER25666 INSURED INSURER B : Schwab-Eaton, PA TRAVELERS IND CO25658 INSURER C : HARTFORD ACCIDENT & IND CO22357 1125 Garden Way INSURER D : BEAZLEY INS CO INC37540 INSURER E : Manhattan, KS 66502 INSURER F : COVERAGESCERTIFICATE NUMBER:REVISION NUMBER:42009263 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION O CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAV ADDLSUBR INSRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSRWVD A6801F79981811/01/15 11/01/14 1,000,000 GENERAL LIABILITY EACH OCCURRENCE$ DAMAGE TO RENTED X 1,000,000 COMMERCIAL GENERAL LIABILITY$ PREMISES (Ea occurrence) X 10,000 CLAIMS-MADEOCCURMED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 2,000,000 GENERAL AGGREGATE$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:PRODUCTS - COMP/OP AGG$ X PRO- $ POLICYLOC JECT 11/01/1411/01/15 BA1F801370 B COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY 1,000,000 (Ea accident)$ X BODILY INJURY (Per person)$ ANY AUTO ALL OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOSAUTOS NON-OWNEDPROPERTY DAMAGE X X $ HIRED AUTOS (Per accident) AUTOS $ X CXCUP001F80454411/01/15 UMBRELLA LIAB 3,000,000 11/01/14 EACH OCCURRENCE$ OCCUR EXCESS LIAB 3,000,000 CLAIMS-MADEAGGREGATE$ X 10,000 $ DEDRETENTION$ WC STATU-OTH- WORKERS COMPENSATION 37WECBT952312/31/14X D 12/31/13 TORY LIMITSER AND EMPLOYERS' LIABILITY Y / N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A N OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below EProfessional LiabilityV15UMR14060107/19/1407/19/15Each Claim2,000,000 Aggregate4,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD RE: Bridge Load Ratings and Signal Pole Sufficiency Analysis The City of Salina, its agents, representatives, officers, offic on the General and Automobile Liability Policies if required by terms and conditions. This insurance is Primary and Non-Contribu required by written contract or agreement subject to the Policy provided in favor of the Additional Insureds on the General, Aut Compensation Policies if required by written contract or agreeme CERTIFICATE HOLDERCANCELLATION 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. 300 W. Ash AUTHORIZED REPRESENTATIVE PO Box 736 Salina, KS 67402-0736 USA © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05)The ACORD name and logo are registered marks of ACORD stephspradling 42009263