Loading...
Insurance Certificate Page 1 of 1 0 YYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 07°A TE'M21LD2'0/25/201919 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 NAME: Millis of Colorado, Inc. FAX c/o 26 Century Blvd 1p No ); 1-8]7-945-]378 I(A'C,No): 1-888-467-2378 E-MAILcartificateseeill is.com P.O. Box 305191 ADDRESS: Nashville, TN372305191 OSA INSURERS)AFFORDING COVERAGE I NAIL! INSVRER A: Great Northern Insurance Company I 20303 INSURED INSURERS: Federal Insurance Company I 20281 rage Group, LLC 1805 29th Street, suite 2050 INSURER C: Sentry Casualty Company I 28460 Boulder, CO 80301 OSA INSURER°: INSURER E: I INSURER F: I COVERAGES CERTIFICATE NUMBER:1112114732 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 TYPE OF INSURANCE IINSDISY2YD POUCY NUMBER I(MWDCDmYY)I(M POLICY I UNITS X I COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,000 I I CLAIMS-MADE IJ OCCUR I PREMI (Ea occurrence) 5 1,000,000 A I MED EXP(Any one person) 5 10,000 I I 3604-53-52 08/01/2019 08/O1/2020I PERSONAL 6ADV INJURY $ 1,000,000 GENE AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 —I POLICY 511,FACT LOC I PRODUCTS-COMPIOP AGG 5 2,000,000 I OTHER: I $ AUTOMOBILE LIABILITY (Es COMBINED nt)SINGLE LIMIT g 1,000,000 accide ANY AUTO BODILY INJURY(Per person) S B OWNED SCHEDULED T 7359-90-85 08/01/2019 08/01/2020 BODILY INJURY(Per accident) 5 I AUTOS ONLY I I AUTOS I HIRED NCH-OWNED PROPERTY DAMAGE g AUTOS ONLY I AUTOS ONLY (Per accident) yI� I I $ 2Lia •LI UMBRELLALIAB I X I OCCUR I EACH OCCURRENCE S 5,000,000 I EXCESS UAe I CINMS .IADE 7989-77-47 08/01/2019 08/01/20201 AGGREGATE Ig 5,000,000 I DED I XI RETENTIONS 10,000 S WORKERS COMPENSATION X I AND EMPLOYERS'LIABILITYY STATUTE I I ERµ C ANYPROPRIETORPARTNEWEXECUTIVE ' t ' EL.EACH ACCIDENT S IN 1,000,000 OFFICERMEMBEREXCLUDED? I ' N/A 90-20463-01 01/01/2019 01/01/2020 i (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE 5 1,000,000 II yes.describe under 1,000.000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 15 C Workers Compensation ' I4 Employers Liability 90-20463-02 01/01/2019 01/01/2020 G.L. Each Accident $1,000,00 0 Each Ebp $1,000,000 Per Statute B.L. -Pol Limiq$l,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached II more space Is required) The City of Salina, Kansas, its agents, representatives, officers, officials and employees are included as Additional Insureds as respects to General Liability and Auto Liability. 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. City of Salina, Kansas AUTHORIZED REPRESENTATIVE Attn: City Clerk � PO Box 736 �C - Y�/�I��> Salina, KS 674020736 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD sx ID: 18291220 AAtal: 1297890 2 of 2 9948 .----....ThPage 1 of 1 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(IDNDP/WYY) `m•----- 12/21/2018 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 POUCIES 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(les)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 NAME: Willis of Colorado, Inc. c/o 26 Century Blvd ((ache Et. 1-877-945-7378 (� No): 1-888-467-2378 E-MAIL certificatesgrillis.com P.O. Box 305191 ADORE$$: Nashville, TN 372305191 USA INSURER(S)AFFORDING COVERAGE HMOs INSURER A: Sentry Casualty Company 28460 INSURED INSURER B: Zaya Group, LLC 1805 29th Street Stn 2050 INSURER C: Boulder, CO 80301 INSURER D: - _ INSURERE: - INSURER F: COVERAGES CERTIFICATE NUMBER:W9538992 REVISION NUMBER: THIS IS TO CERTIFYTHATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT,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 POUCIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY.PAID CLAIMS. CY EXP LIR TYPE OF INSURANCE IIN501SWVDI POLICY NUMBER I(MNDD/YYUCY FYYIF I IMMNDiYYYYI I UNITS I COMMERCIAL GENERALUABIUTY I EACH OCCURRENCE Is — PREMIERENTED�CLAIMS-MADE II OCCUR PREMISES(Ea — OccV-Re.SeJ IS MED EXP(Any one porsonl 15 I PERSONAL&ADV INJURY I$ GENL AGGREGATE OMIT APPLIES PER: GENERAL AGGREGATE 15 PRPOLICY I I J CST LOC PRODUCTS.COMP/OP AGG I$ OTHER: I S AUTOMOBILE LIABILITY COMSINEOSINGLEUMR IS -(Ellaagem) ANY AUTO BODILY INJURY(Per pereon) I S —OWNEDF�I SCHEDULED BODILY INJURY(Per accident)I5 AUTOS ONLY AUTOS HIRED I AUTOS ONLY I NON-OWNED Y AUTOS ONLY 4 PROPERTY 9e9t]DAMAGE I$ ' I IS UMBRELLA LNB I I OCCUR I EACH OCCURRENCE I$ EXCESS UAB I I CLAIMS-MADE 1 AGGREGATE 5 DED I I RETENR7N5 I$ WORKERS COMPENSATION I X I STATUTE I 10Th I AND EMPLOYERS'LIABILITY A ANYPROPRIETONPARTNEW'EXECUTIVE Y/N E.L.EACH ACCIDENT1,000,000 ih1 OFPICEREMBEREXCLUDEDI No N/A 90-20463-01 00 191 01/01/2019 01/01/2020 IS 1.000,000 (Mandato/yin NH) E.L.DISEASE-EA EMPLOYEE:5 DESCRIPTION OOPERATQVS below E.L.DISEASE-POLICYLIMIT I S 1.000,000 A WozGz• Compensation 16 Employers Liability I 90-20463-02 00 191 01/01/2019 01/01/2020 L.L. Each Accident 91,000,000 E L Disease-Each Pap $1,000,000 Per Statute 1 a.L.Disaase-Pol Limit 61,000,000 DESCRIPTION OF OPERATIONS)LOCATIONS/VEHICLES(ACORD 101,Additional Renwka Schedule,may be attached K more slaw b required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Salina, Kansas Attn: City Clerk AUTHORIZED REPRESENTATIVE PO Box 736 �1 ) R Salina, ES 674020736 !.Jp'LRCI ',fy�v}as'L C31988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD SR Is. 17271197 5A701: 998650 2 of 5219 Page 1 of 1 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDYYYY) `m.----- 12/21/2018 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 pollcy(les)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 NAME: Willis of Colorado, Inc. PHONE 1-877-945-7378 FAX 1-888-467-2378 c/o 26 Century Blvd (ASC NO.Ext P.O. Box 305191 E-ADDRESS: IPrC.(Ammo): EMAIL mart is.corn It Nashville, TN 372305191 USA INSURERS)AFFORDING COVERAGE I NAM* INSURER A: Great Northern Insurance Company I 20303 INSURED - INSURER B: Federal Insurance Company I 20281 Eayo Group, LLC 1805 29th Street, Suit. 2050 INSURER C: Sentry Casualty Company I 28460 Boulder, Co 80301 USA INSURER D: I INSURERE: I INSURERF: I COVERAGES CERTIFICATE NUMBER:W9538993 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 ADDESUBR POLICY EFFPOLICY EXP LW TYPE OF INSURANCE L msDIwvn POLICY NUMBER I(MMDDIYYYY)I(MMDDIYYTI7 I LIMITS X I COMMERCIAL GENERALUABIUTY I EACH OCCURRENCE I$ 1,000,000 ICLAIMS-MADE OCCUR I-DAMAGETO RENTED 1,000,000 PREMISESfEa owvmnce) I5 A I I MED EXP(Arty one person) 15 10,000 J Y 3604-53-52 08/01/2018 08/01/2019 PERSONAL a ADV INJURY I$ 1,000,000 GERI AGGREGATE UNIT APPLIES PER: GENERAL AGGREGATE I$ 2,000,000 POLICY I X I‘7118-. LOC I PRODUCTS-COMP/OP AGG 15 2.000.000 I OTHER: 15 AUTOMOBILE UABILIIY COMBINED SINGLE LIMIT 15 1,000,000 -311 JEa ectiOenR) ANY AUTO BODILY INJURY(Per person) I$ BOWNED [1 SCHEDULED Y 7359-90-85 08/01/2018 08/01/2019 BODILY INJURY(Per act4enlll S I AUTOS ONLY AUTOS AUTED OS ONLY I I AUUTOS ONLYY PROP411490 DARTY MAGE I5 I I 1 5 X UMBRELLA LIAB I X I OCCUR I EACH OCCURRENCE 15 5,000,000 B EXCESS IIAB I ICLAIMSMADE 7989-77-47 08/01/2018 08/01/2019 AGGREGATE I5 5,000,000 I DED I X1 RETENTION$10.000 15 I WORKERS COMPENSATION I X I STATUTE I I ETHR I AND EMPLOYERS'LIABILITY C ANYPROPRIETOWPARTNER'EXECUTIVE Y/N E.L.EACH ACCIDENT _1$ 1,000,000 OFFICERMEMBERE(CWDED7 No NIA 90-20463-01 00 191 01/01/2019 01/01/2020 (Mandatory In NH) E.L.DISEASE.EA EMPLOYEEI 5 1,000,000 I des.decals under 1,000,000 OESLRIPiION OF OPERATIONS below E.L.DISEASE POLICY UMR 1$ C 1Workers Compensation 90-20463-02 00 191 01/01/2019 01/01/2020 E.L. Each Accident $1,000.000 L Employers Liability I E.L.Di -Each Eap)$1,000,000 Per Statute I E.L.Diseaae-Pol Limit$1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEIBCLES (ACORD 101,Additional Remarks Schedule.may be attached If mwe space Is required) The City of Salina, Kansas, its agents, representatives, officers, officials and employees are included as Additional Insureds as respects to General Liability and Auto Liability. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Salina, Kansas AUTHORIZED REPRESENTATIVE Attn: City Clerk PO Box 736 �1 • f / Salina, KS 674020736 !Jd'VkCI L et 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD SR ID: 17271197 BATCH: 998650 3 of 5219 ---''''....111, Page 1 of 1 AC® CERTIFICATE OF LIABILITY INSURANCE °2/29/202 7 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 NAME: Willie of Colorado, Inc. PHONE FAX c/o 26 Century Blvd MX.No, ); 1-877-945-7378 ( No); 1-888-467-2378 E-MAIL P.O. Box 305191 ADDRESS: certificates@willis.com Nashville, TN 372305191 DSA INSURER(S)AFFORDING COVERAGE I NAICI INSURER A: Sentry Casualty Company 28460 INSURED INSURER B: Zayo Group, LLC 1805 29th Street Ste 2050 INSURER C: — Boulder, CO 80301 —_ - - — INSURER D: —_ -k - - NSURERE: INSURER F COVERAGES CERTIFICATE NUMBER:W4991415 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. INEXP LTI3 TYPE OF INSURANCE I INSD ISWVDI POLICY NUMBER I(MWDDY/YYYY)EFF I(MMWDDY/YYYY)I OMITS I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE I $ DAMAGE TO RENTED _ I CLAIMS-MADE I_-1occurrence)PREMISES(Ea I$ MED EXP(Any one person) S PERSONAL A ADV INJURY $ GEN_AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE IS POLICY JELOC PRODUCTS-COMP/OP AGG I S I I OTHER: 15 AUTOMOBILELIABILITY COMBINED SINGLE LIMIT I S (Ea accident) ANY AUTO BODILY INJURY(Per person) $ AUUTOTOS S ONLY A ASCHEDULED HIRED NON-OWNED PROPERTY DAMAGE I$ AUTOS ONLY AUTOS ONLY (Per accident) I S UMBRELLA DAB I OCCUR EACH OCCURRENCE 5 — EXCESS LIAB CLAIMS-MADE AGGREGATE $ I DED I I RETENTION S S WORKERS COMPENSATION x I STATUTE I I OER AND EMPLOYERS'LIABILITY A ANYPROPRIETORIPARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBEREXCLUDED? No N/A 90-20963-01 01/01/2018 01/01/2019 _ _ (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 15 A Workers Compensation 90-20963-02 01/01/2018 01/01/2019 B.L. Bach Accident I$1,000,000 E Employers Liability S.L. DISEASE-Each Empl$1,000,000 Per Statute E.L.DISEASE-POL LIHI'31$1,000,000 DESCRIPTOR 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 ACCORDANCE WITH THE POLICY PROVISIONS. City of Salina, Kansas Attn: City Clerk AUTHORIZED REPRESENTATIVE PO Box 736 /1 ,I fT Salina, KS 674020736 !� ` '�'s�'�'1 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD SR IS' 15473713 earce: 554365 7 Page 1 of 1 A E® CERTIFICATE OF LIABILITY INSURANCE DATE 03/2017 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 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 NAME: Willis of Colorado, Inc. PHONE c/o 26 Century Blvd E-MAIL o Extl: 1-877-945-7378 I FAX No): 1-888-467-2378 E-MAIL certificatesewillis.tom P.O. Box 305191 E-MAIL 5: Nashville, TN 372305191 USA INSURER(S)AFFORDING COVERAGE NAZCA INSURER A: Great Northern Insurance Company 20303 INSURED INSURER B: Federal Insurance Company 20281 Zayo Group, LLC 1805 29th Street, Suite 2050 INSURER C: Sentry Casualty Company 28460 Boulder, CO 80301 USA INSURER D: INSURER E: — --__ _ — _ __ . — - INSURER F:_ _ ' _ I__. COVERAGES CERTIFICATE NUMBER:X3204569 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. TITpI TYPE OF INSURANCE IINODISWVDI POLICY NUMBER I(MMIDDPOLICY /YYYY)I(MWDDCDY/YVtVV)I LIMITS X I COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,000 � DAMAGE TO RENTED 1,000,000 I I CLAIMS-MADE I X l OCCUR I PREMISES(Ea occurrence) S A -I MED EC'(Any one person) $ 10,000 I Y N 3604-53-52 08/01/2017 08/01/2018 PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 I POLICY I X I JET Iri LOC I PRODUCTS-COMP/OP AGG $ 2,000,000 I OTHER: I S AUTOMOBILE LIABILITY COMBINEDSINGLE LIMIT $ 1,000,000 (Ea as dent) X I ANY AUTO I BODILY INJURY(Per person) S B IOO OS ONLY I WNED I SCHHEDULED Y N 7359-90-85 08/01/2017 08/01/2018 BODILY INJURY(Per accident) $ _I AIRED IfTOS ONLY I I AUTOS ONLYY I PROPERTY DAMAGE S I I I I S B X I UMBRELLALIAR I X I OCCUR I EACH OCCURRENCE $ 5,000,000 1EXCESS LIAB I I CLAIMS-MADEN N 7989-77-47 08/01/2017 08/01/20181 AGGREGATE S 5,000,000 I DED I X I RETENTIONS 10000 I I S WORKERS COMPENSATIONPER OTH- AND EMPLOYERS'LIABILITY Y/N X I STATUTE I I ER C ANYPROPRIETORPARTNER/EXECUTIVE E.L.EACH ACCIDENT S 1,000,000 OFFICERIMEMBER EXCLUDED? No N/A N 90-20463-01 01/01/2017 01/01/2018 I 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEES S ---- -IIyes;descbe under--- —" - -- 1,000,000 — I DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT I S C Workers Compensation N N 90-20463-02 01/01/2017 01/01/2018 S.L. Each Accident I$1,000,000 & Employers Liability H.L. DISEASE-Each Emp$1,000,000 Per Statute E.L.DISEASE-POL LIMIT$1,000.000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Salina, Kansas, its agents, representatives, officers, officials and employees are included as Additional Insureds as respects to General Liability and Auto Liability. 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. City of Salina, Kansas AUTHORIZEDREPRESENTATIVE Attn: City Clerk A PO Box 736 /1 C R Salina, KS 674020736 ✓ d�*"F�'L 61988.2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD SE ID: 14900197 BATCH: 403249 Page 1 of 1 AC p® CERTIFICATE OF LIABILITY INSURANCE °8/03/22017) 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 ;PHON: Willis of Colorado, Inc. c/o 26 Century Blvd IA/CNNo.Ex111-877-945-7378 FAX FAX No): 1-888-45]-23]8 Ecertificates@willis.com P.O. Box 305191 ADDRESS: Nashville, TN 372305191 USA INSURER(S)AFFORDING COVERAGE NAIC4 _INSURER A: Sentry Casualty Company 28460 INSURED INSURER B: Zayo Group, LLC 1805 29th Street Ste 2050 INSURER C: Boulder, CO 80301 USA INSURERD: INSURER E: _)�__- __ .__ __ - - INSURERF: - _,_ ._ ___ __,_ _-. ____ __I- '_ COVERAGES CERTIFICATE NUMBER:W3204568 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. LiiFI TYPE OF INSURANCE INSDISUBRI WVD I POLICY NUMBER I(MWDCYD/YEY1Y)I(MWDCDYYYYY)P I UMITS I COMMERCIAL GENERAL UABILRY EACH OCCURRENCE I S - I IDAMAGE CLAIMS-MADE II OCCUR PREM SESO(Ea occurrence) I$ I - MED EXP(Any one person) I$ I PERSONAL&ADV INJURY I S GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ I POLICY I I jEECT I I LOC PRODUCTS-COMP/OP AGG $ EI OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ _ (Ea accident) I ANY AUTO BODILY INJURY(Per person) $ IO AUTOS ONLY I II SCHEDULED BODILY INJURY(Per accident) $ _I HIRED AUTOS ONLY I I AUTOS ONLY (Per accident)DAMAGE $ I I I $ I UMBRELLA LIAR I I OCCUR EACH OCCURRENCE $ I EXCESS UAB I I CLAIMS-MADE AGGREGATE $ I DED I I RETENTIONS I I S WORKERS COMPENSATION I X I STPTLITE I I ER AND EMPLOYERS'LIABILITY YIN A ANROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S 1,000,000 P OFFICERMEMBEREXCLUDED? I� N/A N 90-20463-01 01/01/2017 01/01/2018 - - (Mandatory in NH) E.L.DISEASE-EA EMPLOYEEI S 1,000,000 - - If yes:describe under -. - -_ -__ -- - — - . ___ --- DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT I$ _-_1.000,000 A Workers Compensation N N 90-20463-02 01/01/2017 01/01/2018 B.L. Each Accident I$1,000,000 4 Employers Liability B.L. DISEASE-Each Emp$1,000,000 Per Statute E.L.DISEASE-POL LIMIT$1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it 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. City of Salina, Kansas Attn: City Clerk AUTHORIZED REPRESENTATIVE PO Box 736 A yLrL.CJ( R Salina a " C KS 674020736 :Jew�'F�t 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD SR 10± 14900197 BAT®: 403244 ZAYOGRO-01 CRUNKCO ACORO' CERTIFICATE OF LIABILITY INSURANCE 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. DATE 016 12nonol s 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(les) 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 Willis of Colorado, Inc. c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 37230-5191 I CONTACT Willis Towers Watson Certificate Center PHONE (AX,, H., Est): (877) 945-7378 (�, No):(888) 467-2378 noDB€s certificatesawillis.com INSURERS AFFORDING COVERAGE I NAM f 08/01/2016 I INSURER A: Charter Oak Fire Insurance Company 125615 INSURED INSURER B: Phoenix Insurance Company 125623 Zayo Group, LLC 1805 29th Street Ste 2050 I INSURER C: Travelers Property Casualty Insurance Company 136161 I INSURER D: Sentry. Casualty Company 128460 Boulder, CO 80301 INSURER E: I INSURER F: --- - I- - � 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 INSDIDDM WVD POLICY NUMBER I POLICY EFF I POLICY EXP I LIMBS A I 1 1 X I1 COMMERCIAL GENERAL LIABILITY —� CLAIMS -MADE I X I OCCUR I I X I 660-98867518-COF-16 08/01/2016 06/0112017 EACH OCCURRENCE S 1'000'000 DAMAGE TO RENTED s 1,000,000 MED E%P An one a son 1 5 10,000 1 PERSONALBADV INJURY 5 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: 1-1 POLICY 1 X 1 JECT II] LOC 1 OTHER: GENERAL AGGREGATE S 2'000'000 II 2,000,006 PRODUCTS - COMP,OP AGO 5 I 5 B I 1 AUTOMOBILE LIABILITY I ANY AUTO 1 OWNEB ONLY I_I SCHEDULED AUTOS ONLY I I AUTOS ONLY I I I I X 1810-5121N520-PHX-16 08/01/2016 08/01/20771 I EOMBINED SINGLE LIMIT S 1,000,000 BODILY INJURY Per arson 1$ BODILY IN URY Per a tltlent 15 PerOa�mtDAMAGE $ I 5 C IX UMBRELLA LIARi X EXCESS A11 OCCUR CLA1 S I CUP -5121N520 -TIL -16 I 06/01/2016 I 08/01/2017 I EACH OCCURRENCE I$ 5'000'000 AGGREGATE 5 5000'000 0MADE I i 1 X RETENT IS D �OFFICEfLM�MBEER Y/oRKERSCOMPENSAnoN AND EMPLOYERS' ,ABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E%CLUDED? (Mandatory in NH) II-yes'dasaLe under - DESCRIPTION OF OPERATIONS Wm NIA I 9D-20463-01 f"—°--- I_ =A 01/01/2017 01/07/2018 X jMUTE I I ETM E.L. EACH ACCIDENT IS 1'000'000 1,000,000 E.L. DISEASE - EA EMPLOYEE S _ _ _ - -.1,000,000 E.L. DISEASE - POLICY LIMIT 15 D (Workers Compensation '90-20463-02 01/01/2017 01/01/2018 See Attached DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) The City of Salina, Kansas, its agents, representatives, officers, officials and employees are Included as Additional Insureds as respects to General Liability and Auto Liability. - ncoylul"Yv Hnt nco rANCF1 I aTInN ACORD 25 (2016/03) ®1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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, Kansas AUTHORIZED REPRESENTATIVE Attn: City Clerk PO Box 736q-li-- KR 67402-0736 /T Q /� ►a`7_�r. �_ ACORD 25 (2016/03) ®1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDITIONAL COVERAGE SCHEDULE COVERAGE LIMITS POLICY TYPE: Workers Compensation and Employers Per Statute Liability - Retro $1,000,000 E.L. Each Accident CARRIER: Sentry Casualty Company $1,000,000 E.L. Disease - Each Employee POLICY TERM: 0110112017 — 0110112018 $1,000,000 E.L. Disease - Policy Limit POLICY NUMBER: 90-20463-02 7AYOGRn-n1 ESPINESENMI T CERTIFICATE OF LIABILITY INSURANCE FDA12120126 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 Willis of Colorado, Inc. Go 26 Century Blvd P.O. Box 305191 CONTACT Willis Towers Watson Certificate Center NAME' PHONE (ac, No, Eat): (877) 945-7378 1 (Aic, No):(888) 467-2378 Eo AILss: certificates@willis.com Nashville, TN 37230-5191 INSURERS AFFORDING COVERAGE I NAIL• I INSURERA:Sent Casualty Company 128460 DAMAGE E51Ea occurrence I S MED EXP An one erson 15 INSURED INSURER B : I INSURER C: I Zayo Group, LLC INSURER D: 1805 29th Street Ste 2050 Boulder, CO 80301 I INSURER E : I 'INSURER F: = I 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. INSRI TYPE OF INSURANCE IADOLINSD;SUSR WVD POLICY NUMBER POLICY EFF MWDDrfYYYII POLICY EXP LIMrS I IGEN'L I COMMERCIAL GENERAL LIABILITY �CLAIMS-MADE n OCCUR EACH OCCURRENCE I S DAMAGE E51Ea occurrence I S MED EXP An one erson 15 PERSONAL BADV INJURY IS AGGREGATE LIMIT APPLIES PER : I POLICYL1 JEST LOC I OTHER ", GENERAL AGGREGATE IS PRODUCTS -COMP/OPAGG I S Is I I1u AUTOMOBILE LIABILITY'ICOMMBIINNE�D,SINGLE ANY AUTO MEDjj���I 1 (AUTO�q�S ONLY ' AUTOS AUTOS ONLY Irl AUTOS ON`Y LIMIT I S BODILY INJURY Per ers I S BODILYBODILY INJURY (Per accident S PROPERTY DAMAGE IS Per actldem is I� UMBRELLA LIAB I I OCCUR EXCI ESS L CLAIMS -MADE I I EACH OCCURRENCE is AGGREGATE S DEDI RETENTION S S A _ -' WORKERS COMPENSATION AND EMPLOYERS'LIABILJTY YIN ANY PROPRIETORIPARTNER/EXECUTNE IIOFFICERIME^BEER EXCLUDED? I(Mandaro.yi .__-:. _ It es -describe under = DESCRIPTION OF OPERATIONS below NIA ___ I 90-20463-01 T' - _ _-. __ 0110112017 _ __ 0110112018I�sTATUTE _._. _ __ X PER I OTH I ER Is 1,000,000 I E.L. EACH ACCIDENT I 1,000,000 E.L. DISEASE - EA EMPLOYEES 1,000,000 E�L. DISEASE -PoLICY LIMIT 15 A (Workers Compensation I I 190-20463-02 0110112017 01/01/2018 See Attached DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remo Schedule, may be attached if more space Is required) CERT!F!CATE HOLDER CANCFI 1 ATION ACORD 25 (2016103) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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, Kansas AUTHORIZED REPRESENTATIVE Attn: City Clerk PO Box 736 Salina- KS 67402-0736 /L t e Q /�w.l"a�ll fdl.'FV`L ACORD 25 (2016103) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDITIONAL COVERAGE SCHEDULE COVERAGE LIMITS POLICY TYPE: Workers Compensation and Employers Per Statute Liability - Retro $1,000,000 E.L. Each Accident CARRIER: Sentry Casualty Company $1,000,000 E.L. Disease - Each Employee POLICY TERM: 01/0112017 — 0110112018 $1,000,000 E.L. Disease - Policy Limit POLICY NUMBER: 90-20463-02 ZAYOGRO-01 BOLDENJA ACORORCERTIFICATE OF LIABILITY INSURANCE AT8/2/2 D/YYYY) r8/2/2016 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 endors6ment(s). PRODUCER Willis of Colorado, Inc. c/o 26 Century Blvd(A/C,Nc P.O. Box 305191 Nashville, TN 37230-5191 CONTACT NAME: Willis Towers Watson Certificate Center PHONE (g77) 945-7378 I FAX ( ) Ext): A/c No): 888 467-2378 al DRESS: certificates@wiIlis.com INSURERS) AFFORDING COVERAGE I NAIC # INSURER A: Charter Oak Fire Insurance Company 125615 INSURED INSURER B: Phoenix Insurance Company 125623 Zayo Group, LLC INSURER C: Travelers Property Casualty Insurance Company 136161 INSURER D: 1805 29th Street Ste 2050 _----.Boulder,. CO 80301__ _ — _ - - - - - -INSURER E: INSURER F: 08/01/2016 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 LTR I TYPE OF INSURANCE IADDLI INSD UBR1 WVD POLICY NUMBER I POLICY EFF MM/DD POLICY EXP MM/DD/YY I LIMITS A I X 1 COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE 1 $ 1,000,000 CLAIMS -MADE 1� OCCUR X 660-98867518-COF-16 08/01/2016 08/01/2017 DAMAGE TO RENTE ( PREMISES Eaoccurence I S 1,000,000 1 1 MED EXP (Any one person) 1 S 10,000 1 I PERSONAL & ADV INJURY 1 S 1,000,000 1 GEN'L AGGREGATE LIMIT APPLIES PER: 1 GENERAL AGGREGATE 1 S 2,000,000 I_I POLICY 1 X 1 PECOT- ❑ LOC I PRODUCTS - COMP/OP AGG 1 S 2,000,000i OTHER: 1 S 1 AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT 1 g 1,000,000 Ea accident B _ 1 X 1 ANY AUTO X 810-5121 N520-PHX-16 08/01/2016 08/01/2017 BODILY INJURY (Per person) 1 S AALL UTOS OWNED I I SCHEDULED AUTOS NON -OWNED 1 HIRED AUTOS AUTOS I I I I 1 BODILY INJURY (Per accident) I S PROPERTY DAMAGE Per accident) 1$ X I UMBRELLA LIAB I X I OCCUR 1 EACH OCCURRENCE Is 5,000,000 C I I EXCESS LIAB 1 1 CLAIMS -MADE IS CUP -5121N520 -TIL -16 08/01/2016 08/01/2017 1 AGGREGATE 1 S 5,000,000 1 I DED I X I RETENTIONS 10,0001 I I ]WORKERS - COMPENSATIONPER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? 1:1N (Mandatory in NH)- --- / A — - - — - - - ---- - __- _ - - - — OTH- STATUTE ER E.L. EACH ACCIDENT S -&L-DISEASE-EA-EMPLOYEEI-S-_ —.. —_- If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I S DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Salina, Kansas, its agents, representatives, officers, officials and employees are included as Additional Insureds as respects to General Liability and Auto Liability. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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, Kansas AUTHORIZED REPRESENTATIVE Attn: City Clerk PO Box 736 iSalina KS 67402-0736 ACORD 25 (2014/01) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A �'® CERTIFICATE OF LIABILITY INSURANCE DATE01/261D/YYYY) 01 /26/16 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIPA1ATIVFLY OR NEGATIVELY AMEND, EXTENn OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRES:' NTATIV= OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policv(ies) must he endorsed. If SUBROGATION IS WAIVED, subject to tna t -)crus and conditions of the policy, _);tA;n golliia may require an endorsement. A statement On this certificate does not confer rights to POLICY NUMBER PRODUCER Aon Risk Services, Inc of Florida 1001 Brickell Bay Drive, Suite #1100 Miami, FL 33131-4937 CONTACT NAME: Aon Risk Services, Inc of Florida PHONE FAX A/C No Ext): 800-743-8130 A/C No): 800-522-7514 EMAIL ADDRESS: ADP.COI.Center Aon.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: New Hampshire Ins Co 23841 INSURED ADP TotalSource MI VII, LLC (PEO Company) INSURER B: INSURER C : 10200 Sunset Drive Miami, FL 33173 Client of PEO Company. INSURER D: INSURER E Zayo Group LLC 400 Centennial Parkway, Suite 200 INSIJ-F I_�icyillo rn Rnn17 COVERAGES CERTIFICATE NUMBER: 117Fc,6a REVISION NUMBER: T1141 IS O C=RTIFY THAT THE POI 1'�IFS JF INYJ NC=_ UI F__D 91�1 Or.' HA,- FAN , i ) -,Hz If]- 1' 4 D N4VED ABOVE FOR THE POIJCY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ';SUED OR MAY PEP,TAIN THE INSURANCE AFFORDED BY THF PIUC�I _ DESCRIBED HEREIN IS SUBJECT TO ALL THE TEPngS EXCLUSIONS AIVD ONi )I TIONS OF SUCH POLICIES_ LIMITS SHOWN MAY H4VF R3 :=N RPDUC`F) dY PAID CLAIMS r "' I INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS -MADE ❑ OCCUR PREMISES (Ea occur $ MED EXP (Any oneperson) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 71PROJECT F-1 LOC PRODUCTS - COMP/OP AGG $ $ OTHER COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident $ BODILY INJURY Perperson) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident $ PROPERTY DAMAGE NON -OWNED HIRED AUTOS AUTOS Per accident $ UMBRELLA LIABOCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEC I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N X I PER OTH- STATUTE ER E L. EACH ACCIGENT $ 2,000,000 A ANY PROPRIETOR/PARTNERIEXECUTIVE ❑ OFF{CERA/lEMBER EXCLUDED' N / A X WC 034127406 KS 7/1/2015 1/1/2016 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 2,000,000 WORKERS' COMPENSATION & EMPLOYERS' LIABILITY COVERAGE FOR Zayo Group LLC TERMINATED EFFECTIVE 1/1/2016 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) All worksite employees working for ZAYO GROUP LLC, paid under ADP TOTALSOURCE, INC's payroll, are covered under the above stated policy. WAIVER OF SUBROGATION IN FAVOR OF CITY OF SALINA, KANSAS ;ITS AGENTS, REPRESENTATIVES, OFFICERS, OFFICIALS AND EMPLOYEES. AS RESPECTS OF JOB PERFORMED BY ZAYO GROUP LLC AS REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION City of Salina, Kansas SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: City Clerk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 736 ACCORDANCE WITH THE POLICY PROVISIONS. Salina, KS 67402-0736 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD A� CERTIFICATE OF LIABILITY INSURANCE ILTRNSR page 1 of 1 12/30/2015) 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 Willis of Colorado, Inc. c/o 26 Century Blvd. COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR PHONE FAX 877-945-7378 (Air Nn) 888-467-2378 P.O. Box 305191 Nashville, TN 37230-5191 - EMAIL -- certificatesQwillis.com INSURER(S)AFFORDING COVERAGE N_AIC # PO Box INSURERA:sentry Casualty Company 28460-001 occuepDqMErnce) $ INSURED KS 67402-0736 Zayo Group, LLC INSURER B: INSURERC: 1805 29th Street Ste 2050 Boulder, CO 80301 INSURER D: S INUR� INSURER F: COVERAGES CERTIFICATE NUMBER: 24060905 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. ILTRNSR TYPE OF INSURANCE DDL SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS City of COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR AUTHORIZED REPRESENTATIVE Attn: City Clerk PO Box EAACHOCCCURRENCE $ occuepDqMErnce) $ ny one person) i$ KS 67402-0736 C k. PERSONAL & ADV INJURY $ �GEN'LAGGREGATE LIMITAPPLIESPER: PRO - POLICY L_ JECT a LOC GENERALAGGREGATE $ PRODUCTS - COMP/OP AGG $ COMBINED SINGLE LIMIT (Ea accident) $ OTHER: AUTOMOBILE LIABILITY ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS � BODILYINJURY(Perperson) '$ BODILY INJURY(Peraccident) $ HIREDAUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ $ UMBRELLALIAB H OCCUR EACHOCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ ! A A i WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEN/A OFFICER/MEMBER EXCLUDED? 902046301 902046302 1/1/2016 1/1/2016 1/1/2017 1/1/2017 PER H- X E.L. EACH ACCIDENT $ 1,000,000 E.L.DISEASE- EAEMPLOYEE $ 11000,000 ! Mandatory in NH) t yes, describe under E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below I DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additonal Remarks Schedule, maybe attached if more space is required) CERTIFICATE HOLDER rAMrrFI I ATI11K] Co11:4826217 Tpl:2025994 Cert:24060905 ©1988-2014ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 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, Kansas AUTHORIZED REPRESENTATIVE Attn: City Clerk PO Box 736 Salina, KS 67402-0736 C k. Co11:4826217 Tpl:2025994 Cert:24060905 ©1988-2014ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ACORO® CERTIFICATE OF LIABILITY INSURANCEpage 1 of 1 DAT�(MM/DDNYYY) 08/2015 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 Willis of Colorado, Inc. c/o 26 Century Blvd. c/o P.O. Box 305191 g77-945-7378 FAX 888-467-2378 E-MAIL certificatesQwillis.com Nashville, TN 37230-5191 INSURER(S)AFFORDINGOOVERAGE NAIC# INSURERA:The Travelers Indemnity Company 25658-001 INSURED Zayo Group, LLC INSURER B: Travelers Property Casualty Company of Am 25674-001 INSURERC: $ 10,000 1805 29th Street Ste 2050 Boulder, CO 80301 INSURER D: $ 1,000,000 INSURER E: LIMITAPPLIES PER: POLICY D PRO JECT X LOC OTHER: GENERALAGGREGATE INSURER F: PRODUCTS-COMP/OPAGG COVERAGES CERTIFICATE NUMBER: 23454557 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 LTR TYPEOFINSURANCE DDL SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADEIX OCCUR y va.. 6309B867518IND15 8/1/2015 8/1/2016 EACH OCCURRENCE $ 1,000,000 If��ppMMpp FF TT ENTED PREMESQEsoccurence) $ 1,000,000 M ED EXP (Anyone person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: POLICY D PRO JECT X LOC OTHER: GENERALAGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 $ A AUTOMOBILE LIABILITY X ANYAUTO ALLOWNED SCHEDULED AUTOS AUTOS X HIREDAUTOS X NON -OWNED AUTOS y 810512IN52OPHX15 8/1/2015 8/1/2016 COM BINEDSINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY(Per person) $ BODILY INJURY(Per accident) $ PROPERTYDAMAGE (Peraccident) $ B X UMBRELLALIAB EXCESS LIAB X OCCUR CLAIMS -MADE CUP512IN520TIL15 8/1/2015 8/1/2016 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED 7TRIETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) fyes, describeunder DESCRIPTION OF OPERATIONS below N/A PER OTH- TATUTF FR E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additonal Remarks Schedule, may be attached if more space is required) The City of Salina, Kansas, its agents, representatives, officers, officials and employees are included as Additional Insureds as respects to General Liability and Auto Liability. CERTIFICATE HOLDER CANCELLATION Coll:4744592 Tpl:1981794 Cert:23454557 ©1988-2014ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 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, Kansas AUTHORIZED REPRESENTATIVE Attn: City Clerk PO Box 736 Salina, KS 67402-0736 va.. Coll:4744592 Tpl:1981794 Cert:23454557 ©1988-2014ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ACC> Di 'l�w.�4,�I�f'l CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1 08/11/15 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(les) 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 Aon Risk Services, Inc of Florida CONTACT NAME: Aon Risk Services, Inc of Florida PHONE FAX A/C, No, Ext): 800-743-8130 A/C, No): 800-522-7514 1001 Brickell Bay Drive, Suite #1100 Miami, FL 33131-4937 EMAIL ADDRESS: ADP.COI.Center@Aon.com INSURER(S) AFFORDING COVERAGE NAIC # 6A 6A a tv&e , 2110 OfOrIOt1da 1"1 d4 INSURER A : New Hampshire Ins Cc 23841 INSURED ADP TotalSource MI VII, LLC (PEO Company) INSURER B: INSURER C : 10200 Sunset Drive Miami, FL 33173 Client of PEO Company: INSURER D: INSURER E: Zayo Group LLC 400 Centennial Parkway Suite 200 INSURER F: Louisville, CO 80027 COVERAGES CERTIFICATE NUMBER: 1176664 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. LIMITS SHOWN ARE AS REQUESTED. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS AUTHORIZED REPRESENTATIVE COMMERCIAL GENERAL LIABILITY 6A 6A a tv&e , 2110 OfOrIOt1da 1"1 d4 EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS -MADE OCCUR PREMISES Ea occurrence) ccurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 71PROJECT 7 LOC PRODUCTS - COMP/OP AGG $ $ OTHER MIND SINGLE LIMIT AUTOMOBILE LIABILITY Ee acciden $ BODILY INJURY Perperson) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident $ NON -OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DEC I I RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N WC 034127406 KS 07/01/15 07/01/16 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 2,000,000 ANY PROP RI ETOR/PARTNE R/EXEC UTIVE OFFICER/MEMBER EXCLUE F N / A X E.L. DISEASE - EA EMPLOYEE $ 2,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) All worksite employees working for ZAYO GROUP LLC, paid under ADP TOTALSOURCE, INC's payroll, are covered under the above stated policy. WAIVER OF SUBROGATION IN FAVOR OF CITY OF SALINA, KANSAS ;ITS AGENTS, REPRESENTATIVES, OFFICERS, OFFICIALS AND EMPLOYEES. AS RESPECTS OF JOB PERFORMED BY ZAYO GROUP LLC AS REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION City of Salina, Kansas SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: City Clerk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 736 ACCORDANCE WITH THE POLICY PROVISIONS. Salina, KS 67402-0736 AUTHORIZED REPRESENTATIVE 6A 6A a tv&e , 2110 OfOrIOt1da 1"1 d4 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD