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Insurance Certificate ACc CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 08/30/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Amber Bell NAME: Assurance Partners PHONE (800)563-1871 FAx (785)825-5098 (A/C, o,Ext): (A/C,No): 201 E Iron Avenue E-MAILNabell@yourassurance.com ADDRESS: P.O.Box 1213 INSURER(S)AFFORDING COVERAGE NAIC# Salina KS 67402-1213INSURERA: Westchester Surplus Lines Insurance Company 10172 INSURED INSURER B: Nationwide Mutual Insurance Company 23787 Environmental Priority Service,Inc. INSURER C: 7193E Benfield Rd INSURER D: INSURER E: Salina KS 67401-9667 INSURERF: COVERAGES CERTIFICATE NUMBER: 19.20 All Lines 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDDNYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE /� OCCUR DAMAGE 10 REN FED 50,000 PREMISES(Ea occurrence) $ _ X Professional Liability MED EXP(Any one person) $ 10,000 A X Contractors'Pollution Y 024314789008 08/31/2019 08/31/2020 PERSONAL BADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 X POLICY PRO 2,000,000 JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED ACP7212653125 08/31/2019 08/31/2020 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS XHIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY /� AUTOS ONLY (Per accident) _ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 B EXCESS LIAB CLAIMS-MADE ACP7212653125 08/31/2019 08/31/2020 AGGREGATE $ 1,000,000 DED X RETENTION$ 0 $ WORKERS COMPENSATION X STATUTE EORH AND EMPLOYERS'LIABILITY Y/N B ANY PROPRIETOR/PARTNER/EXECUTIVE N/A ACP7212653125 08/31/2019 08/31/2020 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 10 , 00000 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) General Liability and Pollution Liability$2,000,000 Occurrence/Professional Liability$2,000,000 Claims-Made **Umbrella-Auto&Workers Compensation ONLY EN V3100 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Salina ACCORDANCE WITH THE POLICY PROVISIONS. P.O.Box 736 AUTHORIZED REPRESENTATIVE Salina KS 67402-0736 , � I f64 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 08/29/2018 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 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). CONTACT PRODUCER Lindsey Sturn NAME: FAX PHONE Assurance Partners(800) 563-1871(785) 825-5098 (A/C, No): (A/C, No, Ext): E-MAIL 201 E Iron Avenuelsturn@yourassurance.com ADDRESS: P.O. Box 1213 INSURER(S) AFFORDING COVERAGENAIC # SalinaKS67402-1213Westchester Surplus Lines Insurance Company10172 INSURER A : INSURED Nationwide Mutual Insurance Company23787 INSURER B : Environmental Priority Service, Inc. INSURER C : 7193 E Benfield Rd INSURER D : INSURER E : SalinaKS67401-9667 INSURER F : 18.19 All Lines 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 2,000,000 EACH OCCURRENCE$ DAMAGE TO RENTED 50,000 CLAIMS-MADEOCCUR$ PREMISES (Ea occurrence) Professional Liability10,000 MED EXP (Any one person)$ AContractors' PollutionYYH35425890 00708/31/201808/31/20192,000,000 PERSONAL & ADV INJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- 2,000,000 POLICYLOCPRODUCTS - COMP/OP AGG$ JECT $ OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY 1,000,000 $ (Ea accident) ANY AUTOBODILY INJURY (Per person)$ OWNEDSCHEDULED BYACP721265312508/31/201808/31/2019 BODILY INJURY (Per accident)$ AUTOS ONLYAUTOS HIREDNON-OWNEDPROPERTY DAMAGE $ (Per accident) AUTOS ONLYAUTOS ONLY $ UMBRELLA LIAB 1,000,000 OCCUREACH OCCURRENCE$ B EXCESS LIAB ACP721265312508/31/201808/31/20191,000,000 CLAIMS-MADEAGGREGATE$ 0 DEDRETENTION$$ PEROTH- WORKERS COMPENSATION STATUTEER AND EMPLOYERS' LIABILITY Y / N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ B N / A YACP721265312508/31/201808/31/2019 OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) * General Liability and Pollution Liability $2,000,000 Occurrence / Professional Liability $2,000,000 Claims-Made ** Umbrella - Auto & Workers Compensation ONLY RE: Drilling Support Site Wide Remedial Investigation Former Schilling Air Force Base City of Salina is named as an additional insured to general liability and auto liability. General liability is primary and non-contributory. Waiver of subrogation is included for general liability and workers' compensation as allowed by state law. ENV3101, ENV3143, AC7004, WC000313 CERTIFICATE HOLDERCANCELLATION 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 P.O. Box 736 AUTHORIZED REPRESENTATIVE SalinaKS67402-0736 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD COMMERCIAL AUTO AC 7004 03 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESSAUTO PROTECTION -PLUS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SUMMARY OF COVERAGES A.Effect of This Endorsement B.Temporary Substitute Autos –Physical Damage Coverage C.Employees as Insureds –Nonowned Autos D.Additional Insured by Contract, Permit or Agreement E.Prejudgment Interest Coverage F.Personal Effects and Property of Others Extension G.Expanded Towing Coverage H.Expanded Transortation Expense I.Extra Expense –Stolen Autos J.Emergency Lockout K.Transfer Of Rights Of Recovery Against Others To Us L.Section IV –Business Auto Conditions -Notice of Knowledge of Occurrence AC 70 04 03 16 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 3 with its permission AC 70 04 03 16 orsignedbyyoupriortoa“bodilyinjury”or A.EFFECT OF THIS ENDORSEMENT “propertydamage”occurrenceisan“insured” Coverage provided under this policy is modified forCovered Autos LiabilityCoverage. by the provisions of this endorsement. If there However,withrespecttocovered“autos”, is any conflict between the provisions of this insuredonly suchpersonororganizationisan endorsement and the provision(s) of any state- totheextent thatpersonororganizationqualifies specific endorsement also attached to this poli- asan“insured”underA.1.WhoisanInsuredof cy, then the provision(s) of the state-specific SECTIONII–COVERED AUTOS LIABILITY endorsement shall apply instead of the provi- COVERAGE. sions of this endorsement that are in conflict, Ifspecificallyrequiredbythewrittencontract but only to the extent of the conflict, and only to oragreementreferencedintheparagraph the extent necessary to bring such provisions providedbythisen- above,anycoverage into conformance with the state requirement(s) dorsementtoanadditionalinsuredshallbe contained in the provision(s) of the state-specific primaryandanyothervalidandcollectible endorsement. insuranceavailabletotheadditionalinsured B.TEMPORARY SUBSTITUTE AUTOS – shallbenon-contributorywiththisinsurance.If thewrittencontractdoesnotrequirethiscov- PHYSICAL DAMAGE COVERAGE eragetobeprimary andtheadditionalin- The following is added to paragraph C. Certain sured’scoveragetobenon-contributory,then Trailers, Mobile Equipment And Temporary thisinsurancewillbeexcessoveranyotherval- Substitute Autos of the –COVERED AUTOS idandcollectibleinsuranceavailabletothead- SECTION: ditionalinsured. If Physical Damage Coverage is provided by E.PREJUDGMENT INTEREST COVERAGE this Coverage Form, the following types of ThefollowingparagraphisaddedtoSECTIONII vehicles are also covered "autos" for Physi- -COVERED AUTOSLIABILITYCOVERAGE, cal Damage Coverage: SupplementaryPaymentsunderitem: Any "auto" you do not own while used with (7)Prejudgmentinterestawardedagainstthe the permission of its owner as a temporary “insured”onthatpartofthejudgmentwe substitute for a covered "auto" you own that pay.Ifwemakeanoffertopaytheappli- is out of service because of its: cablelimitofinsurance,wewillnotpay a. Breakdown; anyprejudgmentinterestbasedonthat periodoftimeaftertheoffer. b. Repair; F.PERSONAL EFFECTS AND PROPERTY OF c. Servicing; OTHERS EXTENSION d. "Loss"; or 1.The. Care, Custody or Control Exclusion of e. Destruction the SECTION II –COVERED AUTOS The coverage that applies is the same as LIABILITY COVERAGE,does not apply to the coverage provided for the vehicle being "property damage" to property, other than replaced. your property, up to an amount notexceed- C.EMPLOYEES AS INSUREDS –NONOWNED ing $250in any one "accident". Coverage AUTOS is excess over any other valid and collectible insurance. The following is added to paragraph A.1. Who Is An Insured of SECTION II –COVERED AUTOS 2.The following paragraph is added to.Cover- LIABILITY COVERAGE: age Extensionsof SECTION III – PHYSICAL DAMAGE COVERAGE: d.Any "employee" of yours is an "insured" while using a covered "auto" you don't own, c.We will pay up to $500 for your property hire or borrow in your business or your per- that islost or damagedas a result of a sonal affairs. covered “loss”, without applying a de- ductible.Coverage is excess over any D.ADDITIONAL INSURED BY CONTRACT, other valid and collectible insurance. PERMIT OR AGREEMENT G.EXPANDED TOWING COVERAGE ThefollowingisaddedtoA.1.WhoIsAn InsuredofSECTIONII–COVERED AUTOS 1.We will pay up to: LIABILITY COVERAGE: a.$100 for a covered "auto" you own of Anypersonororganizationthatyouare the private passenger type, or requiredtonameasanadditionalinsuredina agreementthatisexecuted writtencontractor Page 2 of 3 Includes copyrighted material of Insurance Services Office, Inc. AC 70 04 03 16 with its permission AC 70 04 03 16 b.$250 for a covered "auto" you own that orstolenandyouhavechangedthe is not of the private passenger type, locktopreventanunauthorized entry;and for towing and labor costs incurred each 3.Originalcopiesofreceiptsforservicesof time the covered "auto" is disabled. alocksmithmustbeprovidedbefore However, the labor must be performed at reimbursementis payable. the place of disablement. 2.Thiscoverage applies only for an "auto" K.TRANSFER OF RIGHTS OF RECOVERY covered on this policy for Comprehensive or AGAINST OTHERS TO US Specified Causes of Loss Coverage and The following is added to theTransfer Of Rights Collision Coverages. Of Recovery Against Others To Us Condition: 3.Payment applies in addition to the otherwise We waive any right of recoverywe may applicable amount of each coverage you have against any person or organization to have on a covered “auto”. the extent required of you by a written con- H.EXPANDED TRANSPORTATION EXPENSE tract executed prior to any “accident” be- Paragraph A.4.a. of SECTION III -PHYSICAL cause of payments we make for damages DAMAGECOVERAGE SECTIONis replaced by under this coverage form. the following: L.NOTICE OF AND KNOWLEDGE OF We will pay up to $50 per day to a maximum of OCCURRENCE $1000 for temporary transportation expense in- SECTION IV –BUSINESS AUTO curred byyou because of the total theft of a CONDITIONS, Paragraph A isamended as covered "auto" of the private passenger type. follows: We will only pay for those covered "autos" for 6.NOTICEOFANDKNOWLEDGEOF which you carry Comprehensive or Specified OCCURRENCE Causes of Loss Coverage. We will pay for tem- porary transportation expenses incurred during a.YourobligationintheDutiesintheEvent the period beginning 48 hours after the theft and of Accident,Claim,SuitorLossCondi- ending, regardless of the policy's expiration, tionrelativetonotification require- when the covered "auto" is returned to useor we mentsappliesonlywhenthe“accident” pay for its "loss" or“loss”isknownto: I.EXTRA EXPENSE –STOLEN AUTOS (1)You,if youareanindividual; The following paragraph is added to Coverage (2)Apartner,if youareapartnership; Extensions. of SECTION III –PHYSICAL (3)Amember,ifyou area limitedliability DAMAGE COVERAGE: company;or c.We will pay for up to $5,000 for the expense (4)An executive officer or insurance of returning a stolen covered “auto” to you. manager, if you are a corporation. We will pay only for those covered “autos” b.Your obligation in the. Duties inthe Event for which you carry Comprehensive or Spec- ofAccident, Claim, Suit or Loss Condition ified Causes of Loss Coverage relativetoprovidinguswithdocuments J.EMERGENCY LOCKOUT –PRIVATE concerningaclaimor“suit”willnotbe PASSENGER VEHICLES breach consideredbreachedunlessthe Wewillreimburseyouupto$75forreasonable occursaftersuchclaim or“suit”isknown expenseincurredfortheservicesofalocksmith to: togainentryintoyourcovered“auto”ofthepri- (1)You,if youareanindividual; vate passengertype subjectto these provisions: (2)A partner, ifyouareapartnership; 1.Yourdoorkeyorkeyentrypadhas (3)Amember, ifyouarealimited beenlost,stolenorlockedinyour liabilitycompany;or covered“auto”andyou areunableto enter such “auto” ,or (4)Anexecutiveofficerorinsurance manager,if youareacorporation. 2.Yourkeyorkeyentrypadhasbeenlost AC 70 04 03 16 Includes copyrighted material of Insurance Services Office, Inc.,Page 3of 3 with its permission WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICYWC 00 03 13 (Ed.4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective ACP722653125 Endorsement No. Policy No. Insured Premium EnvironmentalPriorityService,Inc. NationwideMutualInsuranceCo. Insurance Company Countersigned by __________________________________________ WC 00 03 13 (Ed. 4-84) 1983 National Council on Compensation Insurance. ACOREP CERTIFICATE OF LIABILITY INSURANCE DATE(MM'DONYYY) 08/22/2017 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 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 Jennifer Craft NAME: Assurance Partners AHHCONt o,Eat)_ (800)563-1871 1 No): (785)825-5098 201 E Iron Avenue EMAIL jaaft@yourassurance.com ADDRESS: P.D.Box 1213 INSURERS)AFFORDING COVERAGE NAICS Salina KS 67402-1213 INSURER A: Westchester Surplus Lines Insurance Co 10172 INSURED INSURER B: Nationwide Mutual Insurance Company 23787 • Environmental Priority Service,Inc. INSURER c: 7193 E Benfield Rd INSURER o: INSURER E: Salina KS 67401-9667 INSURER F: COVERAGES CERTIFICATE NUMBER: 17.18 Al Lines 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. MTaRR ADDTYPE OF INSURANCE NSDL USH WVD POLICY NUMBER POLICYEFFMMJD POLICY EXP LIMITS (MOLIC/YEFF (POLICY Y) X COMMERCIAL GENERAL LIABIUTY EACH OCCURRENCE $ 2.000,000 DAMAGE JO RON,cD 50,000 CLAIMS-MADE 1-1 OCCUR PREMISES(Ea occurrence) 5 X Professional LiabilityMED EXP(Any one person) $ 10,000 A X Contractors'Pollution Y Y G24314789006'See Below 08/31/2017 08/31/20182,000,000 PERSONAL ADVIWURY s 2,000,000 GEN.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 2.000,000 X POLICY n PRO- n LOC PRODUCTS-COMP/OP AGG 5 2,000,000 OTHER: $ AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT 5 1,000,000 IEa ewoeml X ANY AUTO BODILY!HAIRY(Per person) $ B OWNED ^—SCHEDULED Y ACP7202653125 08/31/2017 08/31/2018 BODILY INJURY(Per accident) AUTOS ONLY AUTOS _ HIRED NN-ONED PROPERTY DAMAGE 5 X AUTOS ONLY X AUTOS WONLY (Per ecodeml 5 X UMBRELLA MB X OCCUR EACH OCCURRENCE $ 1,000,000 B EXCESSUABCLALNSMADE ACP7202653125"See Below 08131/2017 08131/2018 AGGREGATE 5 1,000,000 DED X RETENTION 5 0 5 WORKERS COMPENSATION AND EMPLOYERS'LWBIUTY YIN X STANTE ERS B ANY PROPRIETOR/PARTNER/EXECUTIVE NIA Y ACP7202653125 08/31/2017 08/31/2018 E.L.EACH ACCIDENT $ 1.00.000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE 5 1,000.000 u yes,desaice under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule.may be attached If more apace is required) •General Liability and Pollution Liability 52,000,000 Occurrence/Professional Liability 52,000,000 Claims-Made Umbrella-Auto 8 Workers Compensation ONLY RE: Drilling Support Site Wide Remedial Investigation Former Schilling Air Force Base City of Salina is named as an additional insured to general liability and auto liability. General liability is primary and non-contributory. Waiver of subrogation is included for general liability and workers'compensation as allowed by state law. ENV3101,ENV3143,AC7004,WC000313 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Salina ACCORDANCE WITH THE POLICY PROVISIONS. P.O.Box 736 AUTHORIZED REPRESENTATIVE Salina KS 67402-0736 2 U ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Named Insured Endorsement Number Environmental Priority Service Inc Policy Symbol Poky Number Poky Period Effective Date of Endorsement ECP G24314789 006 08/31/2017 to 08/31/2018 08/31/2017 ltsued By(Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert Our poky number. The remainder Mahe 4:crmaticn Is lobs Completed only omen this endorsement Is Issced subsequent to the prepataeon of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name Of Person or Organization: Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are perforniing operations, and only at the specific written request of such person or organization to you,wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition is amended try the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products-completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above. All other terms and conditions remain the same. ENV.3143(03-05) Includes copyrighted material of Insurance Services Office,Inc.with its permission Page 1 of 1 COMMERCIAL AUTO AC 70 04 03 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO PROTECTION - PLUS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SUMMARY OF COVERAGES A. Effect of This Endorsement B. Temporary Substitute Autos—Physical Damage Coverage C. Employees as Insureds—Nonowned Autos D. Additional Insured by Contract, Permit or Agreement E. Prejudgment Interest Coverage F. Personal Effects and Property of Others Extension G. Expanded Towing Coverage H. ExpandedTransortation Expense I. Extra Expense— Stolen Autos J. Emergency Lockout K. Transfer Of Rights Of Recovery Against Others To Us L. Section IV—Business Auto Conditions- Notice of Knowledge of Occurrence AC 70 04 03 16 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 3 with its permission ACP BA 72-0-2653125 LI57 17186 INSURED COPY AC7004031600 0001 43 0005222 AC 70 04 03 16 A. EFFECT OF THIS ENDORSEMENT or signed by you prior to a "bodily injury" or Coverage provided under this policy is modified "property damage" occurrence is an "insured' by the provisions of this endorsement. If there for Covered respectAutos Liability Coverage, is any conflict between the provisions of this However, norwith to covered "autos°, endorsement and the provision(s) of any state- to person or organization is an insured only specific endorsement also attached to this poli- to the extent that person or organization qualifies cy, then the provision(s) of the state-specific as an 'insured' under Al.. Who is an Insured of endorsement shall apply instead of the provi- SECTION II — COVERED AUTOS LIABILITY sions of this endorsement that are in conflict, COVERAGE . but only to the extent of the conflict, and only to If specifically required by the written contract the extent necessary to bring such provisions or agreement referenced in the paragraph into conformance with the state requirement(s) above, any coverage provided by this en- contained in the provision(s)of the state-specific dorsement to an additional insured shall be endorsement. primary and any other valid and collectible insurance available to the additional insured B. TEMPORARY SUBSTITUTE AUTOS — shall be non-contributory with this insurance. If PHYSICAL DAMAGE COVERAGE the written contract does not require this cov- The following is added to paragraph C. Certain erage to be primary and the additional in- Trailers, Mobile Equipment And Temporary sured's coverage to be non-contributory, then Substitute Autos of the — COVERED AUTOS this insurance owill be insuranceas over bleany toth other val- id and collectible available the ad- SECTION: ditional insured. If Physical Damage Coverage is provided by E. PREJUDGMENT INTEREST COVERAGE this Coverage Form, the following types of The following paragraph is added to SECTION II vehicles are also covered "autos" for Physi- - COVERED AUTOS LIABILITY COVERAGE, cal Damage Coverage: Supplementary Payments under item: Any "auto" you do not own while used with (7) Prejudgment interest awarded against the the permission of its owner as a temporary "insured" on that part of the judgment we substitute for a covered "auto"you own that pay. If we make an offer to pay the appli- is out of service because of its: cable limit of insurance, we will not pay a. Breakdown; any prejudgment interest based on that b. Repair; period of time after the offer. c. Servicing; F. PERSONAL EFFECTS AND PROPERTY OF d. "Loss"; or OTHERS EXTENSION e. Destruction 1. The. Care, Custody or Control Exclusion of The coverage that applies is the same as the SECTION II — COVERED AUTOS the coverage provided for the vehicle being LIABIeITY COVERAGE, does not apply to replaced. "property damage" to property, other than your property, up to an amount not exceed- C. EMPLOYEES AS INSUREDS — NONOWNED ing $250 in any one "accident". Coverage AUTOS is excess over any other valid and collectible The following is added to paragraph A.1. Who Is insurance. An Insured of SECTION II — COVERED AUTOS 2. The following paragraph is added to. Cover- LIABILITY COVERAGE: age Extensions of SECTION III — d. Any "employee" of yours is an "insured" PHYSICAL DAMAGE COVERAGE: while using a covered"auto" you don't own, c. We will pay up to 3500 for your property hire or borrow in your business or your per- that is lost or damaged as a result of a sonal affairs. covered 'loss", without applying a de- D. ADDITIONAL INSURED BY CONTRACT, ductible. Coverage is excess over any PERMIT OR AGREEMENT other valid and collectible insurance. The following is added to A.1. Who Is An G. EXPANDED TOWING COVERAGE Insured of SECTION II — COVERED AUTOS 1. We will pay up to: LIABILITY COVERAGE: a. 3100 for a covered "auto" you own of Any person or organization that you are the private passenger type, or required to name as an additional insured in a written contract or agreement that is executed Page 2 of 3 Includes copyrighted material of Insurance Services Office, Inc. AC 70 04 03 16 with its permission ACP BA 72-0-2653125 LIST 17186 INSURED COPY AC7004031600 0001 43 0005223 AC 70 04 0316 b. $250 for a covered "auto" you own that or stolen and you have changed the is not of the private passenger type, lock to prevent an unauthorized entry;and for towing and labor costs incurred each 3. Original copies of receipts for services of time the covered "auto" is disabled. a locksmith must be provided before However, the labor must be performed at reimbursement is payable. the place of disablement. 2. This coverage applies only for an "auto" K. TRANSFER OF RIGHTS OF RECOVERY covered on this policy for Comprehensive or AGAINST OTHERS TO US Specified Causes of Loss Coverage and The following is added to the Transfer Of Rights Collision Coverages. Of Recovery Against Others To Us Condition: 3. Payment applies in addition to the otherwise We waive any right of recovery we may applicable amount of each coverage you have against any person or organization to have on a covered"auto". the extent required of you by a written con- H. EXPANDED TRANSPORTATION EXPENSE tract executed prior to any "accident" be- Paragraph A.4.a. of SECTION III - PHYSICAL cause of payments we make for damages DAMAGE COVERAGE SECTION is replaced by under this coverage form. the following: L. NOTICE OF AND KNOWLEDGE OF We will pay up to $50 per day to a maximum of OCCURRENCE $1000 for temporary transportation expense in- SECTION IV — BUSINESS AUTO curred by you because of the total theft of a CONDITIONS, Paragraph A is amended as covered "auto" of the private passenger type. follows: We will only pay for those covered "autos" for which you carry Comprehensive or Specified 6. NOTICE OF AND KNOWLEDGE OF Causes of Loss Coverage. We will pay for tem- OCCURRENCE porary transportation expenses incurred during a. Your obligation in the Duties in the Event the period beginning 48 hours after the theft and of Accident, Claim, Suit or Loss Condi- ending, regardless of the policy's expiration, tion relative to notification require- when the covered"auto"is returned to use or we ments applies only when the "accident' pay for its"loss" or"loss'is known to: I. EXTRA EXPENSE —STOLEN AUTOS (1) You,if you are an individual; The following paragraph is added to Coverage (2) A partner, if you are a partnership; Extensions. of SECTION III — PHYSICAL DAMAGE COVERAGE: (3) A member, if you are a limited liability c. We will pay for up to $5,000 for the expense company;or of returning a stolen covered "auto° to you. (4) An executive officer or insurance We will pay only for those covered "autos" manager,if you are a corporation. for which you carry Comprehensive or Spec- b. Your obligation in the. Duties in the Event Wed Causes of Loss Coverage of Accident, Claim, Suit or Loss Condition J. EMERGENCY LOCKOUT — PRIVATE relative to providing us with documents PASSENGER VEHICLES concerning a claim or "suit° will not be considered breached unless the breach We will reimburse you up to $75 for reasonable occurs after such claim or"suit' is known expense incurred for the services of a locksmith to: to gain entry into your covered "auto' of the pri- vate passenger type subject to these provisions: (1) You, if you are an individual; 1. Your door key or key entry pad has (2) A partner, if you are a partnership; been lost, stolen or locked in your (3) A member, if you are a limited covered "auto' and you are unable to enter liability company;or such"auto' , or (4) An executive officer or insurance 2. Your key or key entry pad has been lost manager,if you are a corporation. AC 70 04 03 16 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 3 with its permission ACP BA 72-0-2653125 LIST 17186 INSURED COPY AC7004031600 0001 43 0005224