Loading...
Insurance CertificateGATEWIR-01 JERPELDING DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 10/30/2019 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). CONTACT Jolene Erpelding, CIC, CISR, CWCS PRODUCER NAME: PHONE FAX Insurance Center, Inc. (ICI) (316) 621-4907(316) 321-5625 (A/C, No, Ext):(A/C, No): 120 W. Central Ave. E-MAIL jerpelding@ici.insurance El Dorado, KS 67042-2138 ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # EMCASCO Insurance Company21407 INSURER A : INSURED Employers Mutual Casualty Company21415 INSURER B : Hartford Fire Insurance Company19682 INSURER C : Gateway Wireless and Network Services LLC 121 S Lulu INSURER D : Wichita, KS 67211 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR POLICY EFFPOLICY EXP TYPE OF INSURANCE POLICY NUMBER LIMITS LTR INSDWVD(MM/DD/YYYY)(MM/DD/YYYY) 1,000,000 A COMMERCIAL GENERAL LIABILITY X EACH OCCURRENCE$ DAMAGE TO RENTED 500,000 CLAIMS-MADEOCCUR X 5X81694 11/1/201911/1/2020 $ 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- 2,000,000 X POLICY LOC PRODUCTS - COMP/OP AGG$ JECT OTHER:$ COMBINED SINGLE LIMIT 1,000,000 B AUTOMOBILE LIABILITY $ (Ea accident) X ANY AUTO 5X81694 11/1/201911/1/2020 BODILY INJURY (Per person)$ OWNED SCHEDULED AUTOS ONLYAUTOS BODILY INJURY (Per accident)$ PROPERTY DAMAGE HIRED NON-OWNED (Per accident)$ AUTOS ONLYAUTOS ONLY $ 2,000,000 B X X UMBRELLA LIABOCCUR EACH OCCURRENCE$ 5X81694 11/1/201911/1/2020 2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE$ DED RETENTION$ $ PER OTH- WORKERS COMPENSATION B X STATUTE ER AND EMPLOYERS' LIABILITY Y / N 5X81694 11/1/201911/1/2020 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A N OFFICER/MEMBER EXCLUDED? 500,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 500,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT$ Leased/Rented Equip.37MSJJ4969 11/1/201911/1/2020 Per Item/Maximum 100,000 C DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Automatic Primary Non-Contributory Additional Insured including Completed Operations for Owners, Lessees or Contractors and Waiver of Subrogation on General Liability per CG7174.3, CG7578; Automatic Additional Insured and Waiver of Subrogation on Auto per CA7450; Automatic Waiver of Subrogation on Workers Compensation per WC000313 - each where allowed by law when required by written contract (forms available upon request) 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. PO Box 736 Salina, KS 67402-0736 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD GATEWIR-01 JERPELDING DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 10/29/2018 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 NAME: PHONE FAX Insurance Center, Inc. (ICI) (316) 321-5600(316) 321-5625 (A/C, No, Ext):(A/C, No): 120 W. Central Ave. E-MAIL ici@ici.insurance El Dorado, KS 67042-2138 ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # EMCASCO Insurance Company21407 INSURER A : INSURED Hartford Accident and Indemnity Company22357 INSURER B : Employers Mutual Casualty Company21415 INSURER C : Gateway Wireless and Network Services LLC 121 S Lulu Hartford Fire Insurance Company19682 INSURER D : Wichita, KS 67211 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR POLICY EFFPOLICY EXP TYPE OF INSURANCE POLICY NUMBER LIMITS LTR INSDWVD(MM/DD/YYYY)(MM/DD/YYYY) 1,000,000 A COMMERCIAL GENERAL LIABILITY X EACH OCCURRENCE$ DAMAGE TO RENTED 500,000 CLAIMS-MADEOCCUR X 5X81694 11/01/201811/01/2019 $ 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- 2,000,000 POLICY LOC PRODUCTS - COMP/OP AGG$ JECT OTHER:$ COMBINED SINGLE LIMIT 1,000,000 B AUTOMOBILE LIABILITY $ (Ea accident) X ANY AUTO 37UECID1601 11/01/201811/01/2019 BODILY INJURY (Per person)$ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident)$ PROPERTY DAMAGE HIRED NON-OWNED (Per accident)$ AUTOS ONLY AUTOS ONLY $ 2,000,000 C X X UMBRELLA LIABOCCUR EACH OCCURRENCE$ 5X81694 11/01/201811/01/2019 2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE$ DED RETENTION$ $ PER OTH- WORKERS COMPENSATION C X STATUTE ER AND EMPLOYERS' LIABILITY Y / N 5X81694 11/01/201811/01/2019 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A N OFFICER/MEMBER EXCLUDED? 500,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 500,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT$ Leased/Rented Equip 37MSJJ4969 11/01/201811/01/2019 Per Item/Maximum 100,000 D DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Automatic Primary Non-Contributory Additional Insured including Completed Operations for Owners, Lessees or Contractors and Waiver of Subrogation on General Liability where allowed by law and when required by written contract. Automatic Additional Insured and Waiver of Subrogation on Auto where allowed by law and when required by written contract. Automatic Waiver of Subrogation on Workers Compensation where allowed by law and when required by written contract. 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. PO Box 736 Salina, KS 67402-0736 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD GATEWIR-01 JERPELDING DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/05/2018 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 NAME: PHONE FAX ICI Insurance Center, Inc. (316) 321-5600(316) 321-5625 (A/C, No, Ext):(A/C, No): 120 W. Central Ave. E-MAIL ici@ici.insurance El Dorado, KS 67042-2138 ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # EMCASCO Insurance Company21407 INSURER A : Travelers Casualty Insurance Company of America INSURED 19046 INSURER B : Employers Mutual Casualty Company21415 INSURER C : Gateway Wireless and Network Services LLC 121 S Lulu Hartford Fire Insurance Company19682 INSURER D : Wichita, KS 67211 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR POLICY EFFPOLICY EXP TYPE OF INSURANCE POLICY NUMBER LIMITS LTR INSDWVD(MM/DD/YYYY)(MM/DD/YYYY) 1,000,000 A COMMERCIAL GENERAL LIABILITY X EACH OCCURRENCE$ DAMAGE TO RENTED 500,000 CLAIMS-MADEOCCUR X 5X81694 01/10/201811/01/2018 $ 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- 2,000,000 POLICY LOC PRODUCTS - COMP/OP AGG$ JECT OTHER:$ COMBINED SINGLE LIMIT 1,000,000 B AUTOMOBILE LIABILITY $ (Ea accident) X ANY AUTO BA-0K522388-17-SEL11/01/2017 11/01/2018 BODILY INJURY (Per person)$ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident)$ PROPERTY DAMAGE HIRED NON-OWNED (Per accident)$ AUTOS ONLY AUTOS ONLY $ 2,000,000 C X X UMBRELLA LIABOCCUR EACH OCCURRENCE$ 5X81694 01/10/201811/01/2018 2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE$ 10,000 X DED RETENTION$ $ PER OTH- WORKERS COMPENSATION C X STATUTE ER AND EMPLOYERS' LIABILITY Y / N 5X81694 01/10/201811/01/2018 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A Y OFFICER/MEMBER EXCLUDED? 500,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 500,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT$ Leased/Rented Equip.37MSJJ4969 11/01/201711/01/2018 Maximum Limit 100,000 D DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) LLC Member Excluded from Workers Compensation. --Revised Certificate-- Automatic Primary Non-Contributory Additional Insured including Completed Operations for Owners, Lessees or Contractors and Waiver of Subrogation on General Liability where required by written contract. Automatic Additional Insured and Waiver of Subrogation on Auto where required by written contract. Automatic Waiver of Subrogation on Workers Compensation where allowed by law and required by written contract. 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. PO Box 736 Salina, KS 67402-0736 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD