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Insurance Certificate (MWDEU A O CERTIFICATE OF LIABILITY INSURANCE DATtinnot�) 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 CONTACT TRUSS NAME: Certificate Department 4551 W. 107th St IPA/CNE No En).913-341-8998 I FAX Not 913341-2923 Suite 300 ADDRESS: Certificates@TrussAdvantage.com Overland Park KS 66207 INSURER(S)AFFORDING COVERAGE NAICtl INSURER A:Argonaut Insurance Co 19801 INSURED VANCE01 INSURER B:Transportation Insurance(CNA) 20494 VanceBrothers, Inc. 5201BrightonINSURER C:The Continental Insurance Co 42625 Kansas City MO 64130 INSURER D: INSURER E: - INSURER F: COVERAGES— --- ---CERTIFICATENUMBER:-i554240762-- - - 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 WTH 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 MD CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I iNm SU BOR POLICY NUMBER I(MMIDDYIYYYYI I(MWDDWYyyl LTR TYPE OF INSURANCE LIMITS C X I COMMERCIAL GENERAL LIABILITY Y 5099653065 1/1/2018 1112019 EACHOCCURRENCE 51000000 I CLAIMS-MADE I X I OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) 51000,000 X Cont.Loeb. MED EXP(Arty one person) 515.000 PERSONAL SADV INJURY 51000000 GENL AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE 52.000.000 -POLICY I, X IJELT LOC PRODUCTS-COMP/OPAGG $2000000 I OTHER: 5 B AUTOMOBILE LIABILITY Y 040343464)24 1/1/2018 1/12019 COMBINED SINGLE LIMIT 5 IEa ecddent) 1000000 X I ANY AUTO BODILY INJURY(Per person) 5 ALL OWNED n SCHEDULED BODILY INJURY Per accident) S AUTOS AUTOS ( ) HIRED AUTOS I NON-0WNED PROPERTY DAMAGE 5 AUTOS (Per ecaoent) X Ls en I 5 UMBRELLA LIAB I OCCUR EACH OCCURRENCE 5 EXCESS LIAB I CLAIMS-MADE AGGREGATE $ I DED I I RETENTION 6 A WORKERS COMPENSATION WC928348285514 1/1/2018 1/12019 I X I STATUTE I I EERH AND EMPLOYERS-LIABRITY ANYPROPRIETORPARTNERJEXECUTIVE YIN E.L.EACH ACCIDENT 51,000000 OFFICERR/EMBER EXCLUDED? N NIA (MandatoryyIn NH) _ _ _ _ E.L.DISEASE-EA EMPLOYEE 51,000000 DESCRIPTIO OF OPERATIONS below I I I EL.DISEASE-POLICY LIMIT 51000000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be anached 8 more space Is required) Re:City of Salina Project No.63094-2016 MicroSurfacing.City of Salina is a primary,non-contributory additional insured as respects General 8 Auto Liability. Waiver of subrogation in favor of City of Salina applies as respects workers compensation as allowed by law. 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 300 W.Ash AUTHORIZED REPRESENTATIVE Salina KS 67402 I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ACORTO® CERTIFICATE OF LIABILITY INSURANCE `� GATE (MMA DYYYY) I 12/20/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER TRUSS 4551 W. 107th St Suite 300 NANffT Certificate Department PHONE913-341-8998 FAx .913-341-2923 EMAIL Certificates@TrussAdvantage.com INSURERS) AFFORDING COVERAGE I NAIL tl Overland Park KS 66207 INSURER A:Af onaut Insurance Co 119801 EACH OCCURRENCE 157,000,000 INSURED VANCE01 INSURERB:The Continental Insurance Co 142625 Vance Brothers, Inc. I INSURER C:Transportation Insurance CNA 120494 NSURER D: 5201 Brighton Kansas City MO 64130 I 15 INSURER E : INSURER F : I V COVERAGES CFRTIFIr.ATF NIIMRFR• 138448000 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICYPERIOD 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IEX �pI TYPE OF INSURANCE jAUDL DI SUEIR WD POLICY NUMBER MILICY EFF MOD/YYYY POLICYIMOYT YYY LIMITS B II 1 1GENLAGGREGATE 1� X' IICCOMMERCIAL GENERAL LIABILITY I J CLAIM54dADE I� OCCUR Cont. Liab -INS Y 5099653065 1/12017 1/1/2018 EACH OCCURRENCE 157,000,000 PREMISES EaE_ enrr 1 $1,000,000 MED EXP (My we Person) 1S15,000 N1X PERSONAL B ADV INJURY 51,000,000 LIMIT APPLIES PER: POLICY ❑ n OTHER' JEa J LOC GENERAL AGGREGATE 1$2,000,000 PRODUCTS - COMP/OP AGG 152,000,000 15 C 1AUTOMOBILE 1X LIABILITY AUTO ANYAUTO ALL 1UTOSULED A NONoWN HIRED AUTOS 1r I AUTOSEO ix MCS 90 F_1 1 V 4034346024 1/1/2017 1/112018 ICOMBINIEa amlceO SINULE LIMI 151,000,000 BODILY INJURY (Percerson) 5 BODILY INJURY (Per accmem)IS Per aentDA E 15 1 15 I I UMBRELLA LIAR EXCESS UAB 1 OCCUR CLAIMSl4ADE I I I EACH OCCURRENCE Is AGGREGATE 15 1 1 DEO 1 I RETENTIONS 1 Is A - WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETORIPA.HTNERIEXECUTIVE N OFFICERIMEM BER EXCLUDED? OFFICERIMEd NH)BER E — — — _ —_ 1. SeaeWioe urxyer DESCRIPTION OF OPERATIONS Delow N / A - _ WC 92822828551 -- - - - - 1/1/2017 — - 1/1/2018 — X STATUTE 1 I �R 1 E.L. EACH ACCIDENT 1 $1,000,000 I EL.D1SE45E - EA EMPLOYEE_51.000,000 FE . DISEASE - POLICY LIMIT I S1.000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (A CORD 101, Additiorul Remarks Schedule, may W adached If mors space is requlmd) Re: City of Salina Project No. 63094 - 2016 MicroSurfacing. City of Salina is a primary, non-contributory additional insured as respects General & Auto Liability. waiver of subrogation in favor of City of Salina applies as respects workers compensation as allowed by law. CERTIFICATE HOLDER CANCELLATION © 1988-2014 AGORO OORPUKA I ION. An rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Salina Kansas 300 W. Ash THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Salina KS 67402 AUTHORIZED REPRESENTATIVE © 1988-2014 AGORO OORPUKA I ION. An rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD