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Insurance Certificate
Client#: 56083 HYDRO4 ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDIYYYY) 03/26/2019 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER I NAMEACT Cheryl York INSPRO Insurance - (PHONNE FAx (,,� o,Ed):402-483-4500 (A.C.No):•402-483-7977 P.O.Box 6847 E-MAIL Lincoln,NE 68506 ADDRESS: cyork@insproins.com INSURER(s)AFFORDING COVERAGE I NAICa 402 4834500 INSURER A:Nationwide Insurance 23787 INSURED INSURER S: Hydro Optimization and Automation Solutions,Inc. INSURER C 2601 W L St.Ste 1 INSURER D: I Lincoln,NE 68522 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. INSRADOUSUBRN ' POLICY EFF POLICY EXP LTR SR IWVD I POLICY NUMBER (MMIDD(YYYY) (MMA)DIYYYY)I TYPE OF INSURANCE LIMITS A X COMMERCIAL GENERAL uABIuTY GLAO7241808895 04/01/2019 04/01/2026EACH GES(EaOCCURRENCE 51,000,000 CLAIMS-MADE X OCCUR I PREMLSnue) sloo,000 X PD Ded:5,000 1MED EXP(Any weperson) $5,000 PERSONAL 8 ADV INJURY 51,000,00° GENL AGGREGATE UNIT APPLIES PER - - I GENERAL AGGREGATE 52,000,000 POLICY JJEECTT LOC - I PRODUCTS-COMP/OP AGG 52,000,000 .OTHER $ A AUTOMOBILE LIABILITY BA724180889504/01/201904/01/2020 pa cddenU INGLELIMIT $1,000,000 _ 1Ea X ANY AUTO BODILY INJURY(Per person) $ — OWNED — SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGEX X AUTOS ONLY AUTOS ONLY (Per accident) $ - $ A x UMBRELLA UAB -X I OCCUR I CAA7241808895 04/01/2019 0410112020 EACH OCCURRENCE s5,000,000 EXCESS LMB I CLAIMS-MADE 1 AGGREGATE $5,000,000 DED I X RETENTIONS° I $ A WORKERS COMPENSATION WC7241808895 04/01/2019 04/01/2026 X I PER OTw AND EMPLOYERS'LUBILTTY STATUTE FR YIN ANY PROPRIETOR/PARTNER/E,XECUTNE _I.E.L EACH ACCIDENT— $1i000,000— -- —OFFICER/MEMBER EXCLUDED:-- -n NIA -.-- __ (Mandatory In NH) I E.L DISEASE-EA EMPLOYEE 51,000,000 e yea.desaibe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT 51,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 1e1,Additional Remarks Schedule,may be attached If more space Is required) Project: Wasterwater Collection System Telemetry Improvements#13-3009 City of Salina Kansas, its agents, representative,officers,officials,and employees are listed as additional insured on a primary and non contributory basis including completed operations with respect to general liability. Waiver of subrogation in favor of The City of Salina Kansas,its agents, representative, officers,officials and employees applies to general liability and workers compensation. CERTIFICATE HOLDER CANCELLATIONANY ELLED City of Salina THELD EXPIRATION D DATE THEF V THEREOF,E E NOTICE WILL E CBE CDELIVERED NE 300 West Ash ACCORDANCE WITH THE POLICY PROVISIONS. Salina, KS 67402-0736 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1075958/M1075928 CEY Client#: 56083 HYDRO4 ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE (I"M/DO/ TTY) 3/22/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCERCONTACT INSPRO Insurance I PN ONE Cheryl York Fax P.O. Box 6847 E- NL Ext): 402-483-4500 (uc,No; 402 483-7977 Lincoln, NE 68506 ADDRESS: cyork@insproins.com INSURERS)AFFORDING COVERAGE NAICI 402 483-4500 INSURER A:Nationwide Ieatmu 23787 INSURED INSURER B: Hydro Optimization and Automation Solutions, Inc. INSURER c: 2601 W L St. Ste 1 INSURER D: Lincoln, NE 68522 INSURERS: 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 IADDL SUBR PODGY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMRIDIYYYY) (MMIDDIYYTY) LIMITS A XI COMMERCIAL GENERAL UABIUTY GLA07231808895 04/01/201804/01/2019EACHOCCURRENCE $1,000,000 I EREMISECLAIMS-MADE X OCCUR PSIEaowirrence) $100,000 X PD Ded:5,000 MED EXP(Any one person) s5,000 PERSONAL 8 ADV INJURY S 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE I$2,000,000 7POLICY JJECOT LOC PRODUCTS-COMP/OPAGG IS2,000,000 I OTHER: $ A IAUTOMOBILELABILITY BA7231808895 04/01/20180410112019]'E°aem"deEr°,pINGLELIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) S IADUTOSDONLY SCHEDULED BODILY INJURY(Per actident) $ I X AUTOS ONLY X 147 -OWOS ONENLY D PROPERTY DAMAGE (Per accident) $ _ AT II I $ A I XI UMBRELLA LABI X OCCUR CAA7221808895 04/01/2018 04/01/2019 EACH OCCURRENCE $5,000,000 I I EXCESS NAB I CLAIMS-MADE AGGREGATE $5,000,000 I DED X RETENTION$0 I $ A WORKERS COMPENSATION WC7231808895 04/01/2018 04/01/2019 X MUTE OT AND EMPLOYERS'LIABILITYFR ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N E.L.EACH ACCIDENT $1,000,000 - - OFFICER/MEMBER EXCLUDED? Y • N/A —_ _- - (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I Si,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD let,Additional Remarks Schedule,may be attached If more space is required) Project: Wasterwater Collection System Telemetry Improvements#13-3009 City of Salina Kansas, its agents, representative, officers,officials, and employees are listed as additional insured on a primary and non contributory basis including completed operations with respect to general liability. Waiver of subrogation in favor of The City of Salina Kansas,its agents, representative, officers, officials and employees applies to general liability and workers compensation. CERTIFICATE HOLDER CANCELLATION City of Salina SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 300 West Ash ACCORDANCE WITH THE POLICY PROVISIONS. Salina, KS 67402-0736 AUTHORIZED REPRESENTATIVE OC 1 b. ,a c - J ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #5948641/M948613 CEY