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Insurance Certificate - UT ROW Work for AT&T ACORn• CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/1'YYY) �--..---- 1/1/2020 12/17/2018 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). PRODUCER Lockton Companies CONTACT 444 W.47th Street,Suite 900 PHONE FAX Kansas City MO 64112-1906 (NC.No.Ext): A c.Not: (816)960-9000 E-MAILDRSS: • INSURERISI AFFORDING COVERAGE NAIC R INSURER A: Hartford Fire Insurance Company 19682 INSURED WILDCAT CONSTRUCTION CO.,INC. INSURER B: Trumbull Insurance Company 27120 1312716 3219 WEST MAY Berkshire Hauways wnnsuranceCom PO BOX 9163 INSURER C: Per PdO> 22276 WICHITA KS 67277 INSURER D: — -- -- - — - - - INSURERE: -- - -- — -- INSURER F: COVERAGES SHE0001 CERTIFICATE NUMBER: 14572930 REVISION NUMBER: XXXXXXX 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. INSRrypE OF INSURANCE QM SUER POLICY EFF POLICY EXP LTR INSR Y/VD POUCY NUMBER JMMIDD/YYYYI IMM/DDIYYYY) LIMITS A x COMMERCIAL GENERAL LIABILITY y N 37CSEQUIOSI 1/1/2019 1/1/2020 EACH OCCURRENCE $ 2.000.000 CLAIMS-MADEn OCCUR DAMAGE TO IEaE�rmncel $ 300.000 '' 11 MED EXP(Any one person) $ 10.000 PERSONAL B ADV INJURY $ 2.000.000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 4.000.000 POLICYn 2a IR. PRODUCTS-COMP/OP AGG S 4,000,000 OTHER: S A AUTOMOBILE LIABILJTY N N 37UENQUIOS2 1/1/2019 1/1/1020 tEO aBINEe00SINGLE LIMIT $ 2000.000 X ANY AUTO BODILY INJURY(Per person) S XXXXXXX _ AUTOS ONLY SCHEDULED BODILY INJURY(Per accident $ XXXXXXX X AlUTOS ONLY X AUTOS ONLY (Petr PROPERTY $ XXXXXXX $ XXXXXXX C X UMBRELLA UABX OCCUR N N 47-XSF-303166-03 (/1/2019 1/1/2020 EACH OCCURRENCE $ 1.000.000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1.000.000 DED RETENTION$ $ XXXXXXX B WORKERS COMPENSATION T PER OTH- AND WORKERLOYERS'LIABILRY N 37WNQUIOS0 I/1/_019 1/1/_020 X STATUTE ER B ANY PROPNETOWPARTNERIEEECIfTNE ® NIA 37W'NQU1083 1/1/2019 1/1/2020 $ 1.000,000 EL.EACH ACCIDENT (manOFFIdatory In NH) EXCLUDED? _ EL.DISEASE-EA EMPLOYEE $ I,000.000_-- . I yyees:d c NM) DESCR BION OF OPERATIONS Eelw EI DISEASE-PIXICY LIMIT $ 1,000.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule.may be attached If more space is required) THE CITY OF SAUNA.KS IS AN ADDITIONAL INSURED AS RESPECTS TO THE GENERAL LIABILITY 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 ACCORDANCE WITH THE POUCY PROVISIONS. 14572930 AUTHORIZED REPRESENTATIVE THE CITY OF SALINA,KS 300 W.ASH ST.,ROOM 206 P.O.BOX 736 SALINA KS 67402-0736 /w- I// ACORD 25(2016103) ©1968-2015 ACORD CORPORATION.All rights reserved The ACORD name and logo are registered marks of ACORD ACORD' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) k....i I/1/2019 12/2 7/201 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 WANED,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 Lockton Companies CONTACT NAME: 444 W.47th street,Suite 900 (PHONNo.Ext): iar'ixc.No): Kansas City MO 64112-1906 E-MAIL (816)960-9000 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC R INSURER A: Hartford Fire Insurance Company 19682 INSURED WILDCAT CONSTRUCTION CO.,INC. INSURER B: Trumbull Insurance Company 27120 1312716 3219 WEST MAY h re I0- Iaua Specialty Insurance Com PO BOX 9163 INSURER C: PttCompany 22276 WICHITA KS 67277 INSURER p: _ _ _ INSURERE: INSURER F: COVERAGES SHE0001 CERTIFICATE NUMBER: 14572930 REVISION NUMBER: XXXXXXX 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 ADOLINNSUER POLICY NUMBER POLICY EFF POLICY EXP YYY LIMITS IPOLICYIMOLICIYEXPry A X COMMERCIAL GENERAL LIABILITY y N 37CSEQU1081 1/1/2018 1/1/2019 EACH OCCURRENCE $ 2.000.000 _ CLAIMS-MADE InOCCUR PREMISES(aRENTED $ 300.000 MED EXP(Any one person) $ 10.000 PERSONAL S.ADV INJURY 5 2.000.000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 4,000.000 POLICY ;Is n LOC PRODUCTS-COMP/OP AGG $ 4.000.000 OTHER' $ A AUTOMOBILELIABILITY N N 37UENQUI082 1/1/2018 1/1/2019 /EOa8w0Ot SINGLE LIMB s 7.000,000 X ANY AUTO BODILY INJURY(Per person) $ XXXXXXX _ AUTOS ONLY SCHEDULED BODILY INJURY(Per accident $ XXXXXXX AHIREDON-OWNED PROPERTY DAMAGE AUTOS ONLY Ni.X AUTOS ONLY Per accident) $ XXXXXXX $ XXXXXXX C X UMBRELLA LIABOCCUR N 47-X$F-303)66-02 1/1/2018 1/1/2019 EACH OCCURRENCE $ 1.000.000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 1.000.000 DED RETENTION$ $ XXXX., XX BWORKERS COMPENSATION PER OTH- ANDEMPLOYERS'LULBILITY N 37\WNQU1080 (/1/2018 1/1/2019 X STATUrE ER B ANY PROPNETORNNiTNERIFMECUTIVE Y® NIA 37\WNQUIOS3 1/1/2018 1/1/2019 $ 1.000.000 E L EACH ACCIDENT EXCLUDED? E%COEOi Mandatory NH) EL.DISEASE EMPLOYEE $ 1.000.000If yttdesote upler - - — oOPERATIONS Dan OF OPERATIONS ' - - ____ — _ EL.DISEASE-POLICY uMr 5 1.000.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) THE CITY OF SALINA.KS IS AN ADDITIONAL INSURED AS RESPECTS TO THE GENERAL LIABILITY 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 ACCORDANCE WITH THE POLICY PROVISIONS. 14572930 AUTHORIZED REPRESENTATIVE THE CITY OF SALINA,KS 300 W.ASH ST.,ROOM 206 P.O.BOX 736 SALINA KS 67402-0736 f_ .-o7 m Afrea ACORD 25(2016103) ©1968-2015 ACORD CORPORATION.All rights reserved The ACORD name and logo are registered marks of ACORD acoRO CERTIFICATE OF LIABILITY INSURANCE L� n/zms DATE (MM2017YY) 3/21/2017 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 INSURERS). AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policylies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED, 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 endorsementls). PRODUCER Lockton Companies 444 W. 47th Street, Suite 900 Kansas Cityy MO 64112-1906 (616)960-9000 CONTA NAME: CT PR INC,No, Ext); tFAXC. No): E -MA L ADDRE : INSURERNSI AFFORDING COVERAGE NAIC e INSURER A : Hanford Fire Insurance COm am' 19682 INSURED WILDCAT CONSTRUCTION CO., INC. 1312716 3219 WEST MAY PO BOX 9163 WICHITA KS 67277 INSURER B: Trumbull Insurance Com anv 27120 8msfolH,ua., SPr<wrymR,r> eConP n ___ INSURER C : ' »%6 N RERD: N RERE: INSURER F: COVERAGES SHE0001 CERTIFICATE NUMBER: 14572930 REVISION NUMBER: XXXXXXX THIS 15 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 TR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF IMMIDONYYY POLICY EXP IMMIODfYYYY LIMITS A X COMMERCIALGENERALLIABILITY CLAIMS -MADE OCCUR Y hr 37CSEQUIOSI 1/1/2017 1/1/201$ EACH OCCURRENCE 2.000.000 PRI RENTED EMES$doccrrnceI 300.000 MED EXP (An one s.) 10.000 PERSONAL S ADV INJURY s 2.000.000 GENL AGGREGATE LIMIT APPLIES PER: POLICY JEST LOC OTHER GENERAL AGGREGATE s 4.000.000 PRODUCTS - COMPIOP AGG S 4.000.000 S AUTOMOBILE X X LIABILITY ANY AUTO AUTOS ONLYPASCUTHOEDSULEDBODILY HIRED AUTOS ONLY AUTO ONLY N \1 j7UENQUlO$21/12017 1/1201$ IEaa amidmlSINGLE LN/R S 2.000.000 BODILY INJURY (Per person) S XXXXXXX INJURY (Per accident S XXXXXXX Pe,.ccdrd nene RTY DAMAGE S XXXXXXX S XXXXXXX C X UMBRELLALMB EXCESS LIAB X OCCUR CLAIMS -MADE N N 47-XSF-303166-01 1/1/2017 1/1/2018 EACH OCCURRENCE s 1.000.000 AGGREGATE s 1.000.000 DED I I RETENTION S S XXXXXXX B B WORKERS COMPENSATIONPER AND EMPLOYERS' LIABILITY ANY PROPFIETOWPARTIJERF_JtECUiNE OFFICEREMD N M 9ER EXCLUDED (NanEatory in NH) u yes. dss . mker DESCRIPTION OF OPERATMS[ekw NIA N 3%WNQU1080 %`wQUIO$.i 1/1/2017 I/12017 1/1/2018 I/IIZOI$ OTM X STATUE I I ER 1EACH ACCIDENT S 1.000.000 EL DISEASE. EA EMKOYEE 1.000.000 EL DISEASE - POLICY LIMB c 1.000.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THE CITY OF SALINA, KS IS AN ADDITIONAL INSURED AS RESPECTS TO THE GENERAL LIABILITY NN'HEN REQUIRED BY WRITTEN CONTRACT. 14572930 THE CITY OF SALINA, KS 300 W. ASH ST., ROOM 206 P.O. BOX 736 SALINA KS 67402-0736 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WALL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. -- ? Ac? 6/03) ©1988.2015 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD