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Insurance Certificate ----1 ACORU° CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `-----"' 5/1/2021 4/7/2020 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 NAME: 444 W.47th Street,Suite 900 PHONE FAX No): Kansas City MO 64112-1906 E-MAIL Ext): (816)960-9000 ADDESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Zurich American Insurance Company 16535 :NSURED GOLDER ASSOCIATES INC. INSURER B 408245 3801 PGA Boulevard INSURER C: Suite 603 INSURER D: Palm Beach Gardens FL 33410 INSURER E: INSURER F: COVERAGES PARENT CERTIFICATE NUMBER: 13920907 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. ISR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP INSD WVD IMM/DD/YYYYIIMM/DD/YYYY) LIMITS A COMMERCIAL GENERAL LIABILITY Y N GL05393921 5/1/2020 5/1/2021 EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE I OCCUR PREMISES(EaEoccurrence) $ 2,000,000 ' ' f MED EXP(Any one person) $ 5,000 ■ PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 ©POLICYn JE n LOC PRODUCTS-COMP/OP AGG $ 4,000,000 .OTHER: $ A AUTOMOBILE LIABILITY N N BAP5393920 5/1/2020 5/1/2021 COMBINED SINGLE LIMIT accident) © ANY AUTO BODILY INJURY(Per person) $ XXXXXX- X OWNED SCHEDULED © AUTOS ONLY _AUTOS BODILY INJURY(Per accident $ XXXXXXX © HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY X AUTOS ONLY (Peraccident) $ XXXXXXX $ XXXXXXX ' , UMBRELLA LIAB _OCCUR EACH OCCURRENCE $ XXXXXXX ■ EXCESS LIAB CLAIMS-MADE NOT APPLICABLE AGGREGATE $ XXXXXXX DED RETENTION$ $ �` AND EMPLOYERS'WORKERS LIABILION TY Y/N N WC5393917 5/1/2020 5/1/2021 X STATUTE OER OFFICER/MEM ER EXCLUDED?PROPRIETOR/PARTNER/EXECUTIVEANY Ii N/A E.L.EACH ACCIDENT $ 2,000,000 (Mandatory in NH) I I E.L.DISEASE-EA EMPLOYEE $ 2,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 2,000,000 • DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:RIGHT-OF-WAY ACCESS PERMIT. THE CITY OF SALINA,KS IS AN ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY, AS REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION See Attachment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 13920907 AUTHORIZED REPRESENTATIVE CITY OF SALINA 300 W.ASH STREET SALINA KS 67401 P ACORD 25(2016/03) ©1 8-2015 ACORD CORPORATION.All rights reserved The ACORD name and logo are registered marks of ACORD ---- 1 ACORD' CERTIFICATE OF LIABILITY INSURANCE DADD/Y)'YY) 11.......---- 5/1/2020 4/17/2019 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 Lockton Companies CONTACT 444 W.47th Street,Suite 900 PHONE FAX Kansas City MO 64112-1906 E-0.Nb,Ertl: A c.No): MAIL (816)960-9000 A ADDRESS: INSURERIS)AFFORDING COVERAGE NAIL# INSURER A: Zurich American Insurance Company 16535 INSURED GOLDER ASSOCIATES INC. INSURER B: 1408345 3801 PGA Boulevard Suite 603 INSURER C: Palm Beach Gardens FL 33410 INSURER D: . INSURER E: INSURER F: COVERAGES PARENT CERTIFICATE NUMBER: 13920907 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD YND POLICY NUMBER IMM/DD IYYYY), nYYY(IMMIDD LIMITS A X COMMERCIAL GENERAL LIABILITY Y N GLO539392I 5/1/2019 5/1/2020 EACH OCCURRENCE $ 2.000.000 CLAIMS-MADE[1 OCCUR DAMAGE /EaE Dns) $ 2.000.000 I 1 MED EXP(Any one oerson) $ 5.000 PERSONAL SADV INJURY 5 2,000.000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4.000.000 n PE 6 fl LOC OTHER: PRODUCTS-COMP/OP AGG $ 4.000.000 OTHER: S A AUTOMOBILE LIABILITY N N BAP5393920 5/1/2019 5/1/2020 fEaaccNeDISINGLELIMIT 5 -2.000.000 X ANY AUTO BODILY INJURY(Per person) S XXXXXXX XX YOWNED SCHEDULED XXXXXXX _ AUTOS ONLY AUTOS BODILY INJURY(Per accident 5 X AUTOS ONLY X AUTOS ONE JPerr a cidentDAJanGE $ XXXXXXX_ $ XXXXXXX UMBRELLA LEAS _OCCUR EACH OCCURRENCE S XXXXXXX EXCESS LIAB CLAIMS-MADE NOT APPLICABLE AGGREGATE $ XXXXXXX DED RETENTION$ 5 AWORKERS COMPENSATION PEN OTH- AND EMPLOYERS'UABILITY YIN N WC5393917 5/1/2019 5/12020 X $iAitfr£ ER ANY PPROPRIE OER EAmNER ECu ® NIA E L EACH ACCIDENT $ 2.000.000 OFF(mandatory In NH) E .DISEASE-EA EMPLOYEE S 2.000.000 _ u RIPTIONOFO DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT s 2,000.000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If mon space is required) RE:RIGHT-OF-WAY ACCESS PERMIT. THE CITY OF SALINA.KS IS AN ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY, AS 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. 13920907 AUTHORIZED REPRESENTATIVE CITY OF SALINA 300 W.ASH STREET SALINA KS 67401 p ACORD 25(2016/03) ©198-2015 ACORD CORPORATION.All rights reserved The ACORD name and logo are registered marks of ACORD ACORO• CERTIFICATE OF LIABILITY INSURANCE DATE(MM!DDNYYY) 4r-i 5/1/2019 4/25/2018 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 (AIC.No,Ext): (AIC.No): (816)960-9000 ADDRESS: INSURER'S)AFFORDING COVERAGE NAIC a INSURER A: Zurich American Insurance Company 16535 INSURED GOLDER ASSOCIATES INC. INSURER B: . 1408245 3801 PGA Boulevard Suite 603 INSURER C: Palm Beach Gardens FL 33410 INSURER D: _ __ _ _ INSURER E: INSURER F: COVERAGES PARENT CERTIFICATE NUMBER: 13920907 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. LTR TYPE OF INSURANCE INSD SVAt POLICY NUMBER POLICY EFF POLICY EXP LIMITS 'POLICY EFF I POLICY XP' A X COMMERCIAL GENERAL LIABILITY y N GL05393921 5/1/2018 5/1/2019 EACH OCCURRENCE $ 2.000.000 CLAIMS-MADE rOCCUR PAMSE (EaERIS occurrence) S 2.000.000 MED EXP(Any one person) $ 5.000 PERSONAL E.ADV INJURY s 2.000.000 GENT AGGREGATE LIMIT IAP�PLIIES PER: GENERAL AGGREGATE S 4.000.000 _ �POLICY n,EC I ILS PRODUCTS-COMP/OPAGG $ 4.000.000 OTHER: 5 A AUTOMOBILE LIABILITY N N BAP5393920 5/12018 5/12019 ,EO aawlNtleDU INGLE LIMIT $ 2,000.000 X ANY AUTO BODILY INJURY(Per person) S XXXXXXX AUSCHEDULED AUTOS ONLY AOBODILY INJURY(Per accident $ XXXXXXX A AUTOS ONLY A AUTOS ONLYY )Peri amdentDAANGE $ XXXXXXX - S XXXXXXX UMBRELLA LIAB OCCUR EACH OCCURRENCE $ XXXXXXX _ EXCESS LIAB —^CLAIMS-MADE NOT APPLICABLE AGGREGATE $ XXXXXXX DED RETENTIONS S A AND EMPLOYERS'WORKERS LIABILITYYIN N WC53939I7 5/1/2018 5/1/2019 X S AME NSATION OER ANY COTPA Ni NIA EL.EACH ACCIDENT $ 2.000.000 OFMandatory N NH) E L.DISEASE-EA EMPLOYEE $ 2.000.000 -- DESCR OF ERATIONS bet. --- Ec-DISEASE=POLICY LIMIT F7.---000.000- -' - ---'—' DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:RIGHT-OF-WAY ACCESS PERMIT. THE CITY OF SALINA.KS IS AN ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY. AS 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. 13920907 AUTHORIZED REPRESENTATIVE . CITY OF SALINA 300 W.ASH STREET SALINA KS 67401 f m ACORD 25(2016103) ©19F6-2015 ACORD CORPORATION.All rights reserved The ACORD name and logo are registered marks of ACORD