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Insurance CertificateDATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 05/22/2019 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 PRODUCER Alexi Mai NAME: FAX PHONE Assurance Partners(800) 563-1871(785) 825-5098 (A/C, No): (A/C, No, Ext): E-MAIL 201 E Iron Avenue amai@yourassurance.com ADDRESS: P.O. Box 1213 INSURER(S) AFFORDING COVERAGENAIC # Salina KS67402-1213 Nationwide Mutual Insurance Company23787 INSURER A : INSURED KS Restaurant & Hospitality INSURER B : Summit Ventures LLC INSURER C : KBI Meats, LLC INSURER D : PO Box 3316 INSURER E : Salina KS67402-3316 INSURER F : 19.20 Pkg Renewal 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. ADDLSUBR INSR POLICY EFFPOLICY EXP TYPE OF INSURANCE LIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE$ DAMAGE TO RENTED 300,000 CLAIMS-MADEOCCUR$ PREMISES (Ea occurrence) 1,000 MED EXP (Any one person)$ A Y Y ACP300779544806/01/2019 06/01/2020 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 AUTOMOBILE LIABILITY 1,000,000 $ (Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED A ACP300779544806/01/2019 06/01/2020 BODILY INJURY (Per accident)$ AUTOS ONLYAUTOS HIRED NON-OWNED PROPERTY DAMAGE $ (Per accident) AUTOS ONLYAUTOS ONLY $ UMBRELLA LIAB 1,000,000 OCCUR EACH OCCURRENCE$ A EXCESS LIAB ACP300779544806/01/2019 06/01/2020 1,000,000 CLAIMS-MADE AGGREGATE$ 0 DED RETENTION$$ PER OTH- WORKERS COMPENSATION STATUTEER AND EMPLOYERS' LIABILITY Y / N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ B N / A 10667 01/01/201901/01/2020 OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Kenwood Cove Concession PB6003, PB0497 Concessions for Magnolia Soccer Complex This is a revised certificate and supersedes any previously issued certificate. 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 300 W Ash AUTHORIZED REPRESENTATIVE Salina KS67401 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD BUSINESSOWNERS PB60030411 THISENDORSEMENTCHANGESTHEPOLICY.PLEASEREADITCAREFULLY. ADDITIONALINSURED–MUNICIPALITIESOR PUBLIC AGENCY–INSUREDPROVIDING PROFESSIONAL SERVICES Thisendorsementmodifiesinsuranceprov idedunderthefollowing: PREMIERBUSINESSOWNERSLIABILITYCOVERAGEFORM professionalservices,adviceofinstruction,subject Thefollowingis addedtoSectionII.WHOISAN tothefollowingadditionalexclusion: INSURED: Thisinsurance,includinganydutywehaveto Themunicipalityand/orpublicagency designatedin defend"suits",doesnotapplyto"bodilyinju ry", theScheduleofthisendorsementisalsoaninsured, "propertydamage"or"personalandadvertising butonlywithrespecttoli abilityfor“bodilyinjury”, injury"thatarisesoutof,inwholeorinpart,orisa “propertydamage”or“personalandadvertising resultof,inwholeorinpart,theactiveorprimary injury”caused,inwholeorinpart,byyouractsor negligenceofthemunicipalityand/orpublicagency omissionsortheactsoromissionsofthoseacting designatedintheScheduleofthisendorsement, onyourbehalfinconnectionwithyouroperations, whetherornotsuchnegligencehasbeenassumed otherthantherendering oforthefailuretorender byyouinacontractoragreement. Alltermsandc onditionsofthispolicyapplyunlessmodifiedbythisendorsement. SCHEDULE Municipalityand/orPublicAgency: THECITYOFSALINA 300W ASHSTRM 100 SALINAKS 674012335 PB60030411 Page1of1 ACPBPFD3077795448AGENTCOPY4316618 THECITYOFSALINA 300W.ASHST.,ROOM100 SALINAKS67401 ACPBPFD3077795448AGENTCOPY4316617 DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 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). CONTACT PRODUCER Susan Flaming NAME: FAX PHONE Assurance Partners(800) 563-1871(785) 825-5098 (A/C, No): (A/C, No, Ext): E-MAIL 201 E Iron Avenue sflaming@yourassurance.com ADDRESS: P.O. Box 1213 INSURER(S) AFFORDING COVERAGENAIC # Salina KS67402-1213 Depositors Insurance Company42587 INSURER A : INSURED KS Restaurant & Hospitality INSURER B : Summit Ventures LLC INSURER C : KBI Meats, LLC INSURER D : PO Box 3316 INSURER E : Salina KS67402-3316 INSURER F : 19.20 All Lines 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. ADDLSUBR INSR POLICY EFFPOLICY EXP TYPE OF INSURANCE LIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE$ DAMAGE TO RENTED 300,000 CLAIMS-MADEOCCUR$ PREMISES (Ea occurrence) 1,000 MED EXP (Any one person)$ A Y Y ACP309779544806/01/2018 06/01/2019 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 AUTOMOBILE LIABILITY 1,000,000 $ (Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED A ACP309779544806/01/2018 06/01/2019 BODILY INJURY (Per accident)$ AUTOS ONLYAUTOS HIRED NON-OWNED PROPERTY DAMAGE $ (Per accident) AUTOS ONLYAUTOS ONLY $ UMBRELLA LIAB 1,000,000 OCCUR EACH OCCURRENCE$ A EXCESS LIAB ACP309779544806/01/2018 06/01/2019 1,000,000 CLAIMS-MADE AGGREGATE$ 0 DED RETENTION$$ PER OTH- WORKERS COMPENSATION STATUTEER AND EMPLOYERS' LIABILITY Y / N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ B N / A 10667 01/01/201901/01/2020 OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Kenwood Cove Concession PB6003, PB0497 Concessions for Magnolia Soccer Complex This is a revised certificate and supersedes any previously issued certificate. 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 300 W Ash AUTHORIZED REPRESENTATIVE Salina KS67401 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD THECITYOFSALINA 300W.ASHST.,ROOM100 SALINAKS67401 ACPBPFD3077795448AGENTCOPY4316617 BUSINESSOWNERS PB60030411 THISENDORSEMENTCHANGESTHEPOLICY.PLEASEREADITCAREFULLY. ADDITIONALINSURED–MUNICIPALITIESOR PUBLIC AGENCY–INSUREDPROVIDING PROFESSIONAL SERVICES Thisendorsementmodifiesinsuranceprov idedunderthefollowing: PREMIERBUSINESSOWNERSLIABILITYCOVERAGEFORM professionalservices,adviceofinstruction,subject Thefollowingis addedtoSectionII.WHOISAN tothefollowingadditionalexclusion: INSURED: Thisinsurance,includinganydutywehaveto Themunicipalityand/orpublicagency designatedin defend"suits",doesnotapplyto"bodilyinju ry", theScheduleofthisendorsementisalsoaninsured, "propertydamage"or"personalandadvertising butonlywithrespecttoli abilityfor“bodilyinjury”, injury"thatarisesoutof,inwholeorinpart,orisa “propertydamage”or“personalandadvertising resultof,inwholeorinpart,theactiveorprimary injury”caused,inwholeorinpart,byyouractsor negligenceofthemunicipalityand/orpublicagency omissionsortheactsoromissionsofthoseacting designatedintheScheduleofthisendorsement, onyourbehalfinconnectionwithyouroperations, whetherornotsuchnegligencehasbeenassumed otherthantherendering oforthefailuretorender byyouinacontractoragreement. Alltermsandc onditionsofthispolicyapplyunlessmodifiedbythisendorsement. SCHEDULE Municipalityand/orPublicAgency: THECITYOFSALINA 300W ASHSTRM 100 SALINAKS 674012335 PB60030411 Page1of1 ACPBPFD3077795448AGENTCOPY4316618 DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 9/21/2017 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 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). CONTACT PRODUCER Jennifer Jones NAME: FAX PHONE (785)825-5098 (800)563-1871 Assurance Partners (A/C, No): (A/C, No, Ext): E-MAIL jjones@yourassurance.com 201 E Iron Avenue ADDRESS: P.O. Box 1213 INSURER(S)AFFORDINGCOVERAGE NAIC# Salina KS 67402-1213 Nationwide INSURER A : INSURED KS Restaurant & Hospitality INSURER B : Summit Ventures LLC INSURER C : KBI Meats, LLC INSURER D : PO Box 3316 INSURER E : Salina KS 67402-3316 INSURER F : Summit Ventures COI COVERAGES CERTIFICATENUMBER:REVISIONNUMBER: 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. ADDLSUBR INSR POLICY EFFPOLICY EXP TYPE OF INSURANCE LIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY X 1,000,000 EACHOCCURRENCE$ DAMAGE TO RENTED 300,000 CLAIMS-MADEOCCUR$ A X PREMISES(Eaoccurrence) X ACP3087795448 6/1/20176/1/2018 1,000 MEDEXP(Anyone person)$ 1,000,000 PERSONAL&ADVINJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- X 2,000,000 POLICY LOC PRODUCTS - COMP/OP AGG$ JECT $ OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY$ 1,000,000 (Eaaccident) BODILYINJURY(Perperson)$ X ANY AUTO A ALLOWNED SCHEDULED BODILYINJURY(Peraccident)$ ACP3087795448 6/1/20176/1/2018 AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X X HIRED AUTOS (Peraccident) AUTOS $ UMBRELLA LIAB X X EACHOCCURRENCE$ 1,000,000 OCCUR EXCESS LIAB CLAIMS-MADE AGGREGATE$ 1,000,000 A X ACP3087795448 6/1/20176/1/2018 $ DED RETENTION$0 PER OTH- WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS' LIABILITY Y / N 17KRH5504 6/1/20171/1/2018 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACHACCIDENT$ 1,000,000 N / A OFFICER/MEMBER EXCLUDED?n B 17KRH5503 6/1/20171/1/2018 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ 1,000,000 Ifyes,describeunder E.L. DISEASE - POLICY LIMIT$ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Kenwood Cove Concession PB6003, PB0491 Concessions for Magnolia Soccer Complex This certificates supercedes the renewal certificate that was previously sen ton 6/1/2017 CERTIFICATE HOLDER CANCELLATION certofins@salina.org 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. 300 W Ash Salina, KS 67401 AUTHORIZED REPRESENTATIVE Debbie Walker/DWALKE ©1988-2014ACORD CORPORATION.Allrights reserved. ACORD25(2014/01)TheACORD nameand logoare registeredmarks ofACORD INS025 (201401) BUSINESSOWNERS PB60030411 THISENDORSEMENTCHANGESTHEPOLICY.PLEASEREADITCAREFULLY. ADDITIONALINSURED–MUNICIPALITIESOR PUBLIC AGENCY–INSUREDPROVIDING PROFESSIONAL SERVICES Thisendorsementmodifiesinsuranceprov idedunderthefollowing: PREMIERBUSINESSOWNERSLIABILITYCOVERAGEFORM professionalservices,adviceofinstruction,subject Thefollowingis addedtoSectionII.WHOISAN tothefollowingadditionalexclusion: INSURED: Thisinsurance,includinganydutywehaveto Themunicipalityand/orpublicagency designatedin defend"suits",doesnotapplyto"bodilyinju ry", theScheduleofthisendorsementisalsoaninsured, "propertydamage"or"personalandadvertising butonlywithrespecttoli abilityfor“bodilyinjury”, injury"thatarisesoutof,inwholeorinpart,orisa “propertydamage”or“personalandadvertising resultof,inwholeorinpart,theactiveorprimary injury”caused,inwholeorinpart,byyouractsor negligenceofthemunicipalityand/orpublicagency omissionsortheactsoromissionsofthoseacting designatedintheScheduleofthisendorsement, onyourbehalfinconnectionwithyouroperations, whetherornotsuchnegligencehasbeenassumed otherthantherendering oforthefailuretorender byyouinacontractoragreement. Alltermsandc onditionsofthispolicyapplyunlessmodifiedbythisendorsement. SCHEDULE Municipalityand/orPublicAgency: THECITYOFSALINA 300W ASHSTRM 100 SALINAKS 674012335 PB60030411 Page1of1 ACPBPFD3077795448AGENTCOPY4316618 THECITYOFSALINA 300W.ASHST.,ROOM100 SALINAKS67401 ACPBPFD3077795448AGENTCOPY4316617 A� CERTIFICATE OF LIABILITY INSURANCE DATE A E(MWDDD Y�) 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 CONTACT Alexi Mai NAME: Assurance Partners PHONE (800)563-1871 FAX (785)825-5098 AIC No Ert: MC No: 201 E Iron Avenueamai@yourassurance.com ADDRESS: P.O.Box 1213 INSURER(S)AFFORDING COVERAGE NAIC a Salina KS 67402-1213INSURER A: .Nationwide Mutual Insurance Company 23787 INSURED INSURER B: KS Restaurant 8 Hospitality Summit Ventures LLC INSURER C: KBI Meats,LLC INSURER D: PO Box 3316 INSURER E: Salina KS 67402-3316 INSURER F: COVERAGES CERTIFICATE NUMBER: 19.20 Pkg Renewal 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 HATH 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 ADDLLUBR POLICY EFF POLICYEXP LTR TYPE OF INSURANCE i INSD WVD, POLICY NUMBER (MMIDDIYYY'Q (MMJDDIYYYY) LIMITS X COMMERCIAL GENERAL UABIUTY 1,000,000 EACH OCCURRENCE 5 CLAIMS-MADE n OCCUR DAMAGE TO REM ED 300,000 PREMISES/Ea occurrence) S MED EXP(Any one person) 5 1,000 — A - Y Y ACP3007795448 06/01/2019 06/01/2020 PERSONAL 8. INJURY $ 1.000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2.000,000 POLICY n PRO 2,000,000 TeLOC PRODUCTS-COMPIOPAGG S OTHER: $ AUTOMOBILE UABIUTY COMBINED SINGLE UMIT 5 1,000,000 (Ea acudentl X ANY AUTO BODILY INJURY(Per person) 5 A OWNED ' SCHEDULED ACP3007795448 06/01/2019 06/01/2020 BODILY INJURY(Per accident) S AUTOS ONLY _ AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE 5 AUTOS ONLY _ AUTOS ONLY Jeer acOdentt . S X UMBRELLA UAB _ OCCUR EACH OCCURRENCE S 1.000,000 A EXCESS UAB CLAIMS-MADE ACP3007795448 06/01/2019 06/01/2020 AGGREGATE S 1.000.000 DED X RETENTION 5 0 S WORKERS COMPENSATION XI STATUTE 0TH ER AND EMPLOYERS'UABIUTY Y/N B ANY PROPRIETOR/PARTNER/EXECUTIVE N/A 10667 01/01/2019 01/0112020 E.L.EACHACGDENT $ 1.000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In In NNH) E.L.DISEASE-EA EMPLOYEE 5 1.000,000 ( If yes,desmbe veer 1,000.000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached U more space Is required) Kenwood Cove Concession PB6003,PB0497 Concessions for Magnolia Sncr r Complex This is a revised certificate and supersedes any previously issued certificate. 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. 300 WAsh AUTHORIZED REPRESENTATIVE I Salina KS 67401 ■ //.j� Y 1 I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACORES® CERTIFICATE OF LIABILITY INSURANCE DATE E(M4DD/YO n 12018 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 CONTACT Lindsey Stum NAME: Assurance Partners PHONE (800)563-1871 I FAX (785)825-5098 IOC.No.Enl: (AIC.No): 201 E Iron Avenue n-MAESS: Isturn@yourassurance.com P.O.Box 1213 INSURERIS)AFFORDING COVERAGE NAIC Salina KS 67402-1213 INSURER A: Depositors Insurance Company 42587 INSURED KS Restaurant 8 Hospitality INSURER B: os P N Summit Ventures LLC INSURER C: KB!Meats,LLC INSURER D: PO Box 3316 INSURER E: Salina KS 67402-3316 INSURER F: COVERAGES CERTIFICATE NUMBER: 18.19 All Lines 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 POLICYEFF POLICY EXP• LTR TYPE OF INSURANCE iINSD YND POLICY NUMBER (MMNDMYYY) (MM/DO/1YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE 5 DAMAGE 40 RcNTED 3000 0,0 CLAIMS.MADE X OCCUR PREMISES(Ea occurrence, 5 _ MED EXP(Any one person) $ 1,000 A Y ACP3097795448 06/01/2018 06/01/2019 PERSONAL SADV INJURY 5 1)000.000 $ 2,000,000GENtAGGREGATEUMIT APPLIES PER: GENERAL AGGREGATE XIPOLICY n LOC 0000 20 OTHER: S • AUTOMOBILE LIABILJTY COMBINED SINGLE LIMIT S 1,000,000 ,Ea accident X ANY AUTO BODILY INJURY(Per person) S A OWNED SCHEDULED ACP3097795448 06/01/2018 06/01/2019 BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED AUTOS NLY PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY (Per accident) X UMBRELLA LIAB OCCUR EACH OCCURRENCE _ $ 1.000,000 A ExCESSUAB CLAIMS-MADE ACP3097795448 06/01/2018 06/01/2019 AGGREGATE $ 1,000,000 DED X RETENTION 0 $ WORKERS COMPENSATIONPER OTH- ANDEMPLOYERS'LJABIIJTY X STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE Y� NIA 10067 01/01/2018 01/01/2019 E.L.EACH ACCIDENT $ 1.000,000 FFICER/MEMBER EXCLUDED9 (Mandatory In NH) E.L.DISEASE EA EMPLOYEE 5 1.000,000 II yes,desmbe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 5 • DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may he attached If more space is required) Kenwood Cove Concession PB6003,PB0491 Concessions for Magnolia Surer Complex • 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. 300 W Ash AUTHORIZED REPRESENTATIVE Salina KS 67401 1x4_ d. V 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD