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Insurance Certificate DATE(MM/DD/YYYY) ACC)Ro CERTIFICATE OF LIABILITY INSURANCE 01/19/2021 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 1-800-300-0325 CONTCONTACT Stacy Bell Holmes Murphy & Assoc - CR PHONE FAX (A/C.No.Ext): (A/C,No): E-MAIL sbell@holmesmurphy.com 201 First Street SE, Suite 700 ADDRESS: p y.com INSURER(S)AFFORDING COVERAGE NAIC# Cedar Rapids, IA 52401 INSURER A: ACADIA INS CO 31325 INSURED INSURER B: FIREMENS INS CO OF WASHINGTON DC 21784 Pepsi-Cola Bottling Company of Salina, Inc. INSURER C UNION INS CO 25844 604 N 9th St. INSURERD: INSURER E: Salina, KS 67401 INSURER F: COVERAGES CERTIFICATE NUMBER: 61218405 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. IPOLICY EFF POLICY EXPNSR IVSD LTR INSD R TYPE OF INSURANCE WVD ADDL SUER POLICY NUMBER (MM/DD/YYYY) (MM/DDM'YY) LIMITS A X COMMERCIAL GENERAL LIABILITY CPA3233580 01/11/21 01/11/22 EACH OCCURRENCE $ 1,000,000 DAMAGE RENTED CLAIMS-MADE X OCCUR PREM SESO(Ea occurrence) $ 300,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X PRO- X JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY CAA3236343 01/11/21 01/11/22 CEaOMBIacadent)NEDSINGLELIMIT $ 1,000,000 ( X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) A UMBRELLALIAB X OCCUR CPA3233580 01/11/21 01/11/22 EACH OCCURRENCE $ 5,000,000 X EXCESSLIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ $ C WORKERS COMPENSATIONWCA3235050 01/11/21 01/11/22 X STATUTE ER H AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE N N NIA E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED7 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A Cargo Liability CPA3233580 01/11/21 01/11/22 Legal Liability 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) THE CITY OF SALINA IS AN ADDITIONAL INSURED WITH RESPECT TO THE GENERAL AND AUTO LIABILITY COVERAGE AS REQUIRED BY WRITTEN CONTRACT WITH THE INSURED, PER POLICY TERMS AND CONDITIONS. THE GENERAL LIABILITY POLICY INCLUDES A WAIVER OF SUBROGATION IN FAVOR OF THE ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT PER POLICY TERMS AND CONDITIONS. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SALINA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 300 W. ASH STREET AUTHORIZED REPRESENTATIVE SALINA, KS 67401 (Katt... COO-f w t USA (f ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD mengstromcr 61218405 ACORD' CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDAYYY) ‘1...-•------ I/1 1/2019 1/5/2018 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). PRODUCERCONTACT Lockton CompPanies NAME: 444 W.47th Street,Suite 900 (A/C,No,Ert): I(AIC,No): Kansas City MO 64112-1906 E-MAIL (816)960-9000 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC s INSURER A: Liberty Insurance Corporation 42404 INSURED MAHASKA BOTTLING COMPANY INSURER B: Liberty Mutual Fire Insurance Company 23035 1432104 PO BOX 50 INSURER C: OSKALOOSA IA 52577-0050 INSURER D' INSURER E' — _ _ — _ __ - - _ _ INSURPRF-- - — . - __ __ _ —.. _ _ _- . COVERAGES MAHBOOI CERTIFICATE NUMBER: 14817383 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 SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER JMM/DDTYYYY)(MMIDD/YYYYL LIMITS A X COMMERCIAL GENERAL LIABILITY y y TB5_Z91-165220-048 1/11/2018 1/11/2019 EACH OCCURRENCE $ 1.000.000 I CLAIMS-MADE El OCCUR DAMAGE (Ea Eooc rence1 $ 300.000 MED EXP(Any one person) $ 10.000 PERSONAL 8 ADV INJURY $ 1.000.000 GEN.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2.000.000 POLICYEIsTa ❑LOC PRODUCTS-COMPIOP AGG s 2.000.000 OTHER: $ B AUTOMOBILE LIABILITY y y A17-Z91-465220-018 1/11/2018 1/11/2019 EeamdeotSINGLE LIMIT $ 1.000.000 X ANY AUTO BODILY INJURY(Per person) 5 XXXXXXX _ AAUTOS ONLY SCHEDULED AUTOSBODILY INJURY(Per accident 5 XXXXXXX HIRED NON-OWNED PROPERTY DAMAGE f XXXXXXX X AUTOS ONLY X AUTOS ONLY Per amAdenII $ XXXXXXX UMBRELLA LIAB OCCUR EACH OCCURRENCE $ XXXXXXX — EXCESS LIAB CLAIMS-MADE NOT APPLICABLE AGGREGATE $ XXXXXXX DED RETENTION$ $ WORKERSCOMPENSATION PER OTH- ER AND EMPLOYERS LIABILITY yIN y 11'C6-Z91-165220-058 1/11/_>018 1/I 112019 X STAiuTE ER ANY PROPRIETOR/PANTNERIEECUTIVE n NIA EL EACH ACCIDENT 5 1.000.000 OFFICEPAIEMBER IXCLUDEbi (Mammon,in NN) • EL DISEASE.ES EMPLOYEE $ 1.000.000 es.describe unciet _ — DDESCRIPTIONOFO OPERATIONsma. _ ___ _ — — - - E DISEASE-POLICY LUNT 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 IS AN ADDITIONAL INSURED FOR LIABILITY COVERAGE.ONLY AS REQUIRED BY CONTRACT AND SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. SUBROGATION IS WAIVED.ONLY AS REQUIRED BY CONTRACT AND WHERE ALLOWED BY LAW,BUT SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. 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. 14817383 AUTHORIZED REPRESENTATIVE CITY OF SALINA 300 W.ASH STREET SALINA KS 67401 ,f . ACORD 25(2016/03) ©19$6-2015 ACORD CORPORATION.All rights reserved The ACORD name and logo are registered marks of ACORD --- 1 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDAYYY) Ihr.-i 1/11/2019 1/5/2018 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 Kansas City MO 64112-1906 E-MAIL,Ext): INC,No): (816)960-9000 ADDRESS: INSURERIS)AFFORDING COVERAGE NAIC a INSURER A: LLherry Insurance Corporation 42404 INSURED MAHASKA BOTTLING COMPANY INSURER B: Liberty Mutual Fire Insurance Company 23035 EPSI-COLA BOTTLING COMPANY OF 1040448 PEPSI-COLA BOTTLING COMPANY OF NORFOLK INC. INSURER c: PEPSI-COLA OF OSKALOOSA PO BOX 50 INSURER D: OSKALOOSA IA 52577-0050 INSURER E' — -- - - - — INSURER F• - --- - - COVERAGES MA1-1BO01 CERTIFICATE NUMBER: 1937555 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. (NSR ADD_ SUERPOSY NUMBER POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE UM MND JMM/DD/YYYYI IMWDD/YYTYI A x COMMERCIAL GENERAL LIABILITY N N TB5-Z91-165220-018 I/11(2013 1/11/2019 EACH OCCURRENCE $ 1.000.000 CLAIMS-MADE I (OCCUR DAMAGE TO RENTED $ 300.000 ' 1 MED EXP(Any one person) $ 10.000 PERSONAL B ADV INJURY $ 1.000,000 GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 2.000.000 _ POLICY[]78,-. n LOG PRODUCTS-COMPIOP AGG $ 2.000.000 OTHER: $ B AUTOMOBILE LIABILITY N N A17-Z91-465220-018 1/112018 1/11/2019 ,ECAIg NIEDnISINGLE LIMIT $ 1,000.000 X ANY AUTO BODILY INJURY(Per person) $ XXXXXXX — OWNED fTOS ONLY SCHEDULEDTBODILY INJURY(Per accident $ XXXXXXX X AUTOS ONLY X AUTOS ONLYY (Per ectodenI)DAMAGE $ XXXXXXX $ XXXXXXX B X UMBRELLA LIABIX (OCCUR N N TH7-Z91-165220-0I8 1/11/2018 1/11/2019 EACH OCCURRENCE $ 1.000.000 EXCESS LJAB CLAIMS-MADE AGGREGATE $ 1.000.000 DED RETENTION S $ XIC XXXX WORKERS COMPENSATION B AND EMPLOYERS LIABILITY YIN N WC6-Z91-465220-058 1/11/2018 (/11/2019 X SinME ER ANY PROPRIETORRARTNERL£%ECUTIVE l ' N/A E L EACH ACCIDENT $ 1,000.000 OFFIC EXCLUDED? (Mandatory in NHI EL DISEASE-EA EMPLOYEE § 1.000.000 II yes.oesame eider DESCRIPTION OF OPERATIONS WUe EL DISEASE.POUCV I)„R _ t.-1.000.000__ — B CARGO N N IM8222196 1/11/2018 1/11/2019 $100000 $5.000 DEDUCTIBLE DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule.may be attached if more space is required) SALINE COUNTY AND ITS OFFICERS.AGENTS AND EMPLOYEES ARE ADDITIONAL INSURED UNDER THE AFORESAID POLICIES FOR THE TERM OF THE RENTAL AGGREEMENT. • 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. 1937555 AUTHORIZED REPRESENTATIVE KENWOOD PARK BUILDINGS SALINE COUNTY,KS 300 WEST ASH SAUNA KS 67401 1 xi ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION.All rights reserved The ACORD name and logo are registered marks of ACORD