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Insurance Certificate ® DATE(MM/DD/YYYY) AC D CERTIFICATE OF LIABILITY INSURANCE 01/28/2021 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 CONTACT Ashley Stucky NAME: Assurance Partners,LLC (A/ ,No,Ext): 563-1871 FAX No): (785)825-5098 201 E Iron Avenue E-MAIL astucky@yourassurance.com ADDRESS: P.O.Box 1213 INSURER(S)AFFORDING COVERAGE NAIC# Salina KS 67402-1213 INSURER A: Travelers Casualty Insurance Company of America 19046 INSUREDINSURER B: Accident Fund General Insurance Company 12304 Main Brothers Inc,DBA:Memorial Art Company INSURER C: 1608 S 9th St INSURER D: INSURER E: Salina KS 67401 INSURER F: COVERAGES CERTIFICATE NUMBER: 21.22 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. NOTWTHSTANDING 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 SIJBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGREN1ED CLAIMS-MADE X OCCUR PREM SESO(Ea occurrence) $ 300,000 MED EXP(Any one person) $ 5,000 A Y Y 6807C667570 02/15/2021 02/15/2022 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JECT PRO LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) _ X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED BA3L98530A 02/15/2021 02/15/2022 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) _ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION OTH- AND EMPLOYERS'LIABILITY X STATUTE ER Y/N 1,000,000 B FF PROPRIETOR/PARTNER/EXECUTIVEEN/A WCV6138556 01/28/2021 01/28/2022 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 10 , 00000 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) CGD037 CGD186 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 PO Box 736 04, Salina KS 67402-0736 idt1X 9-C; teit- tyI ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 02/07/2020 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). CONTACT PRODUCER Kindra Franks NAME: FAX PHONE Assurance Partners(800) 563-1871(785) 825-5098 (A/C, No): (A/C, No, Ext): E-MAIL 201 E Iron Avenue kfranks@yourassurance.com ADDRESS: P.O. Box 1213 INSURER(S) AFFORDING COVERAGENAIC # Salina KS67402-1213 Travelers Casualty Insurance Company of America19046 INSURER A : INSURED Accident Fund General Insurance Company12304 INSURER B : Main Brothers Inc, DBA: Memorial Art Company INSURER C : 1608 S 9th St INSURER D : INSURER E : Salina KS67401 INSURER F : 20.21 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) 5,000 MED EXP (Any one person)$ A Y Y 6807C667570 02/15/202002/15/2021 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 Employment Practices10,000 $ OTHER: Liability COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY 1,000,000 $ (Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED A BA3L98530A 02/15/202002/15/2021 BODILY INJURY (Per accident)$ AUTOS ONLYAUTOS HIRED NON-OWNED PROPERTY DAMAGE $ (Per accident) AUTOS ONLYAUTOS ONLY Medical payments5,000 $ UMBRELLA LIAB OCCUR EACH OCCURRENCE$ EXCESS LIAB CLAIMS-MADE AGGREGATE$ DED RETENTION$$ PER OTH- WORKERS COMPENSATION STATUTE ER AND EMPLOYERS' LIABILITY Y / N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ B Y N / A WCV6138556 01/28/202001/28/2021 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) CGD037 CGD186 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 PO Box 736 Salina KS67402-0736 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD A� CERTIFICATE OF LIABILITY INSURANCE DAE(MA VDD/Y9YY) 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 Rhonda Garcia NAME: Assurance Partners P(u (785)HONE (800)563-1871 FAX 825-5098 201 E Iron Avenue E-MAIL C,No, IA/t,No): ADDRESS: rgafpa©y0Ura5SUfance.COm P.O.Box 1213 INSURERIS)AFFORDING COVERAGE NAIL 0 Salina KS 67402-1213INSURER A: Travelers Casualty Insurance Company of America 19046 INSURED INSURER B: Accident Fund General Insurance Company 12304 Main Brothers Inc. INSURER C DBA:Memorial Art Company INSURER D: 1608S9th St INSURER E Salina KS 67401 INSURER F: COVERAGES CERTIFICATE NUMBER: 19.20 AU 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 ADDL aUBR POLICY EFF POUCY EXP LTR TYPE OF INSURANCE INSD WVD POUCY NUMBER (MMJDDTYYYY) (MMIDDr/YYY) LIMITS X COMMERCIAL GENERAL LIABNTY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE n OCCUR DAMAGE TO RtNTED 300,000 PREMISES(Ea occurrence) 5 MED EXP(Am one person) $ 5.000 A Y Y 68070667570 02/15/2019 02/15/2020 PERSONAL S ADV INJURY 5 1•134K• W GETS_AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2.000.000 X POLICY PRO-JECT LOC PRODUCTS-COMP/OP AGG 5 2.000.000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1.000.000 1E accident) X ANY AUTO BODILY INJURY(Per Person) 5 A OWNED I m SCHEDULED BA3L98530A 02/15/2019 02/15/2020 BODILY INJURY(Per adent) $ AUTOS ONLY FAUTOS — HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ 5 UMBRELLA UAB OCCUR EACH OCCURRENCE 5 -- EXCESS UAB CLALMS-MADE AGGREGATE 5 DED RETENTION 5 5 WORKERS COMPENSATION PER 0TH- ANDEMPLOYERS'LIABRITY X GTATUTE ER YIN BANY PROPRIETORPARTNERIEXECUTIVE E.L.EACH ACCIDENT 5 1,000,000 OFFICER/MEMBER EXCLUDED? n NIA WCV6138556 01/282019 01/28/2020 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE 5 1.000.000 Ifves.desert.unite 1 000 DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT 5 DESCRIPTOR OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached II mon space is required) CGD037 CGD166 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 PO Box 736 AUTHORIZED REPRESENTATIVE fi '- ( Y " Salina KS 67402-0736 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACCORD CERTIFICATE OF LIABILITY INSURANCE DATE (M DDF 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 CONTACT Rhonda Garcia NAME: Assurance Partners PHONE (800)563-1871 FAX (785)825-5098 (AIC,HOER): lac,Na): 201 E Iron Avenue n-MALSS: rgaraa@yourassurance.com P.O.Box 1213 INSURERIS)AFFORDING COVERAGE NAIC$ Salina KS 67402-1213 INSURER A: Travelers Casualty Insurance Company of America 19046 INSURED INSURER B: Accident Fund General Insurance Company 12304 Main Brothers Inc, INSURER c: DBA:Memorial Art Company INSURER D: 1608 S 9th St INSURER E: Salina KS 67401 INSURER F: COVERAGES CERTIFICATE NUMBER: 19.20/18.19 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 ADOL SUER POLICY EFF POUCY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MWDDIYYYY) (MWODIYYYY) WAITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1'000.000 CLAIMS-MADE X OCCUR DAMAGE(0 RLNILD 300 000 PREMISES lEa 000siuce) S MED EXP(My me person) S 5,000 A Y Y 6807C667570 02/15/2018 02/15/2019 PERSONAL 8.ADV INJURY S 1,000.000 GL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2•�•�GSM X POLICYri JECTPRO I�I I I LOC PRODUCTS-COMP/OP ACC S 2•04: • °° OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1.000,000 'Ea accident) X ANY AUTO BODILY LNJURY(Per person) S A OWNED SCHEDULED BA8C250215 02/15/2018 02/15/2019 BODILY INJURY IPer accident) S AUTOS ONLY _ AUTOS HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY _ AUTOS ONLY (Per accident) S UMBRELLA DAB OCCUR EACH OCCURRENCE S EXCESS UAB CLAIMS-MADE AGGREGATE S DED RETENTION S S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY X STATITE ER YIN B ANY PROPRIETOR/PARTNERIEXECUTIVE EEACH ACCIDENT S 1'000.000 OFFICERIMEMBER EXCLUDED? n .L. NIA WCV6138556 01/28/2019 01/282020 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 1.000,000 If yes,descnbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1.00Q000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be anached 11 more space Is required) CGD037 CGD186 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Safina ACCORDANCE WITH THE POLICY PROVISIONS. 300 W.Ash AUTHORIZED REPRESENTATIVE PO Box 736 pima_ i'r" zc 7 _ AL Salina KS 67402-0736 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 02/12/2018 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 Tiffany Lauber NAME: FAX PHONE Assurance Partners(800)563-1871(785)825-5098 (A/C, No): (A/C, No, Ext): E-MAIL 201 E Iron Avenue tlauber@yourassurance.com ADDRESS: P.O. Box 1213 INSURER(S) AFFORDING COVERAGENAIC # Salina KS67402-1213 Travelers Casualty Ins Co of America19046 INSURER A : INSURED Accident Fund General Insurance Company12304 INSURER B : Main Brothers Inc, INSURER C : DBA: Memorial Art Company INSURER D : 1608 S 9th St INSURER E : Salina KS67401 INSURER F : 18.19 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) 5,000 MED EXP (Any one person)$ A Y Y 6807C667570 02/15/201802/15/2019 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 BA8C25021518 02/15/201802/15/2019 BODILY INJURY (Per accident)$ AUTOS ONLYAUTOS HIRED NON-OWNED PROPERTY DAMAGE $ (Per accident) AUTOS ONLYAUTOS ONLY $ UMBRELLA LIAB OCCUR EACH OCCURRENCE$ EXCESS LIAB CLAIMS-MADE AGGREGATE$ 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 WCV6138556 01/28/201801/28/2019 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) CGD037 CGD186 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 PO Box 736 Salina KS67402-0736 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD COMMERC IALGENERAL LIABIL ITY THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. OTHER INSURANCE ADDITIONAL INSUREDS This endorsement mod if ies insurance prov ided under the following: COMMERC IALGENERAL LIABIL ITY COVERA GE PA RT PROVISI ONS b.The"personal injury"or"adv ertising injury"for which coverage is sought arises out of an of- COMMERC IAL GENERAL LIABILI TY CONDITI ONS fense com mit ted (Sect ion IV),Paragraph 4.(Other Insurance),is amended as follows:subsequent to the signing and execut ion of that contract or agreement by you. 1.The following is added to Paragraph a.Primary Insura nce:2.The first Subparagraph(2)of Paragraph b.Ex- cess Insurance regarding any other pri mary in- Howe ver,if you speci fica lly agree in a written co n- surance ava ilable to you is deleted. tract or written agree ment that the insurance pro- 3.The fol lowing is added to Paragraph b.Excess vi ded to an additi onal insured under this Insurance,as an additional subparagraph under Coverage Part must apply on a primary basis,or Subparagraph(1): a primary and non-contributory basis,this insur- ance is prima ry to other insurance that is av ail- That is avai lable to the insured when the insured able to such additional insured which covers such is added as an additional insured under any other additiona l insured as a named insured,and we policy,inclu ding any umbrel la or excess policy. will not share with that other insurance,provided that: a.The"bodily injury"or"property damage"for which coverage is sought occurs;and CG D0 37 04 05 Copyright 2005 The St.Pau l Trav elers Companies,Inc.All rights reserved.Page 1 of 1 COMMERC IALGENERAL LIABIL ITY THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT This endorsement mod if ies insurance prov ided under the following: COMMERC IALGENERAL LIABIL ITY COVERA GE PA RT GENERAL DESCRIP TI ON OF COVERAGE This endorsement broadens covera ge.The fol lowing listing is a general coverage description only.Li mitat ions and exclusions may apply to these coverages.Read all the PRO- VISIONS of this endorsement care ful ly to deter mine rig hts,duties,and what is and is not cove red. A.Broadened Named Insured I.Injury to Co-Emp loyees and Co-Volunteer Wo rkers B.Damage To Pre mises Rented To You Ex tension J.Aircraf t Chartered with Crew Per ils of fire,explosion,lightn ing,smoke,water K.Non-Owned Watercra ft Increased Lim it increased to$300,000 fro m 25 fee t to 50 feet C.Blanket Wa iv er of Subrog ation L.Increased Supplementary Pay ments D.Blanket Additional Insured Managers or Cost for ba il bonds increased to$2,500 Lessors of Pre mises Loss of earnings increased to$500 per day E.Blanket Additional Insured Lessor of Knowledge and Notice of Occurrence M. Leased Equipment or Of fense F.Incidenta l Medica l Malpract ice Unintent ional Om ission N. G.Personal Injury Assumed by Contract Reasonable Force Bodi ly Injury or O. H.Extension of Cov erage Bodi ly Injury Property Damage PROVI SIONS B.DAMAGE TO PREM ISES RENT ED TO YOU EXTENS ION A.BROADENED NAMED INSURED 1.The last paragraph of COVERAG E A.BOD- 1.The Named Insured in Item 1.of the Declara- ILY INJURY AND PROPER TY DAMAG E LI- tions is as follows: ABILITY(Sect ion I Coverages)is dele ted The person or organization named in Ite m 1. and replaced by the fol lowing: of the Declarat ions and any organization, Exclusions c.through n.do not apply to dam- other than a partnership or joint ven ture,ov er age to premises while rented to you,or tem- which you maintain ownership or majority in- porarily occupied by you with perm ission of terest on the ef fec ti ve date of the poli cy. the owner,caused by: Howe ver,cov erage for any such organization will cease as of the date during the pol icy pe- a.Fire; riod that you no longer maintain ownership of, b.Explosion; or major ity interest in,such organizat ion. c.Lightning; 2.WH O IS AN INSURED(Sec tion II)Item 4.a. is deleted and replaced by the fol lowing: d.Smoke result ing from such fire,explosion, or lightn ing;or a.Coverage under this provision is aff orded only until the 180th day after you acquire e.Wa ter. or form the organiza tion or the end of the A separate lim it of insurance applies to this policy period,whiche ver is earlier,unless coverage as described in LIMITS OF INSUR- reported in writing to us within 180 days. ANCE(Sect ion III). 3.This Pro vis ion A.does not apply to any per- 2.This insurance does not apply to damage to son or organization for which cov erage is ex- prem ises while rented to you,or temporari ly cluded by endorsement. CG D1 86 11 03 Copyright,The Trav elers Indemn ity Company,2003 Page 1 of 5 COMMERC IALGENERAL LIABIL ITY occupied by you with perm ission of the COVERAGE A.BODILY INJURY AND owner,caused by: PROPER TY DAMAGE LIABILI TY(Sect ion I Coverages)is excluded by endorsement. a.Rupture,bursting,or operat ion of pres- sure relief de vices; C.BLANKET WAIVER OF SUBRO GATION b.Rupture or bursting due to expansion or We waive any right of reco ver y we may have swelling of the contents of any building or against any person or organization because of structure,caused by or resulting from wa- payments we make for injury or damage arising ter; out of prem ises owned or occupied by or rented or loaned to you;ongoing operations performed c.Expl osion of stea m boilers,steam pipes, by you or on your behalf,done under a contract steam engines,or stea m turbines. with that person or organizat ion;"your work";or 3.Part 6.of LIMIT S OF INSURANCE(Sec tion "your products".We waive this right where you III)is deleted and replaced by the fol lowing: have agreed to do so as part of a written contract, Subject to 5.abo ve,the Damage To Pre m- executed by you prior to loss. ises Rented To You Lim it is the most we will D.BLANKET ADDIT IONAL INSURED MANAG- pay under COVERAGE A.for damages be- ERS OR LESSOR S OF PREM ISES cause of"property damage"to any one prem- WH O IS AN INSURED(Sec tion II)is amended to ises while rented to you,or temporar ily occu- include as an insured any person or organization pied by you with perm ission of the owner, (referred to below as"additiona l insured")with caused by fire,explosion,lightn ing,smoke whom you have agreed in a written contract,exe- resulting from such fire,exp losion,or ligh t- cuted prior to loss,to name as an additional in- ning,or water.The Damage To Pre mises sured,but only with respect to liabil ity arising out Rented To You Lim it will apply to al l damage of the ownership,maintenance or use of that part proxi mate ly caused by the same"occur- of any prem ises leased to you,subject to the fol- rence",whether such damage results from lowing prov isions: fire,exp losion,lightning,smoke resulting from such fire,exp losion,or lightn ing,or water,or 1.Lim its of Insurance.The lim its of insurance any combin ation of any of these. aff orded to the additional insured shall be the lim its which you agreed to prov ide,or the li m- The Damage To Prem ises Rented To You its shown on the Declarations,whiche ver is Lim it wil l be the higher of: less. a.$300,000;or 2.The insurance afforded to the additiona l in- b.The amount shown on the Declarations sured does not apply to: for Damage To Pre mises Rented To You a.Any"occurrence"that takes place after Lim it. you cease to be a tenant in that prem ises; 4.Under DEFINITI ONS(Sect ion V),Paragraph b.Any premises for which cov erage is ex- a.of the de finit ion of"insured contract"is cluded by endorsement;or amended so that it does not include that por- tion of the contrac t for a lease of prem ises c.Structura l altera tions,new construction or that indemn if ies any person or organization demo lition operations perfor med by or on for damage to prem ises while rented to you, behalf of such add itional insured. or temporar ily occupied by you with perm is- 3.The insurance afforded to the additiona l in- sion of the owner,caused by: sured is excess over any va lid and collect ible a.Fire; insurance ava ilab le to such additional in- sured,unless you have agreed in a written b.Explosion; contract for this insurance to apply on a pri- c.Lightning; mary or cont ributory basis. d.Smoke result ing from such fire,explosion, E.BLANKET ADDITIONAL INSURED LESSOR or lightn ing;or OF LEASED EQUIP MENT e.Wa ter. WH O IS AN INSURED(Sec tion II)is amended to 5.This Pro vis ion B.does not apply if cov erage include as an insured any person or organization for Damage To Pre mises Rented To You of (referred to below as"additiona l insured")with Page 2 of 5 Copyright,The Trav elers Indemn ity Company,2003 CG D1 86 11 03 COMMERC IALGENERAL LIABIL ITY whom you have agreed in a written contract,exe-for which no remuneration is demanded or recei ved. cuted prior to loss,to name as an additional in- sured,but only with respect to their liabil ity arising 3.Paragraph 2.a.(1)(d)of WH O IS AN IN- out of the ma intenance,operat ion or use by you SURED(Section II)does not apply to any of equip men t leased to you by such additiona l in- registered nurse,licensed practical nurse, sured,subject to the fol lowing prov isions: emergency med ical technic ian or para medic 1.Lim its of Insurance.The lim its of insurance emp loyed by you,but only while perfor ming aff orded to the additional insured shall be the the serv ices described in paragraph 2.above lim its which you agreed to prov ide,or the li m-and while act ing withi n the scope of their em- its shown on the Declarations,whiche ver is ployment by you.Any"emp loyees"rendering less. "Good Samar itan serv ices"will be deemed to be acting within the scope of their emp loy- 2.The insurance afforded to the additiona l in- ment by you. sured does not apply to: 4.The following exclusion is added to paragraph a.Any"occurrence"that takes place after 2.Exclusions of COVERAGE A.BODILY the equip ment lease exp ires;or INJURY AND PROPERT Y DAMAGE LIABIL- b."Bodily injury"or"propert y damage"aris- ITY(Se ction I Cov erages): ing out of the sole negligence of such ad- (This insurance does not apply to:)Liabil ity ditional insured. arising out of the willf ul vi olat ion of a penal 3.The insurance afforded to the additiona l in- statute or ordinance relating to the sale of sured is excess over any va lid and collect ible pharmaceut icals by or with the knowledge or insurance ava ilable to such additional in- consent of the insured. sured,unless you have agreed in a written 5.For the purposes of deter mining the applic a- contract for this insurance to apply on a pri- ble li mits of insurance,any act or omission, mary or cont ributory basis. together with all related acts or omissions in F.INCIDENTAL MEDICAL MALPRACT ICE the furnis hing of the ser vices described in 1.The de finit ion of"bodily injury"in DEFIN I-paragraph 2.above to any one person,will be considered one"occurrence". TIONS(Sect ion V)is amended to include"In- cidental Medical Malpract ice Injury". 6.This Pro vision F.does not apply if you are in 2.The following de fini tion is added to DEFIN I-the business or occupation of prov iding any of TIONS(Sec tion V):the ser vices described in paragraph 2.abo ve. "Incidenta l med ical malprac tice injury"means 7.The insurance provided by this Pro vision F. bodily injury,menta l anguish,sickness or dis-shall be excess over any other va lid and col- ease sustained by a person,including death lectible insurance ava ilable to the insured, resulting from any of these at any time,aris-whether primary,excess,contingent or on ing out of the rendering of,or fai lure to ren-any other basis,except for insurance pur- der,the fol lowing ser vices: chased specif ical ly by you to be excess of this policy. a.Medical,surgical,denta l,laboratory,x-ray or nursing serv ice or treat ment,adv ice or G.PERSONAL INJURY ASSUMED BY CON- TRACT instruction,or the related furnishing of food or be ve rages; 1.The Contractua l Liabi lity Exc lusion in Part b.The furnishing or dispensing of drugs or 2.,Excl usi ons of COVERA GE B.PER- med ical,denta l,or surgical supplies or SONAL AND ADVERTI SING INJURY LIABIL- appliances;or ITY(Sect ion I Cov erages)is deleted and replaced by the following: c.First aid. (This insurance doe s not apply to:) d."Good Samar itan ser vices".As used in Contractua l Liab ility this Pro vision F.,"Good Samar itan ser- vi ces"are those medica l ser vices ren- "Adver tising injury"for which the insured has dered or provided in an emergency and assumed liabil ity in a contract or agree ment. This exc lusion does not apply to liabil ity for CG D1 86 11 03 Copyright,The Trav elers Indemn ity Company,2003 Page 3 of 5 COMMERC IALGENERAL LIABIL ITY damages that the insured would have in the 3.Subparagraphs 2.a.(1)(a),(b)and(c)and absence of the contrac t of agree ment. 3.a.of WHO IS AN INSURED(Sec tion II)do not apply to"bodil y injury"for which insurance 2.Subparagraph f.of the de fini tion of"insured is prov ided by paragraph 1.or 2.abo ve. contract"(DEFIN ITIONS Sec tion V)is de- leted and replaced by the following:J.AIRCRAFT CHARTERED WI TH CREW f.That part of any other contrac t or agree-1.The following is added to the except ions con- ment perta ining to your business(includ-tained in the Aircraft,Auto Or Watercraft ing an indemni fi cat ion of a munic ipali ty in Exclusion in Part 2.,Excl usio ns of COVER- connection with work perfor med for a AGE A.BODILY INJURY AND PROPER TY DAMAGE LIABILI TY(Sect ion I Cov erages): munic ipality)under which you assume the tort liab il ity of another party to pay for (This exc lusion does not apply to:)Aircra ft "bodily injury,""propert y damage"or"per- chartered with crew to any insured. sonal injury"to a third party or organiza- 2.This Pro vision J.does not apply if the char- tion.Tort liabi lity means a liabi lity that tered aircra ft is owned by any insured. would be imposed by law in the absence of any contrac t or agreement. 3.The insurance prov ided by this Pro vision J. shall be excess over any other va lid and col- 3.This Pro vis ion G.does not apply if COVE R- lectible insurance ava ilable to the insured, AGE B.PERSONAL AND ADVERTI SING IN- whether primary,excess,contingent or on JURY LIABILITY is exc luded by endorse- any other basis,except for insurance pur- ment. chased specif ical ly by you to be excess of H.EXTENS ION OF COVERAGE BODILY IN- this policy. JURY K.NON-OWNED WATERCRAFT The de finit ion of"bodily injury"(DEFINI TIONS 1.The except ion contained in Subparagraph(2) Section V)is deleted and replaced by the follo w- of the Aircraft,Auto Or Watercraft Excl u- ing: sion in Part 2.,Exclusions of COVERAGE A. "Bodily injury"means bodily injury,menta l an- BODILY INJURY AND PR OPERT Y DAMAGE guish,menta l injury,shock,fright,disabi lity,hu- LIABILITY(Sect ion I Cov erages)is deleted mi liat ion,sickness or disease sustained by a per- and replaced by the fol lowing: son,including death resulting from any of these at (2)A watercraf t you do not own that is: any tim e. (a)Fif ty feet long or less;and I.INJURY TO CO-EMPLO YEES AND CO- VOLUNT EER WORKERS (b)Not being used to carry persons or property for a charge; 1.Your"emp loyees"are insureds with respect to"bodily injury"to a co-"employee"in the 2.This Pro vision K.applies to any person who, course of the co-"employee's"emplo ym ent by with your expressed or impl ied consent,either you,or to your"volun teer workers"while per-uses or is responsible for the use of a water- craft. form ing duties related to the conduct of your business,prov ided that this coverage for your 3.The insurance prov ided by this Pro vision K. "emp loyees"does not apply to acts outside shall be excess over any other va lid and col- the scope of their emp loyment by you or while lectible insurance ava ilable to the insured, perfor ming duties unrelated to the conduct of whether primary,excess,contingent or on your business. any other basis,except for insurance pur- 2.Your"volunteer workers"are insureds with chased specif ical ly by you to be excess of this policy. respect to"bodily injury"to a co-"volunteer worker"while perfor ming duties related to the L.INCREASED SUPPLE MENTARY PAYMENTS conduct of your business,or to your"emp loy- Parts b.and d.of SUPPLEMEN TARY PAY- ees"in the course of the"emp loyee's"em- MENTS COVE RAGES A AND B(Sect ion I ployment by you,prov ided that this coverage Cove rages)are amended as follows: for your"vo lunteer workers"does not apply while perfor ming duties unrelated to the con-1.In Part b.the amount we will pay for the cost duct of your business.of bail bonds is increased to$2500. Page 4 of 5 Copyright,The Trav elers Indemn ity Company,2003 CG D1 86 11 03 COMMERC IALGENERAL LIABIL ITY 2.In Part d.the amount we will pay for loss of which you are required to notify us in writing earnings is increased to$500 a day. of the abrupt com mence ment of a discharge, release or escape of"pollut ants"which M.KNOWLEDG E AND NOTI CE OF OCCUR- causes"bodily injury"or"property damage" RENCE OR OFFEN SE which may otherwise be covered under this 1.The fol lowing is added to COMMERCIAL policy. GENERAL LIABILI TY CONDITI ONS(Sec tion N.UNINTEN TIONAL OMISSI ON IV),paragraph 2.(Duties In The Ev ent of Oc- currence,Of fense,Clai m or Su it): The fol lowing is added to COMMERCIAL GEN- ERAL LIABILITY CONDITI ONS(Sect ion IV), Notice of an"occurrence"or of an of fense paragraph 6.(Representations): which may result in a clai m under this insur- ance shall be given as so on as practicable af-The unintentiona l omission of,or unintent ional ter knowledge of the"occurrence"or of fense error in,any infor mat ion prov ided by you shall not has been reported to any insured listed under prejudice your rights under this insurance.How- Paragraph 1.of Sect ion II Who Is An In-ever,this Pro vision N.does not affec t our right to sured or an"employee"(such as an insur-collec t additiona l prem ium or to exerc ise our right ance,loss control or risk manager or admin is-of cancel lation or nonrenewal in accordance with trator)designated by you to gi ve such notice. applicab le state insurance laws,codes or regula- tions. Knowledge by other"employee(s)"of an"oc- currence"or of an of fense does not imply that O.REASONABLE FORCE BODILY INJURY OR you also have such knowledge.PROPER TY DAMAGE 2.Notice shal l be dee med prompt if given in The Expected Or Inte nde d Injury Ex clusion in good faith as soon as practicable to your Part 2.,Excl usi ons of COVERA GE A.BODILY workers‹compensation insurer.This applies INJURY AND PROPERT Y DAMAGE LIABILITY only if you subsequently give notice to us as(Sect ion I Cov erages)is deleted and replaced by the fol lowing: soon as practicable after any insured listed under Paragraph 1.of Sect ion II Who Is An (This insurance does not apply to:) Insured or an"employee"(such as an insur- Expected or Inten ded Inj ury or Damage ance,loss control or risk manager or admin is- trator)designated by you to give such notice"Bodily injury"or"property damage"expected or disco vers that the"occurrence",of fense or intended from the standpoint of the insured.This claim ma y inv olv e this policy. exc lusion does not apply to"bodil y injury"or "property damage"result ing from the use of rea- 3.Howe ver,this Pro vision M.does not apply as sonable force to protec t persons or property. respects the specif ic number of days within CG D1 86 11 03 Copyright,The Trav elers Indemn ity Company,2003 Page 5 of 5