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Insurance Certificate
TE ACORLJ CERTIFICATE OF LIABILITY INSURANCE DA 6/11/2019 MMJoDr1 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 NAME: Jenny Saylor Associated Benefits and Risk Consulting INC,6000 Clearwater Drive .EMI: 952-947-9700 1 (Pn1AXc,Na):952-947-9793 Minnetonka MN 55343 ADo ESS: jenny.saylor@associatedbrc.com INSURER(S)AFFORDING COVERAGE NAIC a INSURER A: Federal Insurance Company/Chubb 20281 INSURED IMAGE13 INSURER B: Hartford Fire Insurance Company 19682 ImageTrend, Inc. 208 208555 Kensington Blvd. INSURER C: Hartford Casualty Insurance Company 29424 Lakeville MN 55044 INSURER D:Trumbull Insurance Company 27120 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:346426491 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. ICY EXP LTR I TYPE OF INSURANCE I NW lSjyyp l POLICY NUMBER I(MWLDDYEFF/YYYY)I(MMMIUDDIYYYY)I UMrrS B I X I COMMERCIAL GENERAL LIABILITY Y Y 4IUUNZT8493 6/15/2019 6/15/2020 I EACH OCCURRENCEDRGE O NTED , $1,000,000 I CLAIMS-MADE I X I OCCUR PREMISES(EaEoccurrence) 51,000,000 MED EXP(My one person) 5 15.000 PERSONAL&ADV INJURY 5 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 52.000,000 I POLICY FX1 JET I I LOC I PRODUCTS-COMP/OP AGG 52,000,000 InOTHER: I S D I AUTOMOBILE LIABILITY Y Y 41UUNZTB493 6/15/2019 6/15/2020 I�OMBa INNEED SINGLE LIMIT I S 1,000,000 I X I ANY AUTO BODILY INJURY(Per person) 15 I I rawly 09 ONLY II ASCHHEEDDULED BODILY INJURY(Per eWdmt)I S XNLY I X I AAUTOAUTOSONLEDY I(Per PROPERTYDAMAGEI S I AUTOS Oin I IS C IX UMBRELLA LAB I X I rrrUR I Y Y 41XHUZT339 6/15/2019 6/15/2020 I EACHOCCURRENCE 155,000,000 EXCESS LAB I I CLAIMS-MADE AGGREGATE 155,000,000 I I DED I X I RETENTION 50 I I s C WORKERS COMPENSATIONI Y 41WEAB6LMI 6/15/2019 6/152020 IX I STATUTE I I ERMTh I AND EMPLOYERS'LIABILITY Y 1 N ANYPROPRIETOR/PARTNER/EXECUTIVE I E.L.EACH ACCIDENT I S 500,000 OFFICER/A/EMBEREXCLUDED? n N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE(5500,000 II yes.DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT I S 500,000 B Technology PmUCyber Uabaty Y 41TE0330029 18 6/15/2019 6/152020 OWAggregate Lund 55,000,000 A 3rd Party rbne/Fldeity 82477411 6/15/2019 6/15/2020 Limn 5500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Network Security and Privacy Injury Liability are included in the Technology Errors 8 Omissions/Professional Liability. GENERAL LIABILITY-Blanket Additional Insured,Primary/Non-Contributory and Waiver of Subrogation(Endorsement#HG00010916);COMMERICAL AUTO-Blanket Additional Insured, Primary-Non-Contributory,Waiver of Subrogation(Endorsement#HA99160312);WORKERS COMPENSATION Blanket Waiver of Subrogation(Endorsement #000313)as required by written agreement or 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. City of Salina 300 Ash AUTHORIZED REPRESENTATIVE Salina KS 67401 I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD acoRO® CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD(YYYY) `.----. 6/13/2018 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 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 NAmE: Associated Benefits and Risk Consulting PHONE Jenny Saylor FAX 6000 Clearwater Drive IANC No.Ex*952-947-9700 (A/C.No):952-947-9793 Minnetonka MN 55343 ADDRESS: jenny.saylor4Qassodatedbrc.com INSURER(S)AFFORDING COVERAGE NAIC 0 INSURER A:Federal Insurance Company/Chubb 20281 INSURED IMAGEIS INSURER B:Hartford Fire Insurance Company 19682 ImageTrend, Inc. 20855 Kensington Blvd. INSURER C:Hartford Casualty Insurance Company 29424 Lakeville MN 55044 INSURER D: INSURER E: INSURER F: I COVERAGES CERTIFICATE NUMBER:410684455 REVISION NUMBER: —THIS IG TOCERTIFYTHAT THEPOLICIES'OF INSURANCE LISTED.BELOW HAVEBEEN 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. ICTR I TYPE OF INSURANCE INSD ISWVD I POLICY NUMBER I(MM/DDIYY YYY)I(MMM/DD�)I LIMITS B X COMMERCIAL GENERAL LIABILITY Y Y 41WNZT8493 6/15/2018 6/152019 'EACH OCCURRENCE 51.000.1100 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $1,000.000 MED EXP(My one person) 515.000 PERSONAL 8 ADV INJURY 51,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2.000,000 X POLICY JIPE� I I LOC PRODUCTS-COMP/OP AGG $].000,000 OTHER $ B AUTOMOBILE LIABILITY AUTOMOBILE Y 41WNZTB4B5 6/15(2018 6/152019 COMBINED SINGLE LIAR $ (Ea accident) 1000.000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ PAUTOS AUTOS HIRED AUTOS x AUTOS NON-OWNED (Pereraaccident) tDAMAGE 5 5 C X UMBRELLA LIAB X OCCUR Y Y 41XHUZT3T9 6/152018 6/152019 EACH OCCURRENCE S 5000.003 EXCESS LIAR CLAIMS-MADE AGGREGATE $5,000.000 DED I X I RETENTION$0 $ C WORKERS COMPENSATION Y 41VrEABSLMI 6/1512018 6/152019 X I STATUTE I I ETµ AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVEE.L EACH ACCIDENT 5000 OFFICER/MEMBER EXCLUDED? n500 NIA (Mandatary In NH) E.L.DISEASE-EA EMPLOYEE $500,003 If yes.describe weer DESCRIPTION OF OPERATIONS below i E.L DISEASE-POLICY UNIT $500.000 -- -e e Tvpbgy Prof�tertIMBN- -- Y 41TE033002918 6/152018 6/152019 OCa/A9¢i 1 Lid 55.000.000 - — -- A 3rd PCMy raneFIdedty 82477411 6/1512018 81152019 Ind $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Network Security and Privacy Injury Liability are included in the Technology Errors&Omissions/Professional Liability. GENERAL LIABILITY-Blanket Additional Insured,Primary/Non-Contributory and Waiver of Subrogation(Endorsement#HC00010916);COMMERICAL AUTO-Blanket Additional Insured, Primary-Non-Contributory,Waiver of Subrogation(Endorsement#HA99160212);WORKERS COMPENSATION Blanket Waiver of Subrogation(Endorsement #000313)as required by written agreement or 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. City of Salina 300 Ash AUTHORIZED REPRESENTATIVE Salina KS 67401 /Cal a ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD