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Insurance Certificate AR® CERTIFICATE OF LIABILITY INSURANCE DATE EM( DD 19 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 Susan Flaming Assurance Partners PHONEFAX Ieut,No,Eel) (800)563-1871 (AIC,No): (785)825-5098 201 E Iron Avenue c-MAIL sflaming@yourassurance.com ADDRESS: g©yo P.O.Box 1213 INSURERIS)AFFORDING COVERAGE NAIL a Salina KS 67402-1213INSURER A: Acadia Insurance Company 31325 INSURED INSURER B: Kansas Builders'Insurance Group 0010 Ponton Construction,Inc. INSURER C: 1325 Armory Rd INSURER D: INSURER E: Salina KS 67401-4067 INSURERF: COVERAGES CERTIFICATE NUMBER: 1920 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 ADDL UBR POLICY EFF POUCY EXP LTR TYPE OF INSURANCE /NSD WVD POUCY NUMBER (MWDDIYYYYI (MMIDDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 1.000,000 DAMAGc 10 RtniTED CLAWS-MADE X OCCUR PREMISES(Ea occurrence) $ 300,0000 MEDEXP(Any me person) $ 10.000 A Y Y CPA3214122 02/01/2019 02/01/2020 PERSONAL INJURY 5 1.000.000 _ 2,0 GEN,AGGREGATE LIMIT APPLIES/PER: GENERAL AGGREGATE $ 00,000 POLICY n;r — efI IES1 LOC PRODUCTS-COMP/OP AGO S 2.000.000 OTHER: S • AUTOMOBILE LIABILITY m COMBINED SINGLE LIMIT s 1.000.000 (Ea sdeml — X ANY AUTO BODILY mum((Per peson) S A OWNED ' SCHEDULED Y Y CPA3214122 02/01/2019 02/01/2020 BODILY INJURY(Per accident) 5 AUTOS ONLY AUTOS — X HIRED X NON-OWNED PROPERTY DAMAGE S — AUTOS ONLY _ AUTOS ONLY (Per accident) S X UMBRELLA UAB X OCCUR EACH OCCURRENCE S 1.000.000 A EXCESS LIAR CLAIMS-MADE CPA3214122 02/01/2019 02/01/2020 AGGREGATE 5 1,000.000 DED X RETENTIONS 0i 1 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY X STATUTE ER YIN B ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S 1.000'000 OFFICER/MEMBER EXCLUDED? n NIA 20190008 01/01/2019 01/012020 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE 5 1.000.000 It yes,describe under DESCRIPTION OF OPERATIONS below EL.DISFACF-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CLC00059,CW3468 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. Neighborhood Services,Rm 105B 300 W Ash AUTHORIZED REPRESENTATIVE Salina KS 67401 ® _i1mnn . ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD