The URL can be used to link to this page

Insurance Certificate -----1 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ‘....------- 5/1/2021 5/1/2020 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). PRODUCER Lockton Companies CONTACT NAME: 444 W.47th Street,Suite 900 PHONE ONr o,Ext): FAX N c,No): Kansas City MO 64112-1906 E-MAIL (816)960-9000 ADDRESS: INSURER/SI AFFORDING COVERAGE NAIC# INSURER A: Fireman's Fund Insurance Company 21873 INSURED LIGHTHOUSE PROPERTIES III,INC. INSURER B: 1352734 PO BOX 856 SALINA KS 67401 INSURER C INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 15291354 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 (MM/DD/YYYY)(MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y N USC015769200 5/1/2020 5/1/2021 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE n OCCUR DAMAGE TO RENTED I ' PREMISES(Ea occurrence) $ 100,000 X 1,IO1 JOR LIABILITY MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 3 POLICY1-7 PECOT n LOC OTHER: PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ XXXXXXX — ANY AUTO NOT APPLICABLE BODILY INJURY(Per person) $ XXXXXXX AUTOS ONLY SCHEDULED BODILY INJURY(Per accident $ XXXXXXX _ AUTOS ONLY NON-OWNEDUUTPROPERTY DAMAGE $ XXXXXXX (Per accident) $ UMBRELLA LIAB _OCCUR EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS-MADE NOT APPLICABLE AGGREGATE _$ XXXXXXX_ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/NNOT APPLICABLE STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE I�I N/A E.L.EACH ACCIDENT $ XXXXXXX OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ XXXXXXX DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ XXXXXXX DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CITY OF SALINA,KANSAS IS NAMED AS ADDITIONAL INSURED ON GENERAL LIABILITY,AS PER WRITTEN CONTRACT. 30 DAYS NOTICE OF CANCELLATION APPLIES, 10 DAYS FOR NON-PAYMENT OF PREMIUM. 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. 15291354 AUTHORIZED REPRESENTATIVE CITY OF SALINA,KANSAS CITY-COUNTY BUILDING 300 W.ASH STREET SALINA KS 67401 ( ACORD 25(2016/03) ©1968-2015 ACORD CORPORATION.All rights reserved The ACORD name and logo are registered marks of ACORD .---1 AcORD• CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) L.------ 5/1/2020 4/30/2019 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). PRODUCERCONTACT LoCompanies NAME: 444 W.47th Street,Suite 900 (AVC,No,Ext): I r .No): Kansas City MO 64112-1906 E-MAIL (816)960-9000 ADDRESS: INSURERISI AFFORDING COVERAGE NAIC e INSURER A: Fireman's Fund Insurance Company 21873 INSURED LIGHTHOUSE PROPERTIES III,INC. INSURER a: 135)734 PO BOX 856 INSURER C: SALINA KS 67401 — -- INSURER D: __ INSURER E: INSURER F' • COVERAGES CERTIFICATE NUMBER: 15291354 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. INSLTR TYPE OF INSURANCE ADDL $ABR POLICY NUMBER MM/DOFF POLICY EXP LIMITS LTR INSO RJB J POUCY YYYYYI IMOLIC/YEXPt A x COMMERCIAL GENERAL LIABILITY y N MLXX80996680 5/1/2019 5/1/2020 EACH OCCURRENCE g 1.000.000 CLAIMS-MADE n OCCUR PREMISES//EaEoMmmOence), $ 100.000 X 1 ROI IOR I IARIl pi l MED EXP(Any one person) $ 5.000 PERSONAL 8 ADV INJURY $ 1.000.000 GENT AGGREGATE LIMIT APPLIES PER: • GENERAL AGGREGATE $ 2.000.000 POLICYn Ta n LOC PRODUCTS-COMP/OP AGO $ 2.000.000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT NOT APPLICABLE $ (Ea $ XXXXX}:X ANY AUTO BODILY INJURY(Per person) $ aXXXX OWNED SCHEDULED BODILY INJURY(Per accident $ XXXXXX){ _ AUTOS ONLY AUTOS HIRAUTOS ONLY _D AUTOS ONLYY PROPERTY aEdentl DAMAGE $ XXX XXXX• $ UMBRELLA UABOCCUR EACH OCCURRENCE $ XXXXXXX_ EXCESS LIAB CLAIMS-MADE NOT APPLICABLE AGGREGATE $ XXXXXXX _ DED RETENTION S $ WORKERS COMPENSATION I STATUTE PER ER AND EMPLOYERS LIABILITY Y/N NOT APPLICABLE �'Vv VVVvVv�`lJV�/ ANY PROPRIETq$RARTNEFIE%ECUTIVE ❑ NIA EL EACH ACCIDENT $ OFEICERMEMBER EXCLUDED? (Mandatory in NH) E DISEASE-EA EMPLOYEE $ XXXXXXX __ - .tl Rs.CesmEe utler _ XXXXXXX �___ DESCRIPTION OF OPERATIONS beim. EL DISEASE-POLKY LIMIT -$ XXXXXXX DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule.may be attached if more space is required) CITY OF SALINA.KANSAS IS NAMED AS ADDITIONAL INSURED ON GENERAL LIABILITY,AS PER WRITTEN CONTRACT. 30 DAYS NOTICE OF CANCELLATION APPLIES, 10 DAYS FOR NON-PAYMENT OF PREMIUM. 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. 15291354 AUTHORIZED REPRESENTATIVE CITY OF SALINA,KANSAS CITY-COUNTY BUILDING 300 W.ASH STREET SALINA KS 67401 i an m . ACORD 25(2016103) ©1 8-2015 ACORD CORPORATION.All rights reserved The ACORD name and logo are registered marks of ACORD