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Insurance Certificate ___..-, YOUNMEN-01 AJANSEN ,acofzo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/°DYYYY) 1/4......_-- 12/21/2020 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 NAMEACT Andrea Finlay Fee Insurance Group,Inc. 2920 N. Plum St ((ENC, o,Ext):(620)2594812 (Nc,No):(620)662-5415 Hutchinson, KS 67502 ADMDRESs:certs@feeinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:WESTBEND MUTUAL INSURANCE COMPANY 15350 INSURED INSURER B:SFM Mutual Insurance Company 11347 Young Men's Christian Association of Salina, Kansas INSURERc: 570 YMCA Drive INSURER D: Salina,KS 67401 INSURER E: INSURER F: 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. INSR TYPE OF INSURANCE IADDLiWUBR( POLICY NUMBER /YPOLICY EFF POLICY EXP LIMITS LTR INSR' VD (MM/DD/YYYY1 (MM/DDYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 i CLAIMS-MADE X OCCUR 2161433 05 12/27/2020 12/27/2021 oAMAGETOR NTED 300,000 PREMISES(Ea occurrence) S MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- 2,000,000 POLICY JECT LOC PRODUCTS-COMP/OP AGG S OTHER: $ A AUTOMOBILE LIABILITY Ea accident)SINGLE LIMIT $ 1,000,000 — ANY AUTO 2161433 05 12/27/2020 12/27/2021 BODILY INJURY(Per person) $ OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOSIRE� ONLY AUpTNOpSyy p BO X AUTOS ONLY X OMB (Perr acEclRdent)AMAGE $ ( S A X UMBRELLA LIAB I X OCCUR EACH OCCURRENCE S 4,000,000 EXCESS LIAB CLAIMS-MADE 2161433 05 12/27/2020 12/27/2021 AGGREGATE $ 4,000,000 DED RETENTIONS $ B WORKERS COMPENSATION X PERTUTE ETH AND EMPLOYERS'LIABILITY 132196.201 12/27/2020 12/27/2021 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACC DENT S OFFICER/MEMBER EXCLUDED? N/A 500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S If yes,describe under 500,000 'DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 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 St. Salina,KS 67401 AUTHORIZED REPRESENTATIVE dAtitiba— ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD /—.11 YOUNMEN-01 AFINLAY ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMY) %..------ 12N 21120192019 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 POUCIES 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 I NAMEpCT Andrea Finlay Fee Insurance Group,Inc. �PHDNE FAx P.O.Box 976 (ac,No Eat)_(620)259-8812 (ac,Ne):(620)662-5415 1 N.Main,SuiteEeaL and rea m eeinsurance.co700 A DDREss: Hutchinson,KS 67501 INSURER(5)AFFORDING COVERAGE NAICe INSURER A:WESTBEND MUTUAL INSURANCE COMPANY 15350 INSURED I INSURER B:Accident Fund General Insurance Company 12304 Young Men's Christian Association of Salina,Kansas INSURER C: 570 YMCA Drive I INSURER D: Salina,KS 67401 INSURER E: INSURER F: 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. jI TRI TYPE OF INSURANCE 1'u9So 15 D I POUCY NUMBER I l M DDYIYYYY)EFF I(MMDD!YYYYI LICY EXP I LIMITS A X I COMMERCIAL GENERAL LIABIIJTY EACH OCCURRENCE S 1,000,000 lMI I CLAIMSDE I X I OCCUR 112161433 04 12/27/2019 12/27/2020 DAMAGE TO RENTED 300,000 • PREMISES(Ea ommenw) S I [MED EXP(Any one person) 5 I I PERSONAL 8 ADV INJURY 5 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 2,000,000 POLICY JECT u LOC PRODUCTS-COMP/OPAGG S 2,000,000 IOTHER: I 5 A AUTOMOBILE IIABIDTY COMBINED SINGLE LIMIT 1,000,000 (EB ardent) 5 ANY AUTO 216143304 12/27/2019 12/27/2020 BODILY INJURY(Per person) 5 OWNED SCHEDULED AUTOSE� ONLY X AUTOSy� BODILY INJURY(Per accident) S PROPMAGE X I AUTOS ONLY X'AUTOONLY (Per aEcc,der8)RTY A 5 5 A I X 1 UMBRELLA LJAB I I OCCUR EACH OCCURRENCE S 4,000,000 I EXCESS LIAB I I CLAIMS-MADE '2161433 04 12/27/2019 12/27/2020 AGGREGATE 5 I I DED I I RETENTION 5 I 5 4,000,000 B IWORKERS COMPENSATION I I X I STATUTE I ER AND EMPLOYERS LIABILITY Y I NI ANY PROPRIETOR'PARTNERIEXECUi1VE^ '. _--JWQV.61073D1___ ___ _112/27/2019112/27/2020 T E.L EACH ACCIDENT_- _1.5. 500,000 _ OFFInCE JMEin NH MBE;EXCLUDED? 1_1 NIA NaI I I E.L.DISEASE-EA EMPLOYEE 5 500,000 II yes.desote Over I E.L.DISEASE-POLICY LIMIT I S 500'000 DESCRIPTION OF OPERATIONS below Oe DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Addidonal Remarks Schedule,may be attached N more space is required( CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Salina(Kenwood Cove) THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 300 W.Ash St. Salina,KS 67401 AUTHORIZED REPRESENTATIVE araIktaa D ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD