Loading...
Insurance ACC) CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 10/14/2020 THIS RTIFICATE 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). CONTACT Julie Piazza CISR PRODUCER NAME: PHONE (330)335-2521 FAX (330)335-2529 Hummel Group, Inc. (A/C,No,Ext): (A/C,No): E-MAIL piazza@hummelgrp.com 148 Main Street ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# Wadsworth OH 44281 INSURER A:Arch Insurance Co. INSURED INSURER B:Technology Insurance Company 42376 Westmoreland Concessions, Inc. INSURERC: 231 FM 2791 INSURERD: INSURER E: Queen City TX 75572 INSURERF: I COVERAGES CERTIFICATE NUMBER:Master Liab. 2020-2021 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 SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSO WVD POLICY NUMBER (MMIDD/YYYY) {MMIDD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s 1,000,000 DAMAGE TO RENTED 1,000,000 A CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) S X Y s5CGi.1643300 11/21/2020 11/21/2021 MED EXP(Any one person) S Excluded PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE S 5,000,000 GEN'LAGGREGATE LIMIT APPLIES PER PRO- X POLICY PRO- LOC PRODUCTS-COMP/OPAGG S 5,000,000 JECTS OTHER. COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea accident) S 1,000,000 BODILY INJURY (Per person) S A X ANY AUTO _ ALL OWNED SCHEDULED X y SNAUT0076900 11/21/2020 11/21/2021 BODILY INJURY (Per accident) S AUTOS AUTOS NON-OWNED PROPERTY DAMAGE s (Per accident) HIRED AUTOS AUTOS Medical payments S 5,000 X UMBRELLALIAB OCCUR EACH OCCURRENCE S 2,000,000 A EXCESS LIAR CLAIMS-MADE AGGREGATE S 2,000,000 DED RETENTION 5 SNFX50080900 11/21/2020 11/21/2021 S PER OTH- WORKERS COMPENSATION STATUTE ER AND EMPLOYERS'LIABILITY Y)N E.L.EACH ACCIDENT S 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/AY Twc3912966 11/21/2020 11/21/2021 EL.DISEASE-EA EMPLOYEE 5 1,000,000 B (Mandatory in NH) If yes,describe under E.L.DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Insured sells Bratwurts & Corndogs. City of Salina, its agents, representatives, officers, official, and employees are additonal insured(s) in regards to General Liability and Auto Liability. Insurance for the additional insured shall extend to Products/ Completed Operations and be as broad as the insurance for the named insured, including defense expense coverage, and shall apply as primary and non-contributory insurance before any other insurance or self- insurance, including any deductible, maintained by, or provided to, the additional insuired(s) . Waiver of subrogation applies to City of Salina, its agents, representatives, officers, officials, and 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. P.O. Box 736 Salina, KS 67402 AUTHORIZED REPRESENTATIVE P Teague Jr. CIC CRM/ ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 2014011