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Insurance Certificate
ACO® DATE(MM/DDmYY) �, CERTIFICATE OF LIABILITY INSURANCE 10/14/2020 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(les)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 MCGRIFF,SEIBELS&WILLIAMS,INC. PHON: P.O.Box 10265 (AH/C No.Ext): 600 476-2211 FAX CC,No): Birmingham,AL 35202 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC a INSURER A:Assoc.Elec.&Gas Ins.Serv.Ltd.(AEGIS)AA-3190004 INSURED INSURER B:Self-Insured Evergy Inc.including Westar Energy,Inc. 1200 Main St. INSURER C: Kansas City,MO 64105-2122 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:JB99QBUC 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 LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS B X COMMERCIAL GENERAL LIABILITY SELF-INSURED UP TO$3M 10/19/2020 10/19/2021 EACH OCCURRENCE $ 3,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED included PREMISES(Ea occurrence) $ _ MED EXP(Any one person)_ $ included — PERSONAL&ADV INJURY $ included — GENAL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ included POLICY n I PRO- I LOC PRODUCTS-COMP/OP AGG $ included JECT OTHER: $ B AUTOMOBILE LIABILITY SELF-INSURED UP TO$3M 10/19/2020 10/19/2021 COMBINED SINGLE LIMIT _ (Ea accident) $ 3,000,000 X ANY AUTO BODILY INJURY(Per person) $ n/a — OWNED —SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS n/a HIRED NON-OWNED PROPERTY DAMAGE _ AUTOS ONLY _ AUTOS ONLY (Per accident) $ n/a $ A UMBRELLA UAB _ OCCUR XL5761503P 10/19/2020 10/19/2021 EACH OCCURRENCE $ _ 5,000,000 X EXCESS UAB X CLAIMS-MADE AGGREGATE $ 5,000,000 DED X RETENTION$3,000,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.I-.DISEASE-EA EMPLOYEE $ If yes,describe under I , tJ I I ----- -- ' SCHIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ . $ $ $ $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached H 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 ACCORDANCE WITH THE POLICY PROVISIONS. CITY OF SALINA ATTN: JUDY LONG AUTHORIZED REPRESENTATIVE P.O.BOX 736 �1 SALINA,KS 67402-0736 Page 1 of 1 ®1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AC ® DATE(MM/DD/YYYY) ACCO CERTIFICATE OF LIABILITY INSURANCE 10/14/2020 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(les)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 MCGRIFF,SEIBELS&WILLIAMS,INC. HOPHON: P.O.Box 10265 (A/C ,No.Ext): 800 476-2211 FAX No): Birmingham,AL 35202 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC I INSURER A:Assoc.Elec.&Gas Ins.Serv.Ltd.(AEGIS)AA-3190004 INSURED INSURER B:Self-Insured Evergy Inc.including Westar Energy,Inc. 1200 Main St. INSURER C: Kansas City,MO 64105-2122 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:ALxDTHMV 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 INSD ADDL SWVD POLICY NUMBER UBR POLICY EFF POLICY EXP LIMITS {MM/DD/YYYY) (MM/DD/YYYY) B X COMMERCIAL GENERAL LIABILITY SELF-INSURED UP TO$3M 10/19/2020 10/19/2021 EACH OCCURRENCE $ 3,000,000 CLAIMS-MADE n OCCUR DAMAGE TO RENTED included PREMISES(Ea occurrence) $ _ MED EXP(Any one person) $ included — PERSONAL&ADV INJURY $ included GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ included POLICY n PRO-T ❑LOC PRODUCTS-COMP/OP AGG $ included JEC OTHER: $ B AUTOMOBILE LIABILITY SELF-INSURED UP TO$3M 10/19/2020 10/19/2021 COMBINED SINGLE LIMIT _ (Ea accident) $ 3,000,000 X ANY AUTO BODILY INJURY(Per person) $ n/a — OWNED SCHEDULED BODILY INJURY(Per accident) $ n/a, AUTOS ONLY AUTOS HIRED — NON-OWNED PROPERTY DAMAGE _ AUTOS ONLY _ AUTOS ONLY (Per accident) $ n/a $ A UMBRELLA UAB OCCUR XL5761503P 10/19/2020 10/19/2021 EACH OCCURRENCE $ 5,000,000 X EXCESS UAB X CLAIMS-MADE X AGGREGATE $ 5,000,000 DED X RETENTION$3,000,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ It yes,describe under I I uESCRIP Duly OF OPERATIONS ueiow E.L.DISEASE-POLICY LIMIT 1 5 $ $ t $ $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more apace Is required) Certificate Holder is included as Additional Insured if required by written contract,subject to policy terms,conditions and exclusions. 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 ATTN: JUDY LONG AUTHORIZED REPRESENTATIVE P.O.BOX 736 / SALINA,KS 67402-0736 / Page 1 of 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ® DATE(MWDD/YYYY) ACCPREP CERTIFICATE OF LIABILITY INSURANCE 10/14/2020 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(les)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 MCGRIFF,SEIBELS&WILLIAMS,INC. NAME: P.O.Box 10265 (A/CNNo,Ext):800476-2211 FAX No): Birmingham,AL 35202 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Assoc.Elec.&Gas Ins.Serv.Ltd.(AEGIS)AA-3190004 INSURED INSURER B:Self-Insured Evergy Inc.including Westar Energy,Inc. 1200 Main St. INSURER C: Kansas City,MO 64105-2122 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:9xNZDKLG REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANGC-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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSDMI .WVD POLICY NUMBER (MDD/YYYY) (MM/DD/YYYY) B X COMMERCIAL GENERAL LIABILITY SELF-INSURED UP TO$3M 10/19/2020 10/19/2021 EACH OCCURRENCE $ 3,000,000 CLAIMS-MADE 1-1 OCCUR DAMAGERENTEDSOincluded PREMISES occurrence) $ MED EXP(Any one person) $ included PERSONAL&ADV INJURY $ included GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ included POLICY 0 PROT I ' I 'LOC PRODUCTS•COMP/OP AGG $ included JEC OTHER: $ B AUTOMOBILE LIABILITY SELF-INSURED UP TO$3M 10/19/2020 10/19/2021 COMBINED SINGLE LIMIT (Ea accident) $ 3,000,000 X ANY AUTO BODILY INJURY(Per person) $ n/a — OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS n/a — HIRED — NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) $ n/a $ A UMBRELLA LIAB XL5761503P 10/19/2020 10/19/2021 OCCUR EACH OCCURRENCE $ 5,000,000 _ X EXCESS UAB X CLAIMS-MADE AGGREGATE $ 5,000,000 DED X RETENTION$3,000,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ It yes.describe under DESCRIPTION OF OPERATIONS below ' E.L.DISEASE-POLICY LIMIT $ $ $ $ $ $ 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 ACCORDANCE WITH THE POLICY PROVISIONS. SALINA COUNTY ENGINEERS OFFICE CITY COUNTY OFFICE BUILDING P.O.BOX 736 AUTHORIZED REPRESENTATIVE ROOM 206 / SALINA,KS 67402 / i Page 1 of 1 ®1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AWRO® DATE(MM/DD/YYYY) �. CERTIFICATE OF LIABILITY INSURANCE 10/14/2020 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 CONTACT MCGRIFF,SEIBELS&WILLIAMS,INC. PHON: E P.O.Box 10265 (NCNNo.Ext):800 476-2211 FAX No): Birmingham,AL 35202 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Assoc.Elec.&Gas Ins.Serv.Ltd.(AEGIS)AA-3190004 INSURED INSURER B:Self-Insured Evergy Inc.including Westar Energy,Inc. 1200 Main St. INSURER C: Kansas City,MO 64105-2122 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:A92TVMFL 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 ADDL SUBR POLICY EFF POLICY EXP LTR IVSD-WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS B X COMMERCIAL GENERAL LIABILITY SELF-INSURED UP TO$3M 10/19/2020 10/19!2021 EACH OCCURRENCE $ 3,000,000 CLAIMS-MADE I I OCCUR DAMAGE TO RENTED included PREMISES(Ea occurrence) $ MED EXP(Any one person) $ included _ PERSONAL&ADV INJURY $ included GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ included POLICY 0 PRO IT LOC PRODUCTS-COMP/OP AGG $ included RJECT OTHER: $ B AUTOMOBILE LIABILITY SELF-INSURED UP TO$3M 10/19/2020 10/19/2021 COMBINED SINGLE LIMIT _ (Ea accident) $ 3,000,000 X ANY AUTO BODILY INJURY(Per person) $ n/a — OWNED —SCHEDULED BODILY INJURY(Per accident) $ n/a _ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE _ AUTOS ONLY _ AUTOS ONLY (Per accident) $ n/a $ A UMBRELLA UAB OCCUR XL5761503P 10/19/2020 10/19/2021 EACH OCCURRENCE $ 5,000,000 _ X EXCESS UAB X CLAIMS-MADE X AGGREGATE $ 5,000,000 DED X RETENTION$3,000,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ It yes.describe under I DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ $ $ $ $ $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Certificate Holder is included as Additional Insured if required by written contract,subject to policy terms,conditions and exclusions. 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. SALINA COUNTY ENGINEERS OFFICE CITY COUNTY OFFICE BUILDING P.O.BOX 736 AUTHORIZED REPRESENTATIVE 14.) ROOM 206 SALINA,KS 67402 Page 1 of 1 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD