1989 Fireworks Permit
PER M I T
"SUPERVISED PUBLIC DISPLAY OF FIREWORKS"
DATE: June 6, 1989
NAME OF PERMITTEE John Ziegler / Salina Jaycees
LOCATION OF DISPLAY East of Municipal Golf Course
DATE OF DISPLAY
July 4, 1989
Subject to compliance with City of Salina Codes - Division 2, Fireworks,
Section 14-51 through 14-58 - approval is hereby granted for a supervised
public fireworks display to be conducted by the above named organization
on the location and date given.
The fireworks will be discharged by
John Ziegler
who has furnished evidence of his competence in accordance with City Code
Sec. 14-53 through 14-54.
In compliance with City Code 14-54, Permittee has on file with the City
Clerk a copy or affidavit of proof of liability insurance in the minimum
amount of $500,000.00.
The City of Salina assumes no liability for this permitted display.
~nA~~
Tom Girard, Flre Cheif
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ALLIED SPECIALTY INSURANCEt INC.
10451. G u 1.'1'" f.l () u I. (i'~V"lr' d Tl- (;"<\'1 ~i; U r' €~ :c!:; I. i:\ ncl f F I. (iI i '.f <:t ,..' .., , 'n._
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Certificate number: 1
CERTIFICATE OF INSURANCE
F:r F,~EWOj;~Kf;; D I f:) F'I... A Y
NAME & ADDRESS OF INSURED:
ti(ewqrks SpectacuLar
t.:' . U . I:; (j x 1. (;~ ,".: .. ....
columbus, Kansas 66125
ADDITIONAL INSURED:
P.RII1ARX.... COV.ERAfJE
EXCESS....COVERAfJE
COMPANY;
I.L.._H,~.,...E~._.InSllr,~nce-_...-
C.o.mp..i:i n):: ........ ...... ........ ........ .... ...............
_.,..........._..?L,MJ~3Q~............_...._....M..
.... .... .... .... .... .... .... ........ .._ .... .... .... ..M.... .... .... ......_ .n' ,.....'. .... ...... ".,..... .... ..".... .... .... .... ........ .... "H .... .."
.... .... .... .... .... .... .... .... _., .... .... .... .... .... ........ .... ._. .... .... u', .... ".. .... ._......... .... .... .... .... _.. .... .... ....-.. .... .... ....
POLICY NUMBER:
LIABILITY LIMIT:
~~~~ ~~ t ~ n ~:~~9: rd .... .......J?~ Q~~.t. ~~QQGSL. .... .... ~ ...........
_.......M................._.................._._.._..M._...-......... .-".~._-_........................................_.-......-......
CLass B Products ___13QQ~QQQ__.
POLICY PERIOD:
From: 4/15/89
To: 4/15/90
.... ........!..... .... .... ............ .... ............ .... .... ~~:............ ........... ~.~ ............ .... ........ ........ ................ :~~: ........
Excess of Excess of
........._:$....................._.......................J~............ ............ili................................................:?!'........
............!P..............._................................................ ............1............................................................
0/00/00
0/00/00
0/00/00
0/00/00
~t .... COMBINED SINGLE L.IMIT
In the event of any material change in, or cancellation of said poLicy( ies),
tll(:~ C(Hllp.i:lny wi 1.1. (".'nc/(",avoj" to giVE' l'\)i"itt€~n notic(~) to HlG~ Pin"ty \'."lom this C.::H'''''
tific.:itE' ii:; j~;;s;u(.::d, but fail.ure to <:-liv(.:! such notiu:" ~;;h.;:dl. iiiiPo~;('":! no I.iabilit),
or obLigation upon the company.
NAME & ADDRESS OF CERTIFICATE HOLDER: DATE OF DI!:if'LA1rb ..Z::...'I...~.j.?i...
RAIN DATE :l::.'f.:::..l~...............
DISPLAY AMOU~T:. ~;~;Z;r{..t':(
,... l ..'''' IJ. ")'. . _ "} .1 I..t" t' - .(li i,' I ",C' ',' ~q~AJ:ION Of DISPLAY:.i'.{. ;5c~. 'I....u. [" ..( [i(L)
L Clf~.c.. t r't ",,1-/"/ "'^ '.> l. I/...C . ~ [) /(.. .' tC Pi~ tl ;JL (.- 3</. 'f -(,..J.t.:'.>
It is a condition of the poliCY that aLL displays be reported to the Company at
Least 24 hours in advance of the dispLay date.
This certificate neither affirmatively ~or negatively amends, extends or alters
the coverage afforded bY the poLicy( le6) described hereon. NOTE: In the event
that raIn or incLement ~eather prohibits this display, coverage wi lL appl.y
on a subse~uent date on which the dispLay is held, within the terms of the
pol.icy contract. CI.(.:~anup and pol.icing of th~:~ displ..ay a j" E-;) thE~ l"(:~spo'ii~;ibi I.it.y'
of th€.~ ':::.pon'50)",,;.
The following are additional insureds: any fair or exposition, association,
spon~:;or'ing ()l"gani;u~tion OJ'' commith:)(.?, HH:~ OWT1t:?T or I.e~;;~:;(~€~ of a'flY pj"f~mi;;;l:~!i; u~;;~::d
by the Na~ed insured,or any pubLic authority granting a permit ~o the Named
Insured. but only as respects accidents arisinq out of the neqLigence of the
N<':HiH::.d If!~.u'n?d 0'( th<-:: NamE:d In~:;uj"E~df~;; r.;.mpl.oYt'.-!(;::.:::..'actinq in the (':OUj"~::.E:' <TIne! ~;;C(iP(;':'
of their empLoyment. ALso, as additional. Named Insurid, any Independent Con-
tractor who fires the dispLay on behalf of the Named Insured. This insurance
clO(0~;; not <:lppl.)1 to <"flY fai 1.1.1\"';::- 'to POl.iC0! or cI.P<'HiUP thE~ di'::;pl.aYt OJ'' Liabi I.ity
arising there from.
This certificate Is not valid unless an originaL signature appears beLow.
(Copies Not VaLid.)
Coverage under the poLicy is conditioned upon fuLL compLiance by aLL Insureds
with all applicabLe NationaL Fire Protection Association (NFPA) codes and
standards In effect at the time of dispLay.
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Date of Certificate Issuance \ .0:.' ~ - ~