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OmahaD COLACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 01 /19/2024 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 Marci Elam NAME: UNICO Group PHONE (q02) 434-7200 A/C No : (402) 434-7272 AIC No Ext 1128 Lincoln Mall E-MAIL melam@unicogroup.com ADDRESS: Suite 200 INSURER(S) AFFORDING COVERAGE NAIC # Lincoln NE 68508 INSURERA: Phoenix Insurance Cc 25623 INSURED INSURER B : Charter Oak Fire Ins CO 25615 Omaha Door & Window Co., Inc. INSURER C : Travelers Property Casualty ofAmerica 25674 4665 G Street INSURER D : Accident Fund General 12304 INSURER E : Omaha NE 68117 INSURER F : COVERAGES CERTIFICATE NUMBER: 24-25 GL-AL-WC-UMB 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 LTR TYPE OF INSURANCE ADDL INSD SUB11 WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE ❑X OCCUR DAMAGE TO PREMISES R occurrence 500,000 $ MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 A DT-CO-2W452041-PHX-24 02/01/2024 02/01/2025 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT PRO ❑ LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident BODILY INJURY (Per person) $ X ANY AUTO B OWNED SCHEDULED AUTOS ONLY AUTOS 810-2W452274-24-26-G 02/01/2024 02/01/2025 BODILY INJURY (Per accident) $ HIRED NON -OWNED PROPERTY DAMAGE Per accident $ AUTOS ONLY AUTOS ONLY $ X UMBRELLA LIAR X1 OCCUR EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 C EXCESS LIAB CLAIMS -MADE CUP-2W500368-24-26 02/01/2024 02/01/2025 DED I I RETENTION $ r $ WORKERS COMPENSATION X1 AND EMPLOYERS' LIABILITY YIN STATUTE EORH E.L. EACH ACCIDENT 500,000 $ D ANY PROPRIETOR/PARTNER/EXECUTIVE � NIA 100089532 02/01/2024 02/01/2025 E.L. DISEASE - EA EMPLOYEE $ 500,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 500,000 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) All Operations (ORG 12/19/22) UtKI II-IUAI t MULUtK GANt;tLLAI IUN City of Blair 218 So. 16th St Blair NE 68008 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ® CERTIFICATE OF LIABILITY INSURANCE . 11. RV DATE(MMIDD/YYYY) 02/03/2023 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 Marci Elam NAME: UNICO Group A//CNN. Ext ; (402) 434-7200 AlC No : (402) 434-7272 E-MAIL melam@unicogroup.com ADDRESS: 1128 Lincoln Mall INSURER(S) AFFORDING COVERAGE NAIC p Suite 200 INSURERA: Phoenix Insurance Co 25623 Lincoln NE 68508 INSURED INSURER B ; Charter Oak Fire Ins CO 25615 INSURER C : Travelers Property Casualty of America 25674 Omaha Door & Window Co., Inc. INSURER D : Accident Fund Insurance Co. 10166 4665 G Street INSURER E : INSURER F : Omaha NE 68117 COVERAGES CERTIFICATE NUMBER: 23-24 GL-AL-WC-UMB 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. NOTWII HSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 LTR TYPE OF INSURANCEADDLSUBR INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence 5 ,000 $ 00 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 A DT-CO-2W452041-PHX-23 02/01/2023 02/01/2024 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY 19 JEPRCT O ❑ LOG PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO B OWNED SCHEDULED AUTOS ONLY AUTOS 810-2W452274-23-26-G 02/01/2023 02/01/2024 BODILY INJURY (Per accident) $ I PROPERTY DAMAGE er accident Par. $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 C EXCESS LIAB CLAIMS -MADE CUP-2W500368-23-26 02/01/2023 02/01/2024 DED I I RETENTION $ D ..$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBEREXCLUDED7 (Mandatory In NH) NIA WCP100089532 02/01/2023 02/01/2024 SPER TATUTE ORH Xi E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 500,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) All Operations (ORG 12/19/22) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Blair ACCORDANCE WITH THE POLICY PROVISIONS. 218 So. 16th St AUTHORIZED REPRESENTATIVE Blair NE 68008 rt�c(0 (.�lfA.t @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD