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Corbion COLQ® CERTIFICATE OF LIABILITY INSURANCE DATE( MfD J20/YYYY) 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 APPORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: if (fie certificate holder Is an ADDITIONAL INSURED, the poiloy(les) must have ADDITIONAL INSURED previsions or be endorsed, If SUBROGATION IS WAIVED, subject to the terms and conditions of the polloy, Certain policies may require an endorsement, A statement on this eerti(loato does not confer rights to the certl0cater holder In lieu of such andorai mont(a), PRODUCER Aon Risk services central, Inc, Chicago IL Office 200 East Randolph Chicago IL 60601 USA CONTACT NAME` INC I! .ExQ; (866) 283-7122 a0 Noll (800) 363-0105 E-MAIL ADDRESS; INSURER(S) AFFORDING COVERAGE NAIL N INSURED INSURER A: Travelers Property cas Co of America 25674 caravan ingredients 8250 Flint street INSURERD; National union Fire Ins co of Pittsburgh 1944S INSURER C: Lenexa KS 66214 USA INSURER Dt INSURER E: INSURER F; cOVER Ar.Fn DFRTIFInATF NI1MRFR: 8700ARd74230 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. Limits shown are as requested INSR TYPE OF INSURANCE ADOL SUBR POLICY HUMDER POLICY EFF POLICY EXP LIMITS D X COMMERCIAL GENERAL LIABILITY CLAIl,ISMADE QOCCUR GL6631768 SIR applies per policy to 1 .3 rs & Condi 01 01 2024 ions EACH OCCURRENCE $2,000,000 D GETORENTED PREM SE Ee to a co $100,000 MED EXP(Any one Person) $10,000 PERSONAL& ADV INJURY $2,000,000 DEN L AGOREGATE LIMIT APPLIES PER: X POLICY PRO. LOC L— IJECT GENERALAGGREOATE $2,000,000 PRODUCTS • CONPNPA00 $2,000,000 OTHER! A AUTOMORILELIABILITY T3CAP-118D6851—TIL-23 01/01/2023 D1/01/2024 CEOLIBRTEDSINGLELIMIT BODILY INJURY (Per person) ,$2,000,000 X ANYAUTO BODILYINJURY (Pot acclden0 OWNED SCHEDULED AUTOS ONLY AUTOS HeIEDAUYOS NON -OWNED ONLY AUTOS ONLY PROPERTYcloal) AGE PerecUdanl B X UMBRELLALIAD X OCCUR 10736199 01/01/2023 01/01 /2024 EACHOGCURRENCE $5,000,000 AOGREOATE $5,000,000 EXCESS LIAR Ll CLAIMS4,JADE DIED I X RETENTION $1,500,000 PRODUOTS-COMPIDPA00 $5,000,000 A WORKERS COMPENSATION AND UB3P2591402351R 01/01/2023 7/01/2024 X PER STATUTE OTN- A EMPLOYER8'LtABILITY yl ANY PROPRIETOR J PARTNER J EXECVTWE OPPICEILMF1d8ERFXCLUDED9 N (Mandatory In NH) NIA AZ MA WI UB3P2601382351K All other States 01/01/2023 01/01/2024 E.L. EACH ACCIDENT $1, 000,000 E,L, DISEASE -EA EMPLOYEE $1,000,000 it pas, dascribo under 0 SCRtPTION OF OPERATIONS below E.L. DISEASE-POUcY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS f LOCATIO148 J VEHICLES (ACORD i0i, Addlilonal R oma,ko Schadu)n, may be allachad 11 more apace la cegolred) CERTIFICATE HOLDER CANCELLATION SHOULD ANY of THE ABOVE DESCRIBED POLICIES HE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WALL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, city of Blair AUTHORIZED REPRESENTATIVE 218 9,16th St, Blair NE 68008 USA JQ41 t�%�;tdfG' c%G•EkYX� �ft�ttxb �/�A @1088.2016 ACORD CORPORATION, All rights reserved, ACORD 26 (2018103) The ACORD name and logo are registered marks of ACORD k