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NebraskaH COLAC Ro® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 08/31/2022 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 NAME: PHONE (g55) 222-5919 FAX C o E t A/C No): Next First Insurance Agency, Inc. PO BOX 60787 Palo Alto, CA 94306 E-MAIL ADDRESS: support@nextinsurance.com ort@nextinsurance.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Next Insurance US Company 16285 INSUREDINSURER B : INSURER C: Jason Crawford Jason Crawford INSURER D: 1500 Adams St Blair, NE 68008 INSURER E: INSURER F: MED EXP (Any one person) $15,000.00 COVERAGES CERTIFICATE NUMBER: 186020037 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 N DL SUBR POLICY NUMBER MM/DI DY EFF LTM/DD/YYYY POLICY LIMITS r X COMMERCIAL GENERAL LIABILITY AUTHORIZED REPRESENTATIVE Click or scan to view EACH OCCURRENCE $1,000,000.00 _7TE CLAIMS -MADE � OCCUR DAMAGE TO PREM SES (Ea olccurrence) $100,000.00 MED EXP (Any one person) $15,000.00 PERSONAL &ADV INJURY $1,000,000.00 A X NXTQKJ7Y9C-00-GL 08/31/2022 08/31/2023 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000.00 X POLICY PRO- JECT ❑ LOC PRODUCTS - COMP/OP AGG $2,000,000.00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accldent BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS H BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident) HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 1 $ 1 UMBRELLA LIAR HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE STEREOR E.L. EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? ❑ N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below Each Occurrence. $25,000.00 A Contractors Errors and Omissions X NXTQKj7Y9C-00-GL 08/31/2022 08/31/2023 Aggregate: $50,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) The Certificate Holder is City of Blair. This Certificate Halder is an Additional Insured on the General Liability policy per the Additional Insured Automatic Status Endorsement. All Certificate Holder privileges apply only if required by written agreement between the Certificate Holder and the Insured, and are subject to policy terms and conditions. CERTIFICATE HOLDER CANCELLATION ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD City of Blair LIVE CERTIFICATE 218 S 16th St SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Blair, NE 68008 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN r ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Click or scan to view 4' , ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD