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TSI COL—� TSIGROU-01 PWHITETREE ACQR'Q ' CERTIFICATE OF LIABILITY INSURANCE DATE (MM/OD/YYYY) 11/23/2022 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(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 Pamela Whitetree NAME: _ ___ _ Rich & Cartmill, Inc. 2738 E. 51st Street, Suite 400 (AICC,Nr o, Ext): (918) 293-7147 (AIC, Ne): E-MAIL Tulsa, OK 74105 ADDRESS: pWhitetreercins.com _ @ INSURED TSI Group LLC 10921 N 161st E Ave Owasso, OK 74055 Ins Co 120494 B:Continental Ins-CP--------- c: nsCoc: National Fire Ins Co of Hart D: rnVCDA2CC rCDTICIrATC NII 111193=0- DG\/IQInK1 NII IMRFR- 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 SUER WVD POLICY NUMBER POLICY EFF (MMIDDNYYYI POLICY EXP IMMIDDIYYYYILIMITS /�I A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1'000'000 CLAIMS -MADE [X] OCCUR 6056782895 12/4/2022 12/4/2023 DAMAGE TO RENTED PREMISES Ea occurrence)_ 100,000 $ MED EXP(Any one person __$ 15'000 PERSONAL & ADV INJURY $ 1'000'000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2'000'000 X POLICY XX jE El LOC PRODUCTS - COMP/OP AGG $ 2'000,000 $ OTHER: B AUTOMOBILE LIABILITY { O aBI EDl� SINGLE LIMIT $ 1,000,000 BODILYINJURY(Perperson $ X ANY AUTO 6056782900 12/4/2022 12/4/2023 BODILY_ INJURY (Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS PROPERTY DAMAGE _=Per accident) _$ $ _— HIRED NON ED AUTOS ONLY AUTOS ONLY =C X Ded Pc�bolel Lx $1,000 B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 6'000'000 AGGREGATE $ 6'000'000 EXCESS LIAB CLAIMS -MADE 6056782914 12/4/2022 12/4/2023 DED I X I RETENTION $ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 6072833474 12/1 /2022 12/1 /2023 ER X STATUTE �RH E L EACH ACCIDENT - 1,000,000 $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) NIA E.L. DISEASE - EA EMPLOYEE - - -- $ 1'000'000 E.L. DISEASE -POLICY LIMIT 1,000,000 $ If yes, describe under DESCRIPTION OF OPERATIONS below A Installation Floater 6056782895 12/4/2022 12/4/2023 Installation 250,000 A Equipment Floater 6056782895 12/4/2022 12/4/2023 UR Equipment 25,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) !`GDTICIrATG unl nGD rAKI1'F=I I ATInKI ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cit of Blair Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 218 S 16th Street Blair, NE 68008 AUTHORIZED REPRESENTATIVE /�I ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD