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® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD VYYY)
<br /> AC
<br /> 5/9/2018
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br /> certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT Brooke Steiner
<br /> NAME:
<br /> C&W Insurance PHONE (785)537-1600 FA/C,AX
<br /> No: 1785)537-1657
<br /> (A/C,No Ext): ----.. l ) -- --
<br /> 555 Poyntz Avenue, Suite 205 EE-MAIL s bsteiner@charlsonwilson.com
<br /> P.O. Box 1989 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Manhattan KS 66505-1989 INsuRERA:Great Northern Insurance Company 20303
<br /> INSURED INSURER B:Federal Insurance Company 20281
<br /> CivicPlus, Inc. INsuRERc:Chubb Indemnity Insurance Company 12777
<br /> 302 S. 4th Street, Suite 500 INSURERD:
<br /> INSURER E:
<br /> Manhattan KS 66502 INSURERF:
<br /> COVERAGES CERTIFICATE NUMBER:Master 2018-2019 REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR' ADDLSUER POLICY EFF POLICY EXP LIMITS
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER •IMM/DD/YYYY) (MM/DD/YYYY)
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE I $ 2,000,000
<br /> DAMAGE TO RENTED 2,000,000
<br /> A CLAIMS-MACE X_ OCCUR ,, PREMISES(Ea occurrence) $
<br /> 3602-53-12 ! 5/17/2018 5/17/2019 MED EXP(Any one person) $ 10,000
<br /> I PERSONAL&ADV INJURY .$ 1,000,000
<br /> GENt AGGREGATE LIMIT APPLIES PER- I GENERAL AGGREGATE $ 2,000,000
<br /> PRO- 2,000,000
<br /> X POLICY JECT i LOC PRODUCTS $
<br /> :OTHER: : 3602-53-12 Technology E&O $ 3,000,000
<br /> AUTOMOBILE LIABILITY ', li COMBINED SINGLE LIMIT $ 1,000,000
<br /> (Ea accident) -. _.
<br /> B X_ANY AUTO BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED
<br /> (18) 7358-87-92 5/17/2018 5/17/2019
<br /> BODILY INJURY(Per accident) $
<br /> AUTOS NON-OWNED I PROPERTY DAMAGE $
<br /> � �
<br /> AUTOS
<br /> HIRED AUTOS AUTOS (Per accident)
<br /> - - $
<br /> X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,0.00,0.00_
<br /> B EXCESS LIAR ,' CLAIMS-MADE AGGREGATE $
<br /> DED RETENTIONS 7989-49-14 5/17/2018 5/17/2019 : $
<br /> WORKERS COMPENSATION I I X PER 0TH-
<br /> STATUTE , ER
<br /> AND EMPLOYERS'LIABILITY Y/N
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? I N , N/A,
<br /> - - ---
<br /> C (Mandatory in NH) ' (18)7174-92-49 5/17/2018 • 5/17/2019E.L DISEASE-EA EMPLOYEE
<br /> I $ 1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below • E.L.DISEASE-POLICY LIMIT I $ 1,000,000
<br /> B Director & Officers 8242-9361 5/17/2018 5/17/2019 General Aggregate $1,000,000
<br /> A Cyber Liability 3602-53-12 5/17/2018 5/17/2019 General Aggregate $3,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> ***FOR INFORMATIONAL PURPOSES ONLY*** THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> AUTHORIZED REPRESENTATIVE ?
<br /> Brooke Steiner/DAD jam'" --,
<br /> ©1988-2014 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
<br /> I NS025(201401)
<br />
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