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PROOF OF INSURANCE (2018) CLOSED Ate""R" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) il%�' I 11/30/2017 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 p'ollcy(les) must 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 Brooke Steiner NAME: Charlson-Wilson Insurance PHONE (785)537-1600 FAX (785)537-1657 (ARC,No,Eaatls (AIC,-No): 555 Poyntz Avenue, Suite 205 E-MAIL bsteinerQcharlsonwilson.com ADDRESS: P.O. Box 1989 MSURER('S)AFFORDING COVERAGE NA,IC ov Manhattan KS 66505-1989 INSURERA:Great Northern 'Insurance Co,. 20303 INSURED INSU'RERB:Federal 'Insurance Company 2,0281 CivicPlus, Inc. INSURER C'. 302 S. 4th Street, Suite 500 INSURER D: INSURER E Manhattan KS 66502 INSURER F: COVERAGES CERTIFICATE NUMBER:2017-2018 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, I � TYPE OF INSURANCE ADOL SUBR POLICY EFF POLICY EXP JNIQ-Avn POLICY NUMBER fMWDDNY'YYf (MMJDDWYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 2,000,000 ' : A CLAIMS-MADE XDAMAGE 10 1")'I;N'I Iz OCCUR PREMISE�'S,(A`'«�e.�,c�,��xa+,��i.�;�y�,u 'S, 2,000,000 X 3602-53-12 5/17/2017 5/17/2018 MED EXP(Any one person) S 10,000 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 X PRO- PRO _ LOC PRODUCTS-COMP/OPAGG S 2,000,000 POLICY L I OTHER: 3602-53-12 5/17/2017 5/17/2018 TechnologyE&O S 3,000,000 AUTOMOBILE LIABILITY COmPINNEDSINGLE LIMIT $ 1,000,000 _ (Ea orcident) B X ANY AUTO BODILY INJURY(Per person) S AOSCHEDULED (16) 7358-87-92 5/17/2017 5/17/2018 BODILY $ AUTOS AUTOS X ) NON-OWNED raROPIL:R1Y UAMAGE HIRED AUTOS AUTOS O:Dar omidoral) $ Terrorism 5 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,,000,.000 B EXCESS LIAB CLAIMS-MADE AGGREGATE $ DE'D RETENTION$ 7989-49-14 5/17/2017 5/17/2018 �I, $, WORKERS COMPENSATION X PER 0,111. 0,111 AND EMPLOYERS'LIABILITY YINER ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT '$' 1,000,000 OFFICER/MEMBER EXCLUDED? N I A A (Mandatory in NH) (17)7174-92-49 5/17/2017 5/17/2018 EL DISEASE-EA EM. M.OYEE. $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT S 1,000,000 A 'Directors & Officers X 8242-9361 5/17/2017 5/17/2018 Aggregate Limit $1,000,000 A Cyber Liability 3602-53-12 5/17/2017 5/17/2018 Aggregate Limit $3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of E1 Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. E1 Segundo, CA AUTHORIZED REPRESENTATIVE Brooke Steiner/TAL ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) C H U B Bm Liability Insurance Endorsement Policy Period MAY 17,2017 TO MAY 17,2018 Effective Date MAY 17,2017 Policy Number 3602-53-12 WUC Insured CIVICPLUS,INC. Name of Company GREAT NORTHERN INSURANCE COMPANY Date Issued MAY 22,2017 This Endorsement applies to the following forms: GENERAL LIABILITY Under Who Is An Insured,the following provision is added. Who Is An Insured Additional Insured- Persons or organizations shown in the Schedule are insureds;but they are insureds only if you are Scheduled Person obligated pursuant to a contract or agreement to provide them with such insurance as is afforded by Or Organization this policy. However,the person or organization is an insured only: • if and then only to the extent the person or organization is described in the Schedule; • to the extent such contract or agreement requires the person or organization to be afforded status as an insured; • for activities that did not occur,in whole or in part,before the execution of the contract or agreement;and • with respect to damages,loss,cost or expense for injury or damage to which this insurance applies. No person or organization is an insured under this provision: • that is more specifically identified under any other provision of the Who Is An Insured section(regardless of any limitation applicable thereto). • with respect to any assumption of liability(of another person or organization)by them in a contract or agreement.This limitation does not apply to the liability for damages,loss,cost or expense for injury or damage,to which this insurance applies,that the person or organization would have in the absence of such contract or agreement. Liability Insurance Additional Insured-Scheduled Person Or Organization continued Form 60-02-2367(Rev.5-07) Endorsement Page 1 CHUBS° Liability Endorsement (continued) Under Conditions,the following provision is added to the condition titled Other Insurance. Conditions Other Insurance— If you are obligated,pursuant to a contractor agreement,to provide the person or organization Primary, Noncontributory shown in the Schedule with primary insurance such as is afforded by this policy,then in such case Insurance—Scheduled this insurance is primary and we will not seek contribution from insurance available to such person Person Or Organization or organization. Schedule Persons or organizations that you are obligated,pursuant to a contract or agrecrnent,to provide with such insurance as is afforded by this policy. All other terns and conditions remain unchanged. Authorized Representative* ' Liability Insurance Additional Insured-Scheduled Person Or Organization last page Form 80-02-2367(Rev.5-07) Endorsement Page 2 CHUaB Name&Mailing Address of the Insured Attached to and Forming Part of CIVICPLUS, INC. Policy Number (18)7174-92-49 302 SOUTH 4TH STREET SUITE 500 Policy Period 05/17/17 to 05!17/18 MANHATTAN KS 66502 FEIN 481202104 Effective Date 12/11/17 Name&Address of the Producer CHARLSON-WILSON INSURANCE AGENCY Name of Company P.O.BOX 1989 CHUBB INDEMNITY INSURANCE COMPANY MANHATTAN KS 66502-1989 Producer Number 1-35789 000 N.C.C.I.Carrier Code 31720 Endorsement Number Continuation of WC 00 03 13 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT Schedule ANOKA COUNTY,MN 2100 3RD AVENUE ANOKA MN 55303 CITY OF KNOXVILLE, ITS OFFICIALS, OFFICERS,EMPLOYEES,AND VOLUNTEERS, KNOXVILLE AREA TRANSIT 400 MAIN STREET,SUITE 699, PO BOX 1631 KNOXVILLE,TN 37901 SUMMIT NJ 512 SPRINGFIELD AVE. SUMMIT, NJ 07901 CITY OF SANTA ROSA 90 SANTA ROSA AVE.,2ND FLR. SANTA ROSA,CA 95404 THE MAYOR AND COUNCIL OF ROCKVILLE, WHICH INCLUDES ITS ELECTED AND APPOINTED OFFICIALS,OFFICERS,CONSULTANTS,AGENTS AND EMPLOYEES CITY OF WHEATON, ILLINOIS 303 W.WESLEY STREET Issue Date 12/18/17 KCO CLD WC 99 06 08(Rev.5.88)(Formerly 0842-0035) CHUBS" WHEATON, IL 60187-0727 THE CITY OF MODESTO, ITS OFFICERS,AGENTS, EMPLOYEES&VOLUNTEERS PO BOX 642 MODESTO,CA 95353 NATIONAL RECREATION AND PARK ASSOCIATION, NOPFMI, THE AUTHORITY AND THE CITY OF NEW ORLEANS, 22377 BELMONT RIDGE ROAD, ASHBURN,VA 20148 TOWN OF WINDSOR 9291 OLD REDWOOD HWY #300A,PO BOX 100 WINDSOR,CA 95492 CITY OF GREEN BAY 100 N.JEFFERSON, ROOM 500 GREEN BAY,WI 54301 CITY OF MURRIETA 1 TOWN SQUARE MURRIETA,CA 92562 CITY OF IRVINE C/O EXIGIS RISK MANAGEMENT SERVICES PO BOX 4668-ECM#35050 NEW YORK NY 10163-4668 CITY OF BEVERLY HILLS 455 NORTH REXFORD DRIVE BEVERLY HILLS,CA 90210 CITY OF LODI, ITS ELECTED AND APPOINTED BOARDS, COMMISSIONS,OFFICERS,AGENTS, EMPLOYEES AND VOLUNTEERS. 221 WEST PINE STREET LODI,CA 95240 City of Vacaville 650 Merchant Street Vacaville,CA 95688 City of El Segundo 350 Main Street EI Segundo,CA 90245-3813 "This endorsement is not applicable for use In the states of Arizona and Florida" Issue Data 12/18/17 KCO CLD WC 99 06 08(Rev.6-88)(Formerly 09.02.0035) CHUBB" All Other Terms and Conditions Remain Unchanged Authorized Representative lam Data 12/18/17 KCO CLD WC ae 06 08(Rev.5-W)(Formerly 08-02-Do35) WORKERS'COMPENSATION AND EMPLOYERS'LIABILITY INSURANCE POLICY WC 124 (4-84) WC 00 03 13 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it Is attached effective on the inception date of the policy unless a different date is indicated below. (The following'attaching clause'need be completed only when this endorsement Is issued subsequent to preparation of the poky.) This endorsement,effective on 12/11/17 at 12:01 A.M.standard time,forms a part of DATE) Policy No. (18)7174-92-49 of the CHUBB INDEMNITY INSURANCE COMPANY (NAME OF INSURANCE COMPA" issued to CIVICPLUS, INC. Endorsement No. Autfwrized Representative We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us' This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. Schedule SEE FORM WC 99 06 08 WC 124(4-84) W C OD 0313 CopyriyM 1989 National Council on Compensation Insurance. Page 1 of 1