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4 • A CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ODIYYYY) 9112/2018 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 NAME: Arthur J. Gallagher Risk Management Services,Inc. PHONE FAX 10050 Regency Circle Suite 300 (NC,no.pat 402-397-5050_ _ (ac,No):402-397-6675 Omaha NE 68114 ADDRESS INSURER(S)AFFORDING COVERAGE NAICX INSURER A: Marketing DO NOT BILL—TEMPORARY INTERNAL INSURED JKASPIi-01 INSURER B: Midwest Builders Casualty Mutual Co 13126 JIL Asphalt Paving Co 3921 W Schimmer Drive INSURER Grand Island NE 68803 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1523083765 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 - ADDL.SUER POLICY EFF POLICY EXP T LIMITS LTR TYPE OF INSURANCE INSR WVD' POLICY NUMBER (MMIDOIYYYVI'(MNVDDIYYYY) A X COMMERCIAL GENERAL LIABILITY 160505300 6/10/2018 6/1012019 EACH OCCURRENCE $1009000_ DAMAGE TO RENTED _ CLAIMS-MADE X1 OCCUR i PREMISES(Ea occurrence) $100.000 I MED EXP(Any one person) ,L$5,000 PERSONAL&ADV INJURY $1.000,000 GENT AGGREGATE LIMIT APPLIES PER: I I GENERAL AGGREGATE S 2,000,000 _ X i POLICY h JECT H LOG PRODUCTS-COMP'OP AGG 52000 30 OTHER: $60505300 CaMBNeD g S INGLE O MIT $1,000.000 A AUTOMOBILEDABILITY I I _ X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED _ AUTOS ONLY ._ AUTOS BODILY INJURY(Per accident) $ x AUTOS ONLY _X. AUTOS NON-OWNED ONLY (Per an accident) $ A X UMBRELLA LIAR ? OCCUR 60505300 6/10/2018 6110/2019 EACH OCCURRENCE $2,000,000 • EXCESS JAB CLAIMS-MADE •AGGREGATE I$2,000000 DED I RETENTIONS I $ B 1WORKERSCOMPENSATION I WC10D0001974201EA 6/10/2018 6/10/2019 X PEATDTE I EOTH AND EMPLOYERS'LIABILITY VIN --- -�-- _ - ANYPROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT $1,000:000 UFFICER/MEMBEREXCLUDED? N/A (Mandalory in NH) _E.L.DISEASE-EA EMPLOYEE $1000,000 -_ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE.POLICY LIMIT $1,00900 A Property I 60505300 6/10/2018 6/1012010 Blanket limit $241,735 1 Equipment Floater Schedule limit: $691,550 DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (ACORD 101.Additional Remarks Schedule,may be attached if more space is required) Hall County is named as Additional Insured as respects General Liability policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Hall County AUTHORIZED REPRESENT YE ©1988.2015 ACORD CORPORATION. All rights reserved. AGGRO 25(2016103) The ACORD name and logo are registered marks of ACORD