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AcaR"' CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) <br />1-.....--''9/1/2019 <br />8/30/2018 <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(les) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in Ileu of such endorsement(s). <br />PRODUCER Lockton Companies <br />3280 Peachtree Road NE, Suite #250 <br />Atlanta GA 30305 <br />(404) 460-3600 <br />GONTCT <br />NAMEA <br />H No Ext): FAX <br />No <br />EMAIL <br />ADDRESS: <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURER A : Gemini Insurance Company 10833 <br />INSURED Summit Food Service, LLC <br />1357140 1751 West County Road B, Suite 300 <br />Roseville MN 55113 <br />INSURER B: Sentry Casualty Company 28460 <br />INSURER C : Sentry Insurance a Mutual Company 24988 <br />INSURER D: <br />INSURER E: <br />INSURER F: <br />rr)%1I:i rFRTIPIr®TF NIIIIVl R1=1/ICICIIJ NIIMi XXXXXXX <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 <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM/DD/YYYY <br />POLICY EXP <br />MM/DD/YYYY <br />LIMITS <br />C <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE � OCCUR <br />Y <br />N <br />90-18840-06 <br />9/1/2018 <br />9/1/2019 <br />EACH OCCURRENCE 1,000,000 <br />DAMAGE ( RENTED 1,000,000 <br />PREMISES Ea occurrence <br />MED EXP (Any oneperson)5 OOO <br />PERSONAL & ADV INJURY $ 1,000,000 <br />GENT AGGREGATE LIMIT APPLIES PER: <br />X POLICY PE C LOC <br />OTHER: <br />GENERAL AGGREGATE $ 2,000,000 <br />PRODUCTS -COMP/OP AGG $ 2,000,000 <br />1 $ <br />C <br />C <br />A <br />AUTOMOBILE <br />X <br />X <br />LIABILITY <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />AUTOS ONLY AUTOS ONLY <br />Drive Other <br />N <br />N <br />90-18840-04 (AOS) <br />90-18840-05 �MA) <br />GVE100207901(1X1) <br />9/1/2018 <br />9/1/2018 <br />9/1/2018 <br />9/1/2019 <br />9/1/2019 <br />9/1/2019 <br />COMBINED SINGLE LIMIT <br />Ea accident)$ 1,000,000 <br />BODILY INJURY (Per person) $ XXXXXXX <br />BODILY INJURY Per accident $ XXXXXXX <br />PROPERTY GE $ XXXXXXX <br />Excess Limit $ 1,000,000 <br />UMBRELLA LIAB <br />EXCESS LAB <br />OCCUR <br />CLAIMS -MADE <br />NOT APPLICABLE <br />EACH OCCURRENCE $ XXXXXXX <br />AGGREGATE $ XXXXXXX <br />DED I I RETENTION $ <br />$ <br />C <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y/N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? � <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N / A <br />N <br />90-18840-01 <br />90-18840-02 (Retro) <br />9/1/2018 <br />9/1/2018 <br />9/1/2019 <br />9/1/2019 <br />X STATUTE O R <br />E.L. EACH ACCIDENT � $ 1,000,000 <br />E,L. DISEASE - EA EMPLOYEE 1,000,000 <br />E.L. DISEASE - POLICY LIMIT 1,000,000 <br />C, <br />Hired Auto Physical Damage <br />N <br />N <br />90-18840-04 (AOS) <br />9/1/2018 <br />9/1/2019 <br />$1,000 Comp/Collision <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) <br />Certificate Holder is included as an Additional insured as respects General Liability are required by written contract. <br />13483555 <br />Kittitas County Jail <br />205 West Fifth Street <br />Ellensburg WA 98926 <br />ACORD 25 (2016/03) <br />SEP a 6 2018 <br />KITTITAS COUNTY SFIE;�ilFF= <br />ACCOUNTING <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />©1'988=20U ACORD CORPOKATION. All rights reserved <br />The ACORD name and logo are registered marks of ACORD <br />