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Image (24)DATE (MMIDD/YYYY) AIR" CERTIFICATE OF LIABILITY INSURANCE 4/23/2025 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 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). CONTACT PRODUCER NAME: - - - Acrisure Great Lakes Partners Insurance Services PHONE 216-688_7100_ _Lac Nor 2t6 658 7101 223 West Grand River Ave #1 E-MAIL Howell MI 48843 ADDRESS, INSURED Jake's Fireworks Inc. 1500 E 27th Terr. Pittsburg KS 66762 INSURER A : 2567 INSURER 8 E: DC\/ICInM MlIMRFR' 21 COVERAGES GEK I IrIk;A I e numot_rc: I a I I I oowa - BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. D R POLICY EFF POLICY EXP LIMITS INSR TYPE OF INSURANCE POLICY NUMBER M D MMIDD B GENERAL LIABILITY 052115105 2/15/2025 2I15/2026 EACH OCCURRENCE $1,000,000 D AGE T E E PREMISES lEa occurrence $ 500,000 X COMMERCIAL GENERAL LIABILITY XI OCCUR MED EXP (Any one person) $ CLAIMS -MADE PERSONAL & ADV INJURY $1,DW.000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPIOP AGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: $ PRO- POLICY X LOC COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ NON -OWNED (Per accident HIRED AUTOS AUTOS $ A UMBRELLA LIAB X OCCUR UXP1037038-05 2/1512025 2/15/2026 EACH OCCURRENCE $1,000,000 EXCESS LIAR CLAIMS -MADE AGGREGATE $1,000.000 X $ DED RETENTION $ WORKERS COMPENSATION WC STATU- OTH- E.L. EACH ACCIDENT $ AND EMPLOYERS' LIABILITY Y� ANY PROPRIETORIPARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYE $ OFFICERIMEMBER EXCLUDED? N / A (Mandatory In NH) If yes. describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) DESCRIPTION OF OPERATIONS Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement. Sales Location: 16628 State Route 507 SE, Yelm, WA 98597; Land Owner: Tim Baublits; Ken Kersey, P.0 Box 1106, McKenna, WA 98558; City of Yelm and all it's employees, 105 W. Yelm Ave., Yelm, WA 98597; Christensen's Furniture and all its employees Term: February 15, 2025 through February 14, 2026; Insureds with respects to General Liability policy as required by written contract. The Certificate Holder and the above listed are Additional Ken Kersey PO Box 1106 McKenna WA 98558 ACORD 25 (2010105) 1..HIV%I CL 11- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED RR pATIVEq_ © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD