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CERTIFICATE OF LIABILITY INSURANCE F'`tA%i3 E DATE
<br /> (M iDD�)
<br /> M13/2THIS 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
<br /> MARSH USA INC.
<br /> PHONE
<br /> PHONE I FAX
<br /> HI A MADISON (q(C_Nc.Exc) Nod—• w,��
<br /> CHICAGO,IL 60661 �was.
<br /> Attn:Fax:212-948-0770 or Chicago.CertRequest@marsh.cam ----- ••--•--.,•---..- .- _..
<br /> INSURER AFFORDING.cOVERAGE I NAIC 9
<br /> _. INSURER A,:
<br /> Liberty Mutual Fire Insurance Company 23035
<br /> _
<br /> I INSUREDADS LLC INSURER B:NIA ._ __.. INiA
<br /> 340 The Bridge Street,Suite 204 INSURER C:Liberty insurance Corporation T42404
<br /> HUNTSVILLE,AL 35806 -""`- _ `-" I
<br /> INSURER D:Indian Harbor Insurance Company 36940
<br /> INSURER E:
<br /> COVERAGES CERTIFICATE NUMBER: CHI-007009653-01 REVISION NUMBER:3
<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 /> iLTR` TYPE OF INSURANCE
<br /> ADDU
<br /> POLICY EFF pOUCY EXi�.,�. ....... ...
<br /> POUCY NUMBER MM/DD MMIDO LIMITS
<br /> A X ? COMMERCIAL GENERALLIABILITYT62-681-004088-047 101101/2017 101101/2018 EACH OCCURRENCE $ 2,000,00
<br /> CLAIMS-MADE n V OCCUR 1OA
<br /> MI a1,000,00
<br /> PR
<br /> MED EXP(Any one person) $ 10,001
<br /> PERSONALBADVINJUR
<br /> 2,000,00f
<br /> Y $
<br /> ' GEN'L AGGREGATE LIMIT APPLIES PER: 3 � �'�
<br /> GENERAL AGGREGATE $PRO-
<br /> 4.000,001
<br /> y X POLICY LOC _ _.
<br /> PRODUCTS-COMP/OP AGG ' $ 4,000,001
<br /> OTHER: I 3
<br /> I A ` AUTOMOBILE LIABILITY ;AS2-681-004088-037 01/01/2017 !01/01/2018 COMBINED SINGLE LIMIT
<br /> — I (Ea acadentl ' $
<br /> X 2,000 001
<br /> ? ANY AUTO j BODILY INJURY(Per person) Is
<br /> Y ALL OWNED , —I SCHEDULED j
<br /> AUTOS AUTOS ( BODILY INJURY(Per accident): $
<br /> _ NON-OWNED
<br /> X HIRED AUTOS X i AUTOS
<br /> 1 PROPERTY DAMAGE
<br /> f 1.tPt;r acC7dent) i $
<br /> f j S
<br /> UMBRELLA LIAB i =
<br /> OCCUR EACH OCCURRENCE i $
<br /> EXCESS LIAB (
<br /> CLAIMS AGGREGATE $
<br /> i _ ! -MAGE! i
<br /> I DED ! 33 I RETENTION$ $
<br /> C WORKERS COMPENSATION WAT680-004088-517(AOS) ;01101/2017 0110112018 X PER i OTH- -
<br /> AND EMPLOYERS'LIABILITY
<br /> Y 7 N STATUTE ER
<br /> 1 C ANY PROPRIETORIPARTNERtEXECUTIVE r i 'WC7-681-004088-017(WI,OR) `01/01/2017 01/01/2016 E` L EACH ACCIDENT $ _ 2,000,001
<br /> OFFICER/MEMBER EXCLUDED? �IN/Al _
<br /> j (Mandatory in NH)yes,describe under ; E.L.DISEASE-EA EMPLOYE $ 2,000,001
<br /> D
<br /> DESCRIPTION OF OPERATIONS below EL DISEASE POLICY LIMIT $ 2000001
<br /> D Professional and Contractors PEC002263310 11213112016 112/31/2017 i Each Claim/Aggregate 2,000,00
<br /> Pollution Legal Liability Retro Date:04/01/2007 , SIR 100,00
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS i VEHICLES (ACORO 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> City of Decatur is included as Additional Insured with respect to General and Automobile Liability coverages as required by written contract,subject to policy terms and conditions.Waiverof Subrogation is applicable
<br /> where required by written contract This insurance is Primary and Non-Contributory over any existing insurance and limited to liability arising out of the operations of the Named Insured and where required by written
<br /> contract.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> City of Decatur SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> 1 Gary K Anderson Plaza THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Decatur,IL 62523 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> AUTHORIZEDREPRESENTATIVE
<br /> of Marsh USA Inc.
<br /> Manashi Mukherjee _Vt_0.,,4..wm 1,-
<br /> @ 1988-2014 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD
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