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Client#: 914933 INTERINC22 <br /> ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE�MM/DD/YYYY) <br /> 9/05/2018 <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(ies)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 any rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER NTA David Miranda <br /> NAME: <br /> USI Insurance Services LLC-CL q/CNNo eX�:512-651-4112 ac No: 512-451-7555 <br /> 7550 IH-70 West,Suite 700 E-MAIL <br /> San Antonio,TX 78229 ADDRESS: <br /> 210 366-0671 INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A•AsPen SpeciaHylnsurance Co 10717 <br /> INSURED INSURER B•Hartford Casualry Insuronce Company 29424 <br /> Intera,Inc. se�t��e���a�.���e c���„�w. 11000 <br /> 1812 CENTRE CREEK DR STE 300 INSURERC: <br /> AUSTIN,TX 78754 INSURERD: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <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 /> LTRR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP <br /> INSR NND POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS <br /> A X COMMERCIALGENERALLIABILITY X X ERAE3AH18 6/01/2018 06/01/201 EACHOCCURRENCE $� OOOOOO <br /> CLAIMS-MADE �OCCUR PREMISES EaEoNccTurrence $3OO OOO <br /> X Pollution Liability MED EXP(Any one person) $25 000 <br /> X BI/D Ded$10,000 PERSONAL&ADVINJURY $'I,OOO�OOO <br /> GEN'L AGGREGATE LIMIT APPLIES PER� GENERAL AGGREGATE $L�OOO�OOO <br /> X POLICY�J COT �LOC X PRODUCTS-COMP/OPAGG $I�OOO,OOO <br /> OTHER $ <br /> (�' AUTOMOBILE LIABILITY X X 65UECZR3402 6/01/2018 06/01/201 COMBINED SINGLE LIMIT ,� 000 000 <br /> Ea accident $ , , <br /> X ANYAUTO BODILYINJURY(Perperson) $ <br /> OWNED SCHEDULED BODILY INJURY(Peraccident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NONAWNED PROPERTY DAMAGE <br /> X AUTOS ONLY X AUTOS ONLY Per accident $ <br /> $ <br /> A UMBRELLALIAB X OCCUR X X EXAE3AK18 6/07/2078 06/01/201 EACHOCCURRENCE $BOOOOOO <br /> �( EXCESS LIAB CLAIMS-MADE AGGREGATE $s OOO OOO <br /> DED RETENTION$ $ <br /> B WORKERSCOMPENSATION X 65WBAS8430 6/01/2018 06/01/201 X PER OTH- <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y�N E.L.EACH ACCIDENT $'I OOO OOO <br /> OFFICER/MEMBER EXCLUDED? � N/A <br /> (Mantlatory in NH) E.L.DISEASE-EA EMPLOYEE $� OOO OOO <br /> It yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $��OOO,OOO <br /> A Professional Liab X ERAE3AH18 6/01/2018 06/01/201 $2,000,000 Aggregate <br /> Each Wrongful Act $1,000,000 <br /> Deductible $100,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attachetl if more space is required) <br /> Re: DECAT.M001 <br /> A 30 days written notice prior to any material change,cancellation,or non-renewal except in the case of <br /> cancellation for non-payment of premium, in which case notice shall be 10 days applies when required by <br /> written contract. <br /> The General Liability and Auto policies include a blanket automatic Additional Insured endorsement that <br /> (See Attached Descriptions) <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Decatur, IIIIf101S SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> #1 Gary K.Anderson Plaza ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Decatur, IL 62523-1196 <br /> AUTHORIZED REPRESENTATIVE <br /> S c*(• �d a�+kati <br /> O 7988-2015 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD <br /> #523805822/M23175627 DZMHB <br />