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Client#: 1551014 KINNECON1
<br /> DATE
<br /> Yrr>
<br /> nTM
<br /> ACORCERTIFICATE OF LIABILITY INSURANCE 6/02/2021
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
<br /> tCERTIFICATE 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 /> NACT
<br /> PRODUCER NAME, Angie Penny
<br /> USI Insurance Services, LLC PHONE 217.281.0335 AX,No), 610.537.2014
<br /> A/C,No,Ext
<br /> ' 310 S. First Street,Suite 102 E-MAIL ie. enn
<br /> ADDRESS: an g p y@usi.com
<br /> Champaign, IL 61820 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> 217 398-4400 Phoenix Insurance Company 25623
<br /> INSURER A: y
<br /> ' INSURED INSURER B:Travelers Property Cas.Co.of America 25674
<br /> Kinney Contractors, Inc. Farmington Casualty Company 41483
<br /> 19342 E. Frontage Rd#1 INSURER C: 9 Y P Y
<br /> INSURER D
<br /> Raymond, IL 62560
<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 CONTRACTOR 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR _ INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY
<br /> ' A X COMMERCIAL GENERAL LIABILITY DTCOOP771523PHX20 12/31/2020 12/31/2021 EACH OCCURRENCE $_1,000,00.0_____
<br /> ENT
<br /> CLAIMS-MADE OCCUR DAMAGE TO RED
<br /> PREMISES RENTED
<br /> $300,000
<br /> X PD Ded:2,000 MED EXP(Any one person) $5,000
<br /> '
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> PRO- PRODUCTS-COMP/OPAGG $2,000,000
<br /> POLICY^I PRO-
<br /> F1 LOC
<br /> OTHER: _ $
<br /> COMBINED SINGLE LIMIT 1 OOO OOO
<br /> VB AUTOMOBILE LIABILITY 8102P4582722026G 12/31/2020 12/31/2021 (Ea accident) _ $
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> PROPERTY DAMAGE
<br /> X AUTOS ONLY HIRED X AUTOS ONLY Per accident) $
<br /> B X UMBRELLA LIAB X OCCUR CUPOP8592442026 12/31/2020 12/31/2021 EACH OCCURRENCE $8,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE s8,000,000
<br /> _ DED X RETENTION$1 OOOO _ $
<br /> C WORKERS COMPENSATION UBOP7723472026G 12/31/2020 12/31/2021 X PER TE _ ER
<br /> �OTH
<br /> AND EMPLOYERS'LIABILITY
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1,000,000
<br /> OFFICERIMEMBER EXCLUDED? a NIA
<br /> ' (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> A Leased/Rented DTCOOP771523PHX20 12/31/2020 12/31/2021 $250,000 per item
<br /> Equipment
<br /> ' DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE: City Project 2021-11, Concrete and Brick Street Rehabilitation
<br /> ' City of Decatur is included as additional insured with regards to the General Liability when required by
<br /> by written contract.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> Cit of Decatur SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> #1 Gary K.Anderson Plaza ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> ' Decatur, IL 62523
<br /> AUTHORIZED REPRESENTATIVE
<br /> ©1988-2015 ACORD CORPORATION.All rights reserved.
<br /> ' ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br /> #S322689791M30722563 ALPAR
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