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ENTLER1 QE IQ-TS
<br /> CERTIFICATE OF LIABILITY INSURANCE °07i z 20'1Y'
<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 holler is an ADDITIONAL INSURED,the pollcy(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 rights to the certificate holder In lieu of such endorsement(s).
<br /> PRODUCER 618-692-9800 cT SHER RUJAWITZ
<br /> Assurance Brokers Ltd. PHONE 618-692.9800 FAX 618-692-9865
<br /> 95 North Research Dr Ste 100 (AIC,No,Ext): (AIC,No):
<br /> Edwardsville,IL 62025 IMS.,
<br /> INSURER(S) AFFORDING COVERAGE NAIC#
<br /> INSU RA:State Auto Insurance Companies 11017
<br /> fegA sunXr CAideT�oaCO,INC INSURER B:
<br /> INSURER C:
<br /> Decatur,IL 6522
<br /> INSURER D
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFLWE 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 /> INSR TYPE OF INSURANCE ADOL SUB POLICY NUMBER POLICY EFF POLICY EXPLTR COL fMWDDM'YY1 LIMITS
<br /> ' A X COMMERCIAL GENERAL LIABILITY1,000,QOO
<br /> EACH OCCURRENCE
<br /> CLAIMS-MADE FX]OCCUR Y 10064269CP 03/1512021 03/15/2022 PREMISES(Ea DAMAGE TO RENTED cel 300,000
<br /> MED EXP(Any one person $ 5,000
<br /> PERSONAL&ADV INJURY 1,000,000
<br /> ' GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000
<br /> POLICY L" t j �T F-1 LOC PRODUCTS-COMPIOP AGG $ 2,000,000
<br /> TH R:
<br /> ' A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
<br /> (Ea accident) $
<br /> X ANY AUTO Y 1 DD64273CA 03115/2021 03/15/2022 BODILY INJURY(Perperson) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUUTTOSSWN p BODILY INJURY Per accident
<br /> AUTOS ONLY AUTOS OY PPeO accderrt AGE
<br /> A X UMBRELLA LIAR X OCCUR EACH OCCURRENCE 5,000,000
<br /> EXCESS LIAR CLAIMS-MADE 10064276CU 03115/2021 03/15/2022 AGGREGATE 5,0001000
<br /> DED RETENTION $
<br /> A ANpPLERSLAALRY XSTAMOYIBIER
<br /> ANY PROR/P�RIIETORJPARTNERIEXECu I VE YIN 100712112WC 05113/2021 05/1312022 E.L.EACH ACCIDENT 1,000,000
<br /> (MFandatory In EXCLUDED? ® N/A 1,000,000
<br /> E.L.DISEASE-EA EMPLOYEE $
<br /> If yes,describe under
<br /> CR PTION OF OPERATIONS below E,L.DISEASE-POLICY LIMIT 1,000,000
<br /> A EQUIPMENT FLOATER 10064269CP 03/15/2021 03/1512022 SCHEDULE 938,000
<br /> LEASED 200,000
<br /> DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached N more space is required)
<br /> RE:2021 STORM DRAINAGE IMPROVEMENT PROJECT
<br /> CITY PROJECT 2021-30
<br /> CITY OF DECATUR, ITS OFFICERS AND EMPLOYEES AND CITY PROJECT 2021-30,2021
<br /> STORM DRAINAGE IMPROVEMENT PROJECT ARE INCLUDED AS ADDITIONAL INSUREDS.
<br /> 7 C R I AT HOLDER CANCELLATION
<br /> CITYDEC
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> CITY OF DECATUR THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> #1 GARY K ANDERSON PLAZA
<br /> DECATUR,IL 62523-1196 AUTHORIZED REPRESENTATIVE
<br /> ' ACORD 25(2016103) ®1989-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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