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® Exhibit 1 DATE(MM/DD/YYYY) <br /> ACC>o CERTIFICATE OF LIABILITY INSURANCE ExhibitE 5/3M/DD/Y <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 rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> NAME: <br /> PHONNo.E Ell: (855)700-6854 ac No: (866)828-2424 <br /> ASSUREDPARTNERS OF IL LLC ADDRESS: Certificate@Hanover.com <br /> 4350 WEAVER PKWY INSURERS AFFORDING COVERAGE NAIC# <br /> WARRENVILLE IL 60555 INSURER A: Massachusetts Bay Ins Cc 22306 <br /> INSURED INSURER B: Allmedca Financial Benefit 41840 <br /> INSURER C: <br /> TESKA ASSOCIATES INC INSURER D: <br /> 627 GROVE ST INSURER E: <br /> EVANSTON IL 60201 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 /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP <br /> LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 <br /> CLAIMS-MADE � OCCUR DAMAG O REN <br /> 1,000,000 <br /> PREMISES Ea occurrence $ <br /> MED EXP(Any one person) $ 10,000 <br /> B Y N Z2C H69171500 8/28/2021 8/28/2022 PERSONAL&AIV INJURY $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 <br /> POLICY PRO- <br /> JECT F6/] LOC PRODUCTS-COMP/OP AGG $ 4,000,000 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> Ea accident $ <br /> _ <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> B OWNED SCHEDULED N N Z2C H691715 00 8/28/2021 8/28/2022 BODILY INJURYPer accident $ <br /> AUTOS ONLY AUTOS ( ) <br /> HIRED ./ NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY Y AUTOS ONLY Per accident <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 <br /> B EXCESS LIAB CLAIMS-MADE Y N Z2C H691715 00 8/28/2021 8/28/2022 AGGREGATE $ 2,000,000 <br /> DED WO RETENTION$ $ <br /> WORKERS COMPENSATION SPER TATUTE ERH <br /> AND EMPLOYERS'LIABILITY <br /> ANYPROPRIETOR/PARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT $ 1,000,000 <br /> A OFFICERIMEMBEREXCLUDED? FN NIA N WDC H567939 00 08/28/2021 08/28/2022 <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 /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CITY OF DECATUR is an Additional Insured on the General Liability pursuant to the terms and conditions by form 421-2915. <br /> CITY OF DECATUR is Primary and Noncontributory to the extent provided by form 421-2915. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> CITY OF DECATUR AUTHORIZED REPRESENTATIVE <br /> #1 GARY K ANDERSON PLAZA <br /> DECATUR IL 62523 <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />