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NORTCOM-01 rRY <br /> CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) <br /> `, �� 7/22/2022 <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 poilcy(les)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 /> Dansig Incorporated PHONE 217 423-3311 Fvxc No_21�428-8767 <br /> 111 East Decatur St _,iA0C,No,Ext): ) _ —�_ __ .__(_. ) - <br /> Decatur,IL 62521crystall®dansig_com _ <br /> INSUREA(SAFFORDING COVERAGE _ NAIC .— <br /> _�_ _ e�suRER A:CInclRnetl,Insurance C0-In 10677 <br /> INsuREO �� _ _q-,.Markel Insurance Company <br /> Northeast Community Fund INWRER C: <br /> 839 N Martin Luther King Jr.Dr. INSURER 0: <br /> Decatur,IL 62521 �� F <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 POUCIES 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 /> tNSR! TYPE OF INSURANCE. SUBRI J–POLICY NUMBER POLICY EFF POLICY 6—PLIMITS <br /> A X !COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE S 500,000 <br /> a OCCUR X j DAMAGE TO REMED 100,000 <br /> CLAIMS-MADE <br /> ENP 0144033 5/19/1021 5/192024 �CIFy ,R s <br /> j ( MED EXP onr f s <br /> 500,000 <br /> PERSONAL a ADV INJURY <br /> ' GEt ft AGGREGATE LIMIT APPLIES PER I GENERAL AGGREGATE5 500,000 <br /> i� X POLICY; T j- LOC PRODUCTS- 5 <br /> P10PwG0 <br /> I 500,000 <br /> f OTHER I s <br /> i AUTOMOBILE LIABILITY 1 COM81NE0 SINGLE ULAtT S — <br /> t ANY AUTOOVVN '-�}{ I BOOT Y IN.IURY,_(Pe_ sM1 S <br /> AUTOO ONLY SCHEDULED � _(Per am0 I <br /> ®® S�p�y.p�yL BODILY INJURY <br /> ZRIF ONLY �AL <br /> IT14 L� PROPERTY DAMAGE S <br /> I I ? ! s <br /> t UMBRELLA UAB I I OCCUR fI EACH OCCURRENCE S <br /> j Excess UAB I`— CLAW At� I AGGREGATE S <br /> I DED RETENTION S S <br /> B 1wow PLROOMPENSATION I PER OH- <br /> �AmyPRoPwETORiPARSNERmxEamvE I AND EMPLOYER&LIABILITY YIN � IMWC0180930-02 2!122022 2/122023 f 100,000 <br /> pFRCER/M�yg�R EXCLUDED? CIN/A I L EACH ACCIDENT F 5 10O 000 <br /> (M.rW.IOr,,In L EMPLOYgo <br /> IKS_SCRI IO wPERATIONS ow I EL.DISEASE•POLICY LMT S $00,000 <br /> Obel <br /> i <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ARD 101.AGt UGMI ROMILS SchotlWa MY Ix 09MChetl M mwaapxe In regWrea� <br /> The City of Decatur Is listed as Additional Insured in regards to the General Liability per wto Fund Event to be held on Saturday, <br /> September 17th,2021 from 10 am to midnight in the 100 block <br /> of North Merchant Street Decatur IL. <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 /> AUTHORIZED REPRESENTATIVE <br /> City of Decatur /`t <br /> 1 Gary K Anderson Plaza / Zc <br />