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Page I of 2 <br /> �T J� DATE(MMIDDNYYY) <br /> ,4CW CERTIFICATE OF LIABILITY INSURANCE 07/30/2024 <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 WTW Certificate Center <br /> NAME: <br /> Willis Towers Watson Midwest, Inc. PHONE1-877-985-7378 FAX 1-888-467-2378 <br /> c/o 26 Century Blvd A/C NoI.. <br /> P.O. Sox 305191 ADDARESS: cartificates@wtwco.com <br /> Nashville, TN 372305191 USA INSURER(SI AFFORDING COVERAGE NAICS <br /> INSURER A: The Charter Oak Fire Insurance Company 25615 <br /> INSURED INSURER B; Travelers Indemnity Company of CT 25682 <br /> Pace Analytical Services, LLC <br /> 2665 Long Lake Road, Suite 300 INSURER C: Travelers Property Casualty Company of Ame 25674 <br /> Roseville, NN 55113 INSURERD: <br /> INSURER E <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:W34371119 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 AU0LTYPE OF INSURANCE 3 IMAM I R� POLICY NUMBER PM 1CDY EFF MPOLICY NYYV LIMITSLTR <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> DAMAGETO <br /> CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) S 500,000 <br /> A <br /> MED EXP(Any one person) $ 10,000 <br /> y B-660-38339745-COF-24 08/01/2024 08/01/2025 PERSONAL 8ADV INJURY $ 1,000,000 <br /> GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> POLICY[K PRO f 7�I LOC PRODUCTS-COMPIOP AGG $ 2,000,000 <br /> JECT O.• I <br /> OTHER: <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 <br /> Ea accident <br /> �( ANY AUTO BODILY INJURY(Per person) $ <br /> B OWNED SCHEDULED 8-810-9W114961-TIL-24-22 08/01/2024 08/01/2025 BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS -- <br /> HIRED NON-OWNED PROPERTY DAMAGE is <br /> AUTOS ONLY AUTOS ONLY Per accident) <br /> $ <br /> C <br /> X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 5,000,000 <br /> EXCESS LIARCLAlMSMADE CUP-5N703311-24-I2 08/01/2024 08/01/2025 AGGREGATE $ 5,000,000 <br /> DED x RETENTION$10,0o0 $ <br /> WORKERS COMPENSATION X STATUTE 'ER <br /> AND EMPLOYERS'LIABILITY YIN 1,000,000 <br /> C ANYPROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? No NIA VB-81(063715-24-I2-C 08/01(2024 08/01/2025 1,000,000 <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yah,describe under 1,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) <br /> Division/Location: IL 72 <br /> Additional Named Insureds: <br /> PDC Laboratories, LLC <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 <br /> 1 Gary Anderson Plaza <br /> Decatur, IL 32232 Y <br /> 01988-2016 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br /> SR it): 26236310 uTca: 3560358 <br />