R2015-71 TEMPORARY CLOSING OF STATE RIGHTS-OF-WAY

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Certificate of Coverage Name and Address of Agency Name and Address of Member Park District Risk Management Agency Decatur Park District 2033 Burlington Avenue 620 E. Riverside Drive Lisle, IL 60532-1646 Decatur, IL 62521 (630)769-0332 Scope of Coverage The Park District Risk Management Agency(PDRMA)is an intergovernmental self-insurance and risk management pool established under the Constitution and the statutes of the State of Illinois to provide coverage for its members against certain claims and losses. Each member of PDRMA is entitled to the scope and amounts of coverage set forth below. In addition,PDRMA may extend the same scope of coverage to non-members. However,any coverage extended to a non-member is subject to all of the terms,conditions, exclusions,and amendments which are applicable to the members. The above named entity is a member in good standing of the Park District Risk Management Agency. The scope of coverage provided by the Agency may,however,be revised at any time by the actions of PDRMA's governing body. As of the date this certificate is issued, the information set out below accurately reflects the scope of coverage established for the current coverage year. Scope of Coverage Policy Number Coverage Dates Limits Each Occurrence General Liability Bodily Injury and Property $1,000,000 x commercial general liability L010115 01/01/2015- Damage Combined x occurrence 12/31/2015 Personal Injury $1,000,000 Automobile Liability L010115 01/01/2015- Bodily Injury and Property $1,000,000 x any auto 12/31/2015 Damage Combined Workers'Compensation WC010115 01/01/2015- Statutory 12/31/2015 Employer's Liability WC010115 01/01/2015- $3,000,000 12/31/2015 Property P0700114 01/01/2015- 12/31/2015 Other 01/01/2015- 12/31/2015 Description of,Operations/L-oca ionslVehicles]Spec eal Mems - . . The City of Decatur and the State of Ilinois Department of Transportation is/are additionally insured for Decatur Park District's Staley Firecracker Road Run/Walk event on July 4, 2015. Coverage is for general liability with respect to the operations of the Decatur Park District. Additional insured coverage shall not apply to any liability resulting from the certificate holder's own negligence or the negligence of its servants agents or employees. Certificate Holder Date Issued: 05/15/2015 City of Decatur One Gary K.Anderson Plaza Decatur, IL 62523 Authorized Representative