R2015-33 TEMPORARY CLOSING OF STATE RIGHT-OF-WAY

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STJOH-1 OP ID: 00 ACORO DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 1 01/28/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu Of such endorsement(s). PRODUCER CONTACT - ,Wnitacre-Mcl4amara Insurance NAME_ -- ---- -- -- --- -- — --- - -- -- ----- PHONE I FAX 2028 N Main Street,Suite 105 (a/C,No,Ext):__--- - _-- ------------------.-_-- ----_,_JA/C,No)____,_---_---_ Decatur, IL 62526 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIL# _ INSURER_A:Cincinnati Insurance Company 10677 INSURED St John's Lutheran Church INSURER B 2727 N. Union Decatur, IL 62525 INSURER C INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: _ _REVISION NUMBER: THIS IS TO CE[;l IFY THAT THE POLICIES OF INSURANCE LIS I EO BELOW HAVt BttN 6,,Ut ) i0 I HE INSURED NAiviED ADOvE F0k 1HE PGL-!Cf FER"a INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR' TYPE OF INSURANCE ADDL SUBR, POLICY EFF POLICY EXP LIMITS LTR I POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A ! X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMA�iET RENTED CLAIMS-MADEX� OCCUR X ICHU1408269 12/01/2014 12/01/2015 PREMISES Ea occurrence 1,000,00 j ! MED EXP(Any one person) $ 5,000 ----------— -- -- l PERSONAL&ADV INJURY $ 1,000,000 SPPR GENERAL AGGREGATL $ 3,000,000 cLN:'n 'II,RI-GnrL:J.limnnPP r 1.IL I oc ' �I I PRODUCTS-CCMP/oP ncr. , i ------ !-$ 1,000 000---------- �—AUTOMOBILE LIABILITY —~— — COMBINED SINGLE LIMI1 $ Ea acc,dent i ANY AUTO BODILY INJURY((Per person) $ I ALI.OWNI D SCHEDULED BODILY INJURY(Per accident)I $ T)IiIREDIIAt)At 08 _ �AU fOS E $ C - NUN-0WNEL III (Perac'cident) ! ,. nuroS $ UMBRELLA LIAR ! OCCUR li EACH OCCURRENCE L$ l .._.- --- — - ----------- -- SS LIA EXCESS BCLAIMS-MADLAGGREGATE ' $ I _DLD RL-TEN iION$ $ WORKERS COMPENSATION II PER OT I I- i ,AND EMPLOYERS'LIABILITY STATURE ER Y/N i --`------ ! ANY PROPRIETOR/PARTNER/EXECUTIVE E1 EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED N/A --_--- (Mandatory in NH) E I. DISEASE-EA EMPLOYER $ If yes_describe under U LL_l.it.I'I Il.'Iv lJI''Jt:iHl IUIJJ Ul'IUW L DISEASE PGLIG.V ".!!T 2 ! I II I I DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached it more space is required) The Certificate Holder&the State of Illinois shall be additl insured in accordance with the terms &conditions of the policy and then only with respect to liability caused by the named insured the negligent acts or omissions of the named insured. CERTIFICATE HOLDER CANCELLATION DECCITY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Decatur ACCORDANCE WITH THE PO_LICY PROVISIONS. and State of Illinois Linda Swartz . AUTHORS E �ESENTATI��#1 Gary K. Anderson PlazaDecatur, IL 62521 ' ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD