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, 3 C;e �f�7ROU-Na of C oue.ra ti <br /> �e ,e4E:Y <br /> Name and Address of Agency Name and Address of Member <br /> Park District Risk Management Agency Decatur Park District <br /> 2033 Burlington Avenue 620 E. Riverside Drive <br /> Lisle, IL 60532-1646 Decatur, IL 62521 <br /> (630)769-0332 <br /> �, ,-$' �� sst4 .+.,s,q � awrEla *�+;a. " ..-..�t ... �':. Wa�.•tyY i .� K�_... ,.. .. <br /> The Park District Risk Management Agency(PDRMA)is an intergovernmental self-insurance and risk management pod established <br /> under the Constitution and the statutes of the State of Illinois to provide coverage for its members against certain claims and losses. <br /> Each member of PDRMA is entitled to the scope and amounts of coverage set forth below. In addition,PDRMA may extend the same <br /> scope of coverage to non-members. However,any coverage extended to a non-member is subject to all of the terms,conditions, <br /> exclusions,and amendments which are applicable to the members. <br /> The above named entity is a member in good standing of the Park District Risk Management Agency. The scope of coverage provided <br /> 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, <br /> the information set out below accurately reflects the scope of coverage established for the current coverage year. <br /> Scope of Coverage Policy Number Coverage Dates Limits Each Occurrent <br /> General Liability Bodily Injury and Property $1,000,000 <br /> x commercial general liability L010114 01/01/2014- Damage Combined <br /> x occurrence 12/31/2014 <br /> Personal Injury $1,000,000 <br /> Automobile Liability GEM-0003-A10001 01/01/2014- Bodily Injury and Property $1,000,000 <br /> x any auto 12/31/2014 Damage Combined <br /> Workers'Compensation WC010114 01/01/2014- Statutory <br /> 12/31/2014 <br /> Employer's Liability GEM-0003-A10001 01/01/2014- $3,000,000 <br /> 12/31/2014 <br /> Property <br /> P0700114 01/01/2014- <br /> 12/31/2014 <br /> Other <br /> 01/01/2014- <br /> 12/31/2014 <br /> Description of,Operationns/LocationsNehicies/Spe ial Items <br /> The City of Decatur and the State of Illinois Department of Transportation is/are additionally insured for Decatur Park District's <br /> use of property for their Roadrun on July 4, 2014. <br /> Coverage is for general liability with respect to the operations of the Decatur Park District. Additional insured coverage shall <br /> not apply to any liability resulting from the certificate holder's own negligence or the negligence of its servants agents or <br /> employees. <br /> Certificate Holder Date Issued: 04/07/2014 <br /> City of Decatur <br /> One Gary K. Anderson Plaza <br /> Decatur, IL 62523 Authorized Representative <br />