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R� CERTIFICATE OF LIABILITY INSURANCE 'OP ID CJ DATE(MMIDDIYYYY) <br /> YOUNG-1 11/11/13 <br /> PRODUCER THIS CERTIFICATE IS ISSUED ASAATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS U ON THE CERTIFICATE <br /> Bennett & Shade Company HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR <br /> P O Box 858 ALTER THE COVERAGE AFFORDER BY THE POLICIES BELOW. <br /> Decatur IL 62525-0858 <br /> Phone:217-428-3411 Fax:217-428-5029 INSURERS AFFORDING COVERAGE NAIC# <br /> INSUREDINSURERA, New Hampshire Insurance <br /> INSURER B: Antrust <br /> Younq Men's Christian Assoc. <br /> Of Decatur INSURER C: <br /> 220 W MCt{Lnley Ave Ste A INSURER D: <br /> Decatur IL 62926 <br /> INSURER E <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTHSTANDING <br /> ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BOT <br /> UED OR <br /> MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITI OF SUCH <br /> POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> LTR INS <br /> TYPE OF INSURANCE POLICY NUMBER DATE MMIDD DATE MM1DD LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $1,000,000 <br /> A X X COMMERCIAL GENERAL LIABILITY 01-LX-9425873-9 10/01/13 10/01/14 PREMIS S Eaoccurence $100,000 <br /> CLAIMS MADE OCCUR MED EXP(Any are person) s5,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GENE AGGREGATE s2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $1,000,000 <br /> POLICY ,JC LOC <br /> AUTOMOBILE LIABILITY <br /> A X ANY AUTO 01-LX-9425873-9 10/01/13 10/01/14 COM(Ea awcaOnt)BINIED SINGLE LIMIT $1,000,000 <br /> M) <br /> ALL OWNED AUTOS <br /> BODILY INJURY $ <br /> SCHEDULED AUTOS (Per pe ) <br /> HIRED AUTOS <br /> BODILY INJURY $ <br /> NON-OWNED AUTOS (Per a 'ent) <br /> PROPERTY DAMAGE $ <br /> (Per a ent) <br /> GARAGE LIABILITY AUTO LY-EA ACCIDENT $ <br /> ANY AUTO OTHER THAN ACC E <br /> AUTO ONLY: AGG $ <br /> EXCESS I UMBRELLA LIABILITY EACH O CURRENCE s2,000,000 <br /> A X I OCCUR EICLAIMSMADE 01-UD-0587890-9 10/01/13 10/01/14 AGGREGATE s2,000,000 <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION X TO Y LIMITS ER _ <br /> AND EMPLOYERS LIABILITY <br /> B OFFICER/MEMBEANYE.L. A TO BE ASSIGNED 10/01/13 10/01/14 EHACCIDENT $500,000 <br /> (Mandatory In NH) E.L DIS SE-EA EMPLOYEE $500,000 <br /> If yes,describe under <br /> SPECIAL PROVISIONS below E.L.DIS E-POLICY LIMB $500 000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br /> RE:2 MILES to MILES-12/31/13;Alternate date 02/09/14. The Certificate holder <br /> and the State of IL shall be an Additional Insured in accordance with all <br /> the terms,conditions and limitations of the policy and then only with <br /> respect to liability caused by the negligent acts or omissions of the n�med <br /> insured. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED PO IES BE CANCELLED BEFORE THE EXPIRATION <br /> `.ITy0p-D DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMEPTO THE LEFT,BUT FAILURE TO DO SO SHALL <br /> City of Decatur IMPOSE NO OBLIGATION OR LIABILITY OF ANYJKIND UPON THE INSURER,ITS AGENTS OR <br /> Attn: Linda Swartz <br /> #1 Gary Anderson Plaza AUTHORREPRESENTATIVES. <br /> Decatur IL 62523 William P ISD REPRESENTATIVE <br /> WillShade III <br /> ACORD 25(2009/01) ©1988-2009 ACORD CORPO TION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />