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A6 ® CERTIFICATE OF LIABILITY IN DATE(MWDD/YYYY)
<br /> `..� SURANCE 06/28/2012
<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 be endorsed. If SUBROGATION IS WAIVED, subject to
<br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br /> certificate holder in lieu of such endorsement(s).
<br /> PRODUCER 1-800-527-9049 CONTACT
<br /> Holmes Murphy and Associates NAME:
<br /> - Peoria PHONE FAX
<br /> 311 S.W. water Street xt: AIC No):
<br /> Suite 211 ADDRESS:
<br /> Peoria, IL 61602-4108 INSURERS AFFORDING COVERAGE NAIC#
<br /> Paula Dixon INSURER A: CHARTER OAR FIRE INS CO 25615
<br /> INSURED
<br /> Bainbridge, Gee, Milanaki & Associates INSURER B: TRAVELERS IND CO 25658
<br /> INSURER C: TRAVELERS CAS & SURETY CO 19038
<br /> 1670 Taylorville Road INSURER D:
<br /> Decatur, IL 62521 INSURER E:
<br /> INSURER F
<br /> COVERAGES CERTIFICATE NUMBER: 27984429 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 I AM
<br /> LTR TYPE OF INSURANCEPOLICY NUMBER MM/DDnYYY MM/D/YYYY LIMITS
<br /> A GENERAL LIABILITY 6802748L565 07/09/1 07/09/13 EACH OCCURRENCE $ 1,000,000
<br /> X COMMERCIAL GENERAL LIABILITY -DAMAGE TO RENTED 1,000,000
<br /> PREMISES Ea occurrence $
<br /> CLAIMS-MADE Fi]OCCUR MED EXP(Any one person) $ 10,000
<br /> PERSONAL 8 ADV INJURY $ 1,000,000
<br /> GENERAL AGGREGATE $ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> POLICYFX PRO- X LOC $
<br /> B AUTOMOBILE LIABILITY BA27481,332 07/09/1: 7 9 1 COMBINEDSINGLELIMIT
<br /> XEa accident 1,000,000
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED
<br /> AUTOS AUTOS BODILY INJURY(Per accident) $
<br /> X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE
<br /> AUTOS Per accident $
<br /> $
<br /> B X UMBREEXCESS LAB X OCCUR CUP6745Y549 07/09/1 07/09/13 EACH OCCURRENCE $ 1,000,000
<br /> EXCESS LtAB CLAIMS-MADE
<br /> AGGREGATE $ 1,000,000
<br /> DED I X I RETENTION$10,000 $
<br /> B WORKERS COMPENSATION UB6745Y353 WCSTATU- OTH-
<br /> AND EMPLOYERS'LIABILITY Y/N 07/09/1 07/09/13 X
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE
<br /> OFFICER/MEMBEREXCLUDED? FN I E.L.EACH ACCIDENT N/A $ 1,000,000
<br /> and
<br /> If yes,describe under EMPLOYE(Mandatory in E.L.DISEASE-EA EM $ 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> 00,000
<br /> C Professional Liability 105304894 07/09/1 07/09/13 Each Claim 2,000,000
<br /> Claims Made
<br /> Aggregate 2,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required)
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Decatur THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Richard G. Marley ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> #1 Gary R Anderson Plaza
<br /> AUTHORIZED REPRESENTATIVE
<br /> Decatur, IL 62523
<br /> USA
<br /> ©1988-2010 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
<br /> tstoeckeril
<br /> 27984429
<br />
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