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�® CERTIFICATE OF LIABILITY INSURANCE Doe/ o/zATE20/2/Yo12 <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 1-630-773-3800 CONTACT <br /> NAME: Rate Ackert <br /> Arthur J. Gallagher Risk Management Services, Inc. PHONE (630) 694-5167 FAX <br /> x A/C No: (630) 285-3922 <br /> Two Pierce Place E-MAIL kate_ackert@ajg.com <br /> com <br /> ADDRESS: Jg• <br /> Itasca , IL 60143-3141 INSURERS AFFORDING COVERAGE NAIC# <br /> Kate Ackert INSURERA: ZURICH AMER INS CO 16535 <br /> INSURED <br /> INSURER B <br /> L.W. Matteson, A Division of <br /> Great Lakes Dredge & Dock Company, LLC INSURER C: <br /> 2122 York Road INSURERD: <br /> Oak Brook, IL 60523 INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 28748031 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 TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP <br /> LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS <br /> A GENERAL LIABILITY GLO6554597-02 10/01/1 10/01/12 EACH OCCURRENCE $ 1,000,000 <br /> X DAMAGE TO RENTED <br /> COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 300,000 <br /> CLAIMS-MADE 1XI OCCUR MED EXP(Any one person) $ 10,000 <br /> PERSONAL&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 /> X POLICY 7 PRO- LOC $ <br /> A AUTOMOBILE LIABILITY 72 10 1 1 1 1 1 COMBINED SINGLE LIMIT <br /> Ea accident 1,000,000 <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED tid <br /> P <br /> BODILY INJURY(Per accident)AUTOS AUTOS ( ) $ <br /> HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS Per accident <br /> I $ <br /> UMBRELLA LAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> A WORKERS COMPENSATION WC6554594-02 10/01/1 10/01/12 X WCSTATU- I OTH- <br /> AND EMPLOYERS'LIABILITY Y/NCRY LIM <br /> FR <br /> ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ 1,000,000 <br /> OFFICER/MEMBER EXCLUDED? � N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 $ 1,000,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> RE: R1077 - Decatur Water Pumping, IL ; Supplying a pumping system to pump water from Lake Tokorozawa <br /> The City of Decatur, its officers and employees, are shown as additional insured with respect to General Liability <br /> coverage as evidenced herein as required by written contract with respect to the work performed by the named insured. <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 /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Attn: City Engineer <br /> 1 Gary K. Anderson Plaza AUTHORIZED REPRESENTATIVE <br /> Decatur, IL 62523 ' <br /> USA 707Z64-01i —R- <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br /> katlohl <br /> 28748031 <br />