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® CERTIFICATE OF LIABILITY INSURANCE [—TATE <br /> 05/15IDD/Y2 <br /> A�bos/ls/zol <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 /> NAME: <br /> Holmes Murphy and Associates PHONE FAX <br /> - Peorialln Ext), AIC No: 888-898-6385 <br /> 311 S.W. Water Street E-MAIL <br /> ADDRESS: <br /> Suite 211 <br /> Peoria, IL 61602-4108 INSURERS AFFORDING COVERAGE NAIC# <br /> Paula Dixon INSURER A: US SPECIALTY INS CO 29599 <br /> INSURED INSURER B: <br /> Phillip W. Cochran <br /> Consulting Engineer INSURER C: <br /> 5130 Hickory Point Frontage Rd Suite 2 INSURER D: <br /> Decatur, IL 62526 INSURER E: <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER: 27137578 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 ADD SUBR POLICY NUMBER MMIDD/YYPOLICY FF <br /> POLICY EXP <br /> LTR MWDDIYYY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> DAMAGETO RENTED <br /> COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ <br /> CLAIMS-MADE r_1 OCCUR MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: I PRODUCTS-COMP/OP AGG $ <br /> POLICY PRO LOC E $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> NON-OWNED r accident) <br /> c PROPERTY $DMAGE <br /> HIRED AUTOS AUTOS <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR HCLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ $ <br /> WORKERS COMPENSATION ITOC <br /> STATURY <br /> OTH- <br /> AND EMPLOYERS'LIABILITY <br /> ANY PRO PRIETOR/PARTNER/EXECUTIVE� NIA E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> A Professional Liability USS1122049 08/14/1 08/14/12 Each Claim 1,000,000 <br /> Claims-Made Aggregate 1,000,000 <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 /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> #1 GARY K ANDERSON PLAZA AUTHORIZED REPRESENTATIVE <br /> DECATUR, IL 62523 <br /> USA <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD <br /> lbomaritoil <br /> 27137578 <br />