R2012-104 AUTHORIZING AGREEMENT WITH AGRICULTURAL WATERSHED INSTITUTE

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AGR1000 OP ID: RT CERTIFI kTE OF LIABILITY INSL ANCE DATE(MMIDD/YYYY) 06/03/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER 217-877-3344 NAME: Randy S Taylor___ J.L.Hubbard Insurance&Bonds PHONE 217-877-3344 Fvc No 217-87'7-0795 1090 South Route 51, PO Box 14 217-877-0795 lac No,Extl: ) Forsyth, IL 62535-0014 EMAIL _ ADDRESS: rtaylor@jlhubbard.com Kevin J.Breheny INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:United Fire&Casualty Company INSURED Agricultural Watershed INSURER Institute INSURER C: 4004 College Park Road - — Decatur, IL 62521 INSURER D: INSURER E: _ INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDL SUBR POLICY EFF POLICY EXP ILTR TYPE ONSR INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RE Et3 A X COMMERCIAL GENERAL LIABILITY X 60335894 06/09/11 06/09/12 PREMISES Ea occurrence $ 100,000 CLAIMS-MADE A I OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO $ LOC AUTOMOBILE LIABILITY Ea acccidentSINGLE LIMIT $ 1,000,000 A ANY AUTO 60335894 06/09/11 06/09/12 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ — AUTOS PROPERTY DAMAGE X HR DSAUTOS X NON-OWNED Per accident) $ AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X WC STATU- OTH- TORY LIMIT ER AND EMPLOYERS'LIABILITY 100,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 60335894 06/09/11 O6/O9/12 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 'I/A 100,000 (Mandatory in and E.L.DISEASE-EA EMPLOYEE $ If yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,000 I DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Re:All Work City of Decatur is named as additional insured under the General Liability; subject to written contract. CERTIFICATE HOLDER CANCELLATION ouflnnn? SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Decatur _ 1 Gary K Anderson Plaza AUTHORIZED REPRESENTATIV ^� Decatur, IL 62523 ✓' '�� Kevin J. Breheny - f�� ©1988-2010 ACORD CORPORATION. A rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD