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A�d7® Dog/12/z s1) <br /> CERTIFICATE ®F LIABILITY INSURANCE <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 /> - Peoria C N A/C No): <br /> 311 S.W. Water Street E-MAIL <br /> ADDRESS: <br /> Suite 211 <br /> Peoria, IL 6 16 02-410 8 INSURERS AFFORDING COVERAGE NAIL <br /> Paula Dixon INSURER A: XL SPECIALTY INS CO 37885 <br /> INSURED INSURERS: <br /> Blank, Wesselink, Cook & Assoc <br /> INSURER C <br /> 2623 Pershing Rd INSURER D: <br /> INSURER E: <br /> Decatur, IL 62526 <br /> INSURERF: <br /> COVERAGES CERTIFICATE NUMBER: 23033288 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 SUBR POLICY NUMBER MM�IDYIYYYY MMIDDPOLICY/YYYY EXP LIMITS <br /> LTR 'NSR WVD <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> _5AWMAGETO RENTED <br /> COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ <br /> CLAIMS-MADE FIOCCUR MED EXP(Any one person) S <br /> PERSONAL&ADV INJURY $ <br /> GENERAL AGGREGATE S <br /> GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ <br /> POLICY PRO LOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> Ea accident) <br /> ANY AUTO BODILY INJURY(Per person) S <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> NON-OWNED PROPERTY DAMAGE $ <br /> HIRED AUTOS AUTOS Per accident <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ <br /> EXCESS LIAR HCLAIMS-MADE AGGREGATE S <br /> DED I I RETENTION$ S <br /> WORKERS COMPENSATION WC STLIMITS FR <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? N/A <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 DPR9695151 09/16/1 09/16/12 Each Claim 1,000,000 <br /> (Claims Made) Aggregate 1,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS I 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 /> 41 Civic Center Plaza AUTHORIZED REPRESENTATIVE G <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 /> lbomaritoil <br /> 23033288 <br />