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Exhibit DATE(MM/DDIYYYY) <br /> �lEP ' CERTIFICATE OF LIABILITY INSURANCE OP ID BF 10/29/10 <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 NAME: Becky Fatheree <br /> J.L.Hubbard Insurance & Bonds AIC,No,Ext: 217 -877-3344 (AXC,No): 217-877-079 <br /> 1090 South Route 51, PO Box 14 ADDRESS: bfatheree@jlhubbard.com <br /> Forsyth IL 62535-0014 CUSTOMERID#: BLA2006 <br /> Phone:217-877-3344 Fax:217-877-0795 INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURED INSURER A: United Fire a casualty Company <br /> Blank, Wesselink, Cook, Ec ABso INSURER B: Accident Fend insurance Co. 10166 <br /> Blank, Wesselink, Cook <br /> Construction Manager Inc INSURER C <br /> 2623 E. Pershing/ POB 2910 <br /> Decatur IL 62524 INSURER D: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 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 /> LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDIYYYY) (MM/DDIYYYY) LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1000000 <br /> A X COMMERCIAL GENERAL LIABILITY 60353711 11/01/10 11/01/11 PREMISES(Ea occurrence) $ 100000 <br /> CLAIMS-MADE ❑X OCCUR MED EXP(Any one person) $ 5000 <br /> PERSONAL&ADV INJURY $ 1000000 <br /> GENERAL AGGREGATE $2000000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2 0 0 0 0 0 0 <br /> RO r] POLICY X JECT LOC $' <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 <br /> (Ea accident) <br /> A X ANY AUTO 60353711 11/01/10 11/01/11 BODILY INJURY(Per person) $ <br /> ALL OWNED AUTOS <br /> BODILY INJURY(Per accident) $ <br /> A SCHEDULED AUTOS PROPERTY DAMAGE <br /> X HIRED AUTOS (Per accident) $ <br /> X NON-OWNED AUTOS $ <br /> pl UMBRELLA LIAB X OCCUR 60353711 11/01/10 11/01/11 EACH OCCURRENCE $ 1000000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1000000 <br /> DEDUCTIBLE $ <br /> X RETENTION $ 10000 $ <br /> B WORKERS COMPENSATION WCV6025111 11/01/10 11/01/11 X TORYLIMITS ER <br /> AND EMPLOYERS'LIABILITY <br /> ANY PRO PRI ETOR/PARTNER/EXECUTIV�YIN N/A E.L.EACH ACCIDENT $ 500000 <br /> OFFICER/MEMBER EXCLUDED? ! -' 1 <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> RE: All Work <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> BLA1015 THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> City of Decatur <br /> #1 Civic Center Plaza Kevin J. Breheny <br /> Decatur IL 62523 <br /> ©1988-2009 AMR18ORPORATION. All rights rese <br /> ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD <br />