Laserfiche WebLink
4 <br /> 1 ® DATE(MM/DD/YYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 07/25/2011 <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(les)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 A/C No): <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 INSURERA: XL SPECIALTY INS CO 37885 <br /> INSURED INSURERS: <br /> Homer L. Chastain & Associates <br /> INSURERC: <br /> 5 N. Country Club Rd. INSURER D: <br /> INSURER E: <br /> Decatur, IL 62521 <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 22408973 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 I TYPE OF INSURANCE ADSL SUBR POLICY NUMBER MM/DDYEFF/YYYY MM DD/YYYY LIMITS <br /> EXP <br /> LTR <br /> GENERAL LIABILITY rDAMAGE <br /> CCURRENCE $ <br /> T RENTED <br /> COMMERCIAL GENERAL LIABILITY ES Ea occurrence $ <br /> CLAIMS-MADE �OCCUR P(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ <br /> POLICY PRO LOC $ <br /> ACOMBINED SINGLE LIMIT <br /> AUTOMOBILE LIABILITY <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <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 LIAB HCLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION WC STATURY - OTH- <br /> ER <br /> AND EMPLOYERS'LIABILITY y/N <br /> ANY PROPRIETOR/PARTNER/EXECUTIVEF—] N/A E.L.EACH ACCIDENT $ <br /> OFFICERIMEMBER 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 1$ <br /> A Professional Liability DPR9691443 04/13/1 04/13/12 Each claim 2,000,000 <br /> (Claims Made) Aggregate 2,000,000 <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 /> Attn: Matthew C. Newell, P.E. <br /> #1 Gary Anderson Plaza AUTHORIZED REPRESENTATIVE <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 /> 22408973 <br />