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DATE(MMIDDIYYYY) <br /> ACORN® CERTIFICATE OF LIABILITY INSURANCE 2/28/2011 <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 WNIAW <br /> NAME: FA <br /> KILLAM & ENGLUND INSURANCE PHONE <br /> f: (217)774-3618 A/C No:(217)774-3641 <br /> PO BOX 20 <br /> ADDRESS:killamins@consolidated.net <br /> SHELBYVILLE, IL 62565 _WDUCER <br /> CUSTOMERID#: <br /> INSURER(S) AFFORDING COVERAGE NAICM <br /> INSURED PHIL W COCHRAN ENGINEERING INSURER A:THE HARTFORD <br /> INSURER B: <br /> 5130 HICKORY POINT FRONTAGE RD INSURER C: <br /> DECATUR, IL 62526 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 /> ILTR TYPE OF INSURANCE Y EFF PO C LIMITS <br /> g POLICY NUMBER MMI IC MMIDD <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ <br /> CLAIMS-MADE FlOCCUR MED EXP(An one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ <br /> POLICY I <br /> PRO LOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> (Ea accident) <br /> ANYAUTO <br /> BODILY INJURY(Per person) $ <br /> ALL OWNED AUTOS <br /> BODILY INJURY(Per accident) $ <br /> SCHEDULED AUTOS <br /> PROPERTY DAMAGE $ <br /> HIRED AUTOS (Per accident) <br /> NON-OWNED AUTOS $ <br /> UMBRELLA LIAR �_JOCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> LIMI <br /> WORKERS COMPENSATION - <br /> ANDEMPLOYERS LIABILITY YIN X L <br /> A ANY PROPRIETORIPARTNERIEXECUTIVE ❑ 8 4 WECNA8111 10-01-10 10-O l-11 E.L.EACH ACCIDENT $ '000,000 <br /> OFFICERRdEMBER EXCLUDED? NIA Q 0 0 <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ <br /> If nesdescribe under 1,000,000 <br /> DESGtRiPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Aftech ACORD 101,Additional Remarks Schedule,If more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITY OF DECATUR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> #1 GARY K ANDERSON THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> DECATUR IL 62523 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUT RI ED ESENTATIVE <br /> ©7988-2009 AC D CORPORATION. All rights reserved. <br /> ACORD25(2009/09) The ACORD name and logo are registered marks of ACORD <br />