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<br /> I ' � �c:��`� CEF��'OFiC�.TE �F ���,����TY II�t�E���i��E D6/2M%1CIYYYY)
<br /> I 1 '�
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<br /> ITHIS CERTIFICATE (S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br /> � CERTIFICATE DO�S NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EY.TEND OR ALT=P, THE COVERAGE AFFORDED BY THE POLICIES
<br /> j BELOW. THIS CEftTIrICATc OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWcEN 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 WAIVE�,subject to
<br /> the terms and conditions of the policy,certain poiicies 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 /> A/C No:
<br /> - Peoria E-MAIL
<br /> 37.1 S.W. Water Street ADDRESS:
<br /> Suite 211 PRODUCER
<br /> Peoria, IL 616 0 2-410 8 _sSo{vLERID1t___
<br /> Paula Dixon INSURER S AFFORDING COVERAGE NAIC it
<br /> INSURED WSURERA: CHARTEP, OAf: PIRE INS CO I 25615
<br /> Bainbridge, Gee, Milanaki & Associates INSURERa: TRAVEL�RS IND CO �25656
<br /> 1670 Taylorville Road INSURERC: TRAVE;,ERS CAS & SIIRETY CO I19038
<br /> INSURER 0:
<br /> Decatur, IL 62521
<br /> � INSURER E: _
<br /> I
<br /> INSURER F:
<br /> I, COVERAGES CERTIFICATE NUMBER: 1632se�3 REV1510N NUMBER:
<br /> I' THIS IS TO CERTI;�Y THAT THc POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABbVE FOf�THE POLICY PERIOD
<br /> I INDICAT�D. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMcNT 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 /> I EXCLUSIONS AND CONDITIONS OF SUCH POI.ICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> fLTR TYPE OF INSURANCE IAOOL SUBR pOLICY NUMBER MMI'�IYYYY MM/�D YYYY LIMITS
<br /> � A GENERALLIABILITY 6802748L565 07 09/10 07/09/11
<br /> I / I EACH OCCUftRENCE $ 1,000,000
<br /> g �AMA��f RERt�€�- 1,000,000
<br /> COMMERCIAL GENERAL LIABILITY II PREMISES Ee occurrence �
<br /> I CLAIMS-MAOE �OCCUR ', MED EXP(An one person) S 10,000
<br /> � � PERSONAL&ADVINJURY �$ 1,000,000
<br /> i �
<br /> -GGN6RALAGGREOATE $ 2,000,000
<br /> i
<br /> ( GEN'L AGOREGATE LIMIT APPLIES PER: PROOUCTS-COMPIOP AGG S z.000,000
<br /> � POLICY�PRO- X i LOC I - §
<br /> j B AUTOMOBILELIABILI7Y BA2748L332 07/09/1CI 07/09/11 COMBINE�SINGLELIMIT � 1,000,000
<br /> i Y I I (Ea accldentj
<br /> ANY AUTO BODILY INJURY(Por person) $
<br /> i
<br /> ALL OWNED AUTOS I i I i BO�ILY INJURY(Per accldent) 5
<br /> � SCHEDULED AUTOS i I � i ! .
<br /> � � PROPERTYOAMAGE ,$ .
<br /> � Y HIRED AUTOS � � � (Per accldent) ,
<br /> � X NON-OWNED AUTOS j $ �'�,
<br /> 5
<br /> ' B X UMBRELLALIAB X OCCUR CUP6745Y549 07/09/1 07/09/11 EACHOCCURRENCE t� 1,000,000 I,
<br /> EXCESS LIAB CLA1M5-MADE AGGREGATE s� 1,000,000 I'
<br /> � DEDUCTIBLE � '''
<br /> � X RETENTION $ 10,000 � $ '�
<br /> g WORKERSCOMPENSATION UB6745Y353 07/09/ld 4��09/11 7i WCSTATUS OTH-
<br /> � ANO EMPLOYERS'LIABILITY Y/N �
<br /> � ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT s� 500,000
<br /> OFFICERIMEMBER EXCLUDED? a N/A
<br /> ' (Mandatory in NH) E.L.DISEASE-EA EMPLOYE 5 500,OOD
<br /> If yos,describe under 500,000
<br /> � DESCRIPTION OF OPERATIONS below E.L DISEASE-POUCY LIMIT g
<br /> � C Profeasional Lia i ity 105304894 I 0 09 q 07 09 11 Bac C a m 2,000,000
<br /> Claims Made I Aggregate 2,D00,000
<br /> i
<br /> I
<br /> � DESCRIPTION OF OPERATlONS I LOCATIONS/VEHICLES(Altach ACORD 101,Addlllonal Remarks 9chedule,If more space Is requlred)
<br /> I
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<br /> ICERTIFICATE HOLDER CANCELLATION
<br /> � SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> j City of Decatur THE EXPIRATION DATE THEREOF, NOTICE WILL BE �ELIVERED IN
<br /> I ACCORDANCE WITH THc POLICY PROVISIONS.
<br /> � Richard G. Narley
<br /> ; #k1 Gary K Anderson Plaza
<br /> pUTHORIZED REPRESENTATIVE
<br /> � Decatur, IL 62523 �
<br /> ' USA �/�/,�(�./�.r�i/��%`�
<br /> � lbomaritoii O 1988-2009 ACORD CORPORATION. AI1 rights reserved.
<br /> i ACORD 25(2009I09) The ACORD name and logo are registered marks of ACORD
<br /> 15328973
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