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i^'� BLA2006 OP ID:CST
<br /> ACORO' CERTIFICATE 4F LIABILITY INSURANCE �A7E(MMlDDIYYYY)
<br /> `-�-� 10/f 4/20'E 5
<br /> THIS CERT(fiCATE IS ISSUED AS A MATTER OF INFQRMATION ONLY AND CONFERS NO RIGH7S UPON 7HE CERTfFICATE HOLDER. 7HIS
<br /> CERTiFlCATE DDES NOT AFFIRMATIVELY OR N�GATIVELY AMEND, EXTEND OR ALTER THE GOVERAGE AFFORDEO BY THE POl.ICiES
<br /> BELOW. THiS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CdNTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br /> REPRESEN7A71VE OR PRODi10ER,AND THE CERTlFlCATE HOLDER.
<br /> IMPORYANT: tf the certificate hotder is an ADDITIONAL INSURED,the policy(ies} must be endorsed. If SUBROGA71pN 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 NAMEACS Matthew D.Bennett
<br /> J.i..Hubbard insurance&Bonds -------------�---7---------------
<br /> 1090 South Route 51,PO Box 14 �ac°.NNo.e,n�:217-877-33�44 ________________�Sa����217-877-0795______
<br /> Forsyth, IL 62535-0014 ADDRIESS:
<br /> Kevin,l.Breheny ------._....._.__.______.._.---�.__..--_ ..____._----.__.._.__._.-_-I------
<br /> _ INSURER(5�AFFORDINGCOVERAGE--- ------_-�-__--NAIC.#_.,..._._
<br /> - ---.. .-'---
<br /> _,._,________ iNsuReRa:United Fire&Casualty Company 13021
<br /> tNSURE� Blank,Wesselink, Cook,�Asso iNsuRERe:Accident Fund Insur�nce Co. �10166
<br /> BWC Construction Manager, inc INSURERC: ^ '+ ^ i�—�
<br /> 2623 E.Pershing/POB 2910 --- --------._.__.._.___._.__..__...---._.___._._..................------------.-----.-y--..._--•----._.....__.;
<br /> Decatur,IL 62524 INSURER D: _ ______________ ___
<br /> _�
<br /> INSURER E; i
<br /> fNSUREft F:
<br /> GOVERAG£S CERTIF{CATE NUMBER: REVlSION NUMBER:
<br /> THIS IS 70 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUftED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. MOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WNICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AF�ORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHpWN MAY HAVE BEEN REDUCED BY PAID CIAIMS.
<br /> --- —�------------------------- ---
<br /> INSR 7ypE OF INSpRANCE 'A�DL�UB �Y������ � POLICY EFF POLICY EXP i LIMITS
<br /> LTR D POIICY NUMBER MMlDDlYYYY i MMlDDJYYYY :
<br /> A ; X �COMMERCIAL GENERAL I.IABIL1iY ; � I � � EACH OCCURRENCE !
<br /> , ;$ �,aoo,00
<br /> ; � ' I ! i I"DAMAG�fi0 RENT�f7----,_-.__..._......_...._...___.......__._...
<br /> i CLAIMS•MADE �X i oCCUR ,fi0353711 11/01/2015;11/01/2016 pREMISES�Ea occurrence '$ 140,04
<br /> —L–r-----------
<br /> ',.____,;___�____ __ ; � MEO EXP(Any one person) �$ 5,00
<br /> � � ---
<br /> i ; ' � � PERSONAL 8 ADV fNJURY 5 �,OOO,OO
<br /> `—'-----'-'-----._..._...._.__�__----'--'-- ' : --.____ .____-------'-----
<br /> i GEN'L AGGREGATE LIMI7 APPLIES PER: i � ? � GENERAL AGGREGATE $ Z�OOO,OO
<br /> _..._..._.______._—_-------'--_'-_-...._...___-----'----
<br /> r— i�PRO- �1 � j
<br /> j POLICY�__�ECT 'LOC � i PRODUCTS-COMP/0P AGG $ 2�000,00
<br /> --} ----- — -
<br /> i OTNER:
<br /> S
<br /> �AUTUMOBILE LIABILITY ; COMBINED SINGLE LtMiT '
<br /> i I � i �_(Eaaccidernl_._..---------__�$-..�_.__.__...__1,OOO,QO.
<br /> A �X I qNYAUTO � i6035371'I � 11l07/2015 'I'IIO'I/ZO'If) I BODILYINJURY(PerpersonJ �S __ __ __
<br /> � -1 AEL�WNED � SCHEDULED � �
<br /> �
<br /> ' i AUTOS AUTOS � � � I BODILY INJURY(Per accident)i S
<br /> �I � NON•OWNE� i I � '.PROPERTY DAMAGE �
<br /> ` ; HIREDAUTOS AUTOS � � + i Peraccidenl $
<br /> —. i � I r�---------�--------�--._� . ... .......__...._......._.
<br /> i � I.g...�.____--
<br /> �
<br /> ' X : UMBRELLA LIAB X OCCUR � � � I � EACH OCCURRENCE �$ Z,OOO,OO
<br /> �_I y s i � i �--------------+-------
<br /> A y ; EXCESSUAB I CLAIMS-MADE� �60353714 � 'I'IIO'IIZU'IS�11/091201fi AGGREGATE _ I.$ Z,OOO�OOO
<br /> __._...J."__'1� I _..._y__— _
<br /> ' DED 'i X ;RETENTION$ ��iOOO j � �g
<br /> i WORKERS COMPENSATION i � PER ; OTH• ;
<br /> i AND EMPLOYERS'LJABILITY Y I N � �� ' _,.__. STA7UTE i __i ER _____
<br /> B �ANYPROPRIETORlPARTNEWEXECUTIVE I � �wCVfi02$��'� ': 11101/2015i 11/Q112018 �.L.EACNACCIDEN7 �$ 50���0
<br /> iOFFICER/MEMBEREXCLUDED7 ❑IN/A'; ; � --�-�--�-��------------
<br /> !(Mandalory in NH� � i E.L.DISEASE-EA EMPLOYEE'S SOO�OO
<br /> If yes,describe under ��-'�--'-'--J'�'-'---- --"— --'
<br /> I RESCRIPTION OF OPERATIONS below � E.L.DISEASE-POLICY LIMIT $ 5OQ,O�
<br /> I �
<br /> �
<br /> ; i i i �
<br /> � t i
<br /> 1 i
<br /> dESCRIPTION OF OPERATIONS 1 L6CATIONS/VENICLES {ACORD 101,Adaitiortal Remarks Schedule,may 6e attach¢d i(mota space is requiretl)
<br /> RE: All Work
<br /> CERTIFICATE F{OLDER CANCELLATtON
<br /> BLA1 Q15
<br /> SHOULD ANY OF THE ABOVE DESCRIBEp POLICI�S 8E CANCELLED BEFORE
<br /> 7HE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City of Decatur ACCORDANCE WITH THE POUCY PROVISIONS.
<br /> #1 Civic Center Plaza AUTHORlZED REPRESENTATNE
<br /> Decatur,IE.62523 ����,/���
<br /> O 1988-2044 ACORD CQRPORATION. Ali rights reserved. ,
<br /> AC�i2Q 25{2014l81y The ACORD name and iogo are registered marks of ACORD �
<br /> ��\��� � � I
<br />
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