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���" DATE(MM/DD/YYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 09/03/2015 <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 1-800-527-9049 CONTACT <br /> NAME: <br /> Holmes Murphy and Associatea PHONE FAX <br /> - Peoria o Ex : A/C No: <br /> E-MAIL <br /> 311 S.W. Wdter Street ADDRESS: <br /> Suite 211 INSURER S AFFORDING COVERAGE NAIC# <br /> Peoria, IL 61602-4108 INSURERA: XL SPECIALTY INS CO 37685 <br /> INSURED <br /> INSURER B: <br /> Blank, Wesaelink, Cook & Asaoc <br /> INSURER C: <br /> 2623 Perahing Rd INSURERD: <br /> INSURER E: <br /> Decatur, IL 62526 INSURERF: <br /> COVERAGES CERTIFICATE NUMBER: 44911263 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 TypE OF INSURANCE ADOL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR POLICY NUMBER MM/DD/YYYY MMIDD/YYYY <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> CLAIMS-MADE � OCCUR DAMAGE TO RENTED <br /> PREMISES Ea occurrence S <br /> MED EXP(Any one person) $ <br /> PERSONAL 8 ADV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ <br /> POLICY� PR� � LOC PRODUCTS-COMP/OP AGG $ <br /> JECT <br /> OTHER: <br /> $ <br /> AUTOMOBILE LIABILI7Y COMBINED SINGLE LIMIT $ <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 /> HIREDAUTOS AUTOS Peraccident $ <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY STATUTE ER <br /> Y/N <br /> ANY PROPRIETOR/PARTNERlEXECUTIVE ❑ N�A E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER 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 $ <br /> A Profesaional Liability DPS9726375 09/16/15 09/16/16 Each Claim 1,000,000 <br /> (Claima Made) Aggregate 1,000,000 <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached 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 W <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> #1 Civic Center Plaza I <br /> AUTHORIZED REPRESENTATIVE I <br /> Decatur, IL 62523 <br /> USA ��l�l;�/r��1/,'�i,%i <br /> O 1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br /> lbomaritoil ,r � <br /> eeo„�c� �N ll�L.,��� <br />