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'°��!��� CERTiFICATE 4F LiABILITY INSURANCE Dq/2�0 6 '
<br /> TNES CERTIFICATE 18 lSSUED AS A MATTER �F INFOt2MA1'ION bNLY ANb CONFERS NO RIdH7S UpON TME CERT(FICA1'� WOLDER. TNIS
<br /> CER7IFICA7E QOEB NOT AF�IRMA7iVELY OR N�GATIVELY AMEND, EXTEND OR AL7Eii THE COvpRAGE AFF'ORDED BY 7ME POUCtEs
<br /> B�LOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTI7U'TE A CONTRAC7 BETW�EN THE ISSUING tN5URER(8�, AUTNORIZEq
<br /> REPRSSENTASIVE OR PRODUCER,AND THE CERTIFICATE HOLbER.
<br /> IMpOR?ANT: If the eertificata bolder is an ADDITIQNAL INSURED,tha policy(iesj must be endoraed. 1f SUSROC�A71dN IS WAIVED,subJect to
<br /> the terms end conditions of the paNay,certain poltcies may require an endorsement. A atatement on thia eerNficate does nat eo�fer rights to the
<br /> certiflcate hoEder in(leu of such e�dorsement s.
<br /> PRODUCER �E,
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<br /> Brat Dixon inauranae PN�E (888)249-0035 ��� 1.^(888�399_0035 N
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<br /> 403 S. Frair3e St. E'M�� mail�br�td3xonine.cam
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<br /> PO �ox 205 1N5URER,{51APFOpDINGCpVEWWE_,,., i NAIc#_.
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<br /> Sethalto TL 52010-0205 iNsua�Ra:stone�ete ineurane� Compsey _ ____ s].4012
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<br /> INSUR�D INSURERIS Urlderwritera at Lloyd'a London `
<br /> .._.._..____._�_ _......_.__.�_._._..__._.. ._._.._......_._...�._,_..;_ .._........_.
<br /> Wild nog saloon incorporatefl INSURERC: :
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<br /> DBA: FT�,1CF DOg SBI,OOi1 INSURERD:
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<br /> 815 S a2nd Street INSURERE:
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<br /> Decatus IL 62521 INS
<br /> COVERAGES CERTlFICAFE NUMBER:CL1642109969 REVISION uUMBER:
<br /> THIS 13 70 CERTIFY THAT THE i'OLIC�ES OF IN3URANCE Lt3TED BELOW kAVE BEEN ISSUED TQ THE INSUREO NAMED AEOVE FOR 7}tE POLICY F�ERIOD
<br /> INdICA'P�p. NO'rW1't'N�'PtwDtNG,ANv t��qlrIREM�NT,T�RM 4fi CpNptTION p��Nr CC�NT�AC�'Qri 4TH�Ft pOCUA�r�T wi'tH aESK��G7 TQ wNICH Tni�
<br /> C�R7IFIGAT'E MAY 8E ISSUEP OR MAY pERTAiN, TH� iNSURAIVC�A�FORQECI BY TN� F�UCIBS pESCR{f3ED M�R�IN iS SUBJ�CT TtJ Ai.l THE'E�F2MS,
<br /> EXCIUSibNS ANO CONpITEONS OF SUCM POLICIES.LIMIT.^�Sh1�WN MAY HAVE BEEN REOUCED BY PAID CLAfMS.
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<br /> TYPEOFINSURANCH � ' YWIJId R E Pd7.(EYECK�...HOLI�Y�7�...�.._,.._�_.�.,__—._�_..�.....__.LIMIT3..._.._.__..�,..�.__............. .
<br /> X `COMMERCIq6GENERAI LIABIUIY 5103COfi0 ? S/26/9016 j 5/27/2D16 ��ACNOCCURRENCE :$ 1.D00,OQO
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<br /> QEN'L AC�CR£QATE LIMIi APPI.IE3 PER: � : ;GCNERAL At3GREQATE• FS Z�000.000
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<br /> WORICERS COMPENSATIQN ' � V�,�yx ��POrnt11 cpo�r � t ; : . :
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<br /> ANY PiZpPftIETORIPAR7NERIFXEGU�iVE Y.��.i � � � ;E.L.EACN ACCIt1ENT ?S
<br /> OFFICER/MEMBERFJIGLUDED7 N/A� i ; ...............__..._.__.A_.__....
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<br /> C f+ N F P 7 i E.L.DISEASE-POLICY LIMiT�g
<br /> A Liquor Liability CP11002333 ` B/23/a015 ; 8/23/2016 iEa�;hCommon(:aueF 51,000,000
<br /> OEBCRIPTION OF OPEiiATIONB/LOCATIONB/VEMICLEB(ACORD f01,Atltlidonal RemerMs 8che0pla,may aa etmr.heu tt rooro spaca�a mqWrao�
<br /> xhe aforementioned aoverage a�plles to the inauxed�$ evert loaated at 87.5 S 22nd Stxeet �n AecaCur, xL
<br /> 62521 on 5/26/2016 from Sp-12a.
<br /> CERTIFICATE HOLDER CANCElLAT10N
<br /> (217)424�2732
<br /> SHOULO ANY OF 7fEE/IB�VE DE6CRIBED POLIGIES BE CANCELLED BEFORE
<br /> CxE]� a� Decatur THE EXPlRATION DATE THEREOF, NOTICE WiLL BE D&W@RED IN
<br /> I Gdr]�' R. Anderaon Pl�.ZaZ ACCOROANCE WI'T?i THE POLICY PROVISION$.
<br /> Aocatuz, Ii, f>2523
<br /> AtlTNopIZBD pBpti�S6NTAT�
<br /> Br�G I)�Y_O11�KMV � '.. T � .•�'�'�`�'�
<br /> �tas6-2oaa ACORO CoaPORATION. An�ighls�esenrea.
<br /> ACDRD 25(2b14lo9) The ACORO nante�nd togo a�e regi�tered marks of ACORD
<br /> tNS02S reo�ko�1
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