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<br /> DATE(MM/DD/YYW)
<br /> A�Ro CERTIFICATE OF LIABILITY INSURANCE o5,�„20�6
<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 hoider in lieu of such endorsement(s).
<br /> PRODUCER 1-500-527-9049 CONTACT
<br /> NAME:
<br /> Holmes Murphy and Associates PHONE F/�
<br /> - Peoria � A/C No:
<br /> E-MAIL
<br /> 311 S.W. Water Street ADDRESS:
<br /> Suite 211 INSURER S AFFORDING COVERAGE NAIC#
<br /> Peoria, IL 61602-4108 INSURERA: CHARTER OAK FIRE INS CO 25615
<br /> INSURED INSURERB: TRAVELERS IND CO 25658
<br /> Bainbridge, Gee, Milanski & Associates INSURERC: TRAVELERS CAS & SURETY CO 19038
<br /> 1670 Taylorville Road INSURERD:
<br /> INSURER E:
<br /> Decatur, IL 62521 INSURERF:
<br /> COVERAGES CERTIFICATE NUMBER: 468�9422 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 ADDI SUBR POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE yyyp POLICY NUMBER MMIDD/YYYY MMIDD/YYYY LIMITS i
<br /> A X COMMERCIALGENERALLIABILITY 6802748L565 07/09/15 07/09/16 EACHOCCURRENCE $ 1,000,000 '.
<br /> CLAIMS-MADE �OCCUR PREM SES�Ea oocuErrDence $ l,000,000
<br /> MED EXP(Any one person) $ 10,0 00
<br /> PERSONAL&ADVINJURY $ 1,000,000
<br /> GEN'LAGGREGATELIMITAPPLIESPER: GENERALAGGREGATE $ 2.000,000
<br /> POLICY� PR� � LOC PRODUCTS-COMP/OPAGG $ 2.�00,000
<br /> JECT
<br /> OTHER: $
<br /> B AUTOMOBILE LIABILITY BA2748L332 07/09/15 07/09/16 COMBINED SINGLE LIMIT $ 1,000,000
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS AUTOS PROPERTY DAMAGE $
<br /> NON-OWNED
<br /> X HIRED AUTOS X AUTOS Per accident
<br /> $
<br /> g g UMBRELLALIAB X OCCUR CUP6745Y549 07/09/15 07/09/16 EACHOCCURRENCE $ 4,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 4,000,000
<br /> DED X RETENTION$10,000 $
<br /> B WORKERSCOMPENSATION jJ$6745Y353 07/09/15 07/09/16 X STATUTE �ERH
<br /> AND EMPLOYERS'LIABILITY
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y�N E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N� N�A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS beiow E.L.DISEASE-POLICY LIMIT $
<br /> C Professional Liability 105304894 07/09/15 07/09/16 Each Claim 1,000,000
<br /> Claims Made Aggregate 1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 701,Additional Remarks Schedule,may be attached if more space is required)
<br /> Project: Shore Oak Pump Station / Green Oak Force Main Improvements
<br /> City of Decatur is additional insured on the General Liability policy on a primary and non-contributory
<br /> basis. City of Decatur is additional insured on the Auto Liability policy.
<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 IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> #1 Gary K Anderson Plaza AUTHORIZED REPRESENTATIVE
<br /> Decatur, IL 62523 /,,�tA','.P .;rti1�f"<;;�
<br /> USA '
<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
<br /> 46879422
<br />
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