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CERTIFICATE OF INSURANCE <br /> ThU�rtifies that �..1 STATE FARM FIRE AND CASUALTY COMPANY, Bloominqton, Iltinois . <br /> ❑STATE FARM GENEFA�INSURANCE COMPANY, Bloom��ton, Iliinas <br /> insures the folbw�ng policyholder for the coverages indicated bebw: <br /> Name of po6Cyholder �� �'�+r` ��- � 1 L h��\ry l�� <br /> � ) ^ � <br /> ^ � ��AddrE55 Of pOliCyhOldEt �-c..�` T,�\�/� r `-� ��� '� � <br /> ���'�, Il'� � 1 L �J L�L.. 1.� <br /> Location of operations �` ���/�'' <br /> Descnptbn of operatio�s �' I P�..'��� � r�`.` L.C', "��'��..�"-�'- <br /> The pWic�es listed below have been issued to the policyholder tor the policy penods shown. The�nsurance descnbed�n these polic�es is subjec: to all the tertns, <br /> exclusions. and conditans of those policies. The limits of tiab�lity shown may have been reduced by any paid cla,ms. <br /> POLICY NUMBER TYPE OF INSURANCE POLICY PERIOO I LIMITS OF UABILITY <br /> Effective Date ; Expiratio� Date (at beginning of policy period) <br /> — Com rehensive � .xr� IS F}<�� BOOILY IN.JUFY AND <br /> � •, � � p c <br /> C�r PFOPERTY DAMAGE <br /> C�'�. ��.�l(v.�y--`�----• --•Business Uabdity -����1--�--�-!--r'�-�---------------------�-- <br /> ------------=--------- - �---..._..-- ------ <br /> This insurance includes: ❑ Products-Completed Operations <br /> � Contractual Liabii' <br /> ❑ Underground H ard Coverage Each Occurrence S �'J ����� <br /> Q Personal Injury <br /> ❑ Advertising Injury General Aggregate � � �+J`� . �'�J� — <br /> ❑ Explosion Hazard Coverage Products-Completed <br /> ❑ Collapse Hazard Coverage Operations Aggregate � <br /> ❑ General Aggregate Limit applies to each project <br /> ❑ <br /> a <br /> EXCESS LIABtLITY POLICY PERIOD BODIIY INJURY AND PROPERTY DAMAGE <br /> Effective Date � Expiration Date (Combined Single Umit) <br /> ❑ Umbrella Each Occurrence � <br /> ❑ Other Aggregate � <br /> Part 1 STATUTORY <br /> Part 2 BOOILY INJURY <br /> Workers' Compensation Each Accident $ <br /> and Employers Liability Disease Each Employee S <br /> Disease-Poiicy Limit $ � <br /> POLICY NUMBEA TYPE OF INSURANCE P011CY pERIOD LIMITS OF IIABILITY <br /> Effective Date � Expiration Date (at beginning ot policy period) <br /> I <br /> If any of the described policies are canceled before its <br /> expiration date,State Farm will try to maii a written notice to <br /> the certificate holder -�- days before canceilation. If, <br /> however, we fail to mail such notice, no obligation or liabiliry <br /> will be imposed on State Farm or its agents or representa- <br /> Name and Address of Certificate Holder tives. ^ <br /> `V^ �. � � � <br /> . �+�� �-'1 � ' �..'_��1 ln� _" �(1�T ..J��� . ' ^ <br /> f.j � ���l`��'T�; ��S � <br /> � \ � S�atwe ol Auu»�zeG aepisser�atrve <br /> � � <br /> 3 C-�:t�� �. �fi��'?`/\ ������� �"�'��. L` �Z'`-� �o <br /> '� rrty Oate <br /> ��1�•�\•`� � 1� � WZS�� . AtJBnt'4 COdB St3rtIP <br /> r, ^ l ' _, J�dP!?C G� L.,y i�:i�1 f:S� 1 <br /> L�G�nSe f:�.c.p c�'►-�'��cs�.�,�c-� - ' D F�� <br /> ssaas.a.z a«.,za, �,e.a�u.s.n. 1^S�nC:�rG�� �Cl i ;� <br /> _ ,.� <br />