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<br /> OUTING
<br /> EQUEST : . . .
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br /> C��S� HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br /> Please... T0: ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br /> ❑ Read 7� �'��F�G� � COMPANIES AFFORDING COVERAdE
<br /> �I Handle ���+�� �+� �N������ COMPANY
<br /> (�' Approve ��'�G� -�/���� � ��T A NEW HAMPSHIRE INSURANCE CO.
<br /> And... ��T� 7*�� �h���c �� COMPANY
<br /> ❑ Forward ��
<br /> Tf�IE ATt-AC�J� �S�'L— B ILLINOIS NATIONAL INSURANCE CO
<br /> ❑ Return °u. A °oMc Y
<br /> ❑ Keep or Toss COMPANY
<br /> ❑ Review with Me Date:-T�Z o
<br /> �-�►�,� _... . ........ . ......... . ,
<br /> ............................. ;;,.:...:::.::.::<::::::::::. ..:::::::.......................::::.
<br /> EN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> Y CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> .,"„„�.,,..� �..,,� „� �,,,,,,", „�� ,.,,.. .��.,�.,., ,,,� ,,.,,,.,.,.,.,,� ,.,,,,,,��., �, 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 /> CO 7ypE OF INSURANCE POLICY NUMBER �UCY EFFECTIVE POLlCY EXPIRATION LIMRS
<br /> �� DATE(MIuVDD/Yn DATE(NMIDD/YY)
<br /> pj GENERAL W1BILfTY CPP0000512621797 01/2 7/9 7 O 1/2 7/9 8 �ENERAL AGGREGATE $
<br /> COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AG� S
<br /> CLAIMS MADE �OCCUR PERSONAL&ADV INJURY $
<br /> OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $
<br /> FIRE DAMAGE(My one fire) $
<br /> MED EXP(My one person) $
<br /> A AUTOMOBILE W181LfTY CA0000512621897 �1.�2 7�9 7 O 1/2 7/9 8 COMBINED SINOLE LIMIT $10��
<br /> ANY AUTO
<br /> ALL OWNED AUTOS
<br /> BODILY INJURY $
<br /> SCHEDULED AUTOS LECATUR� ILLIN I! (Per peraon)
<br /> HIRED AUTOS
<br /> c� rQ BODILY INJURY
<br /> NON-OWNED AUTOS ����tii'i's (r '� �" (Per accident) $
<br /> REC�D RISK GT. PROPERN DAMAGE $
<br /> GARAGE W1BILlTY AUTO ONLY-EA ACCIDENT $ I
<br /> ANY AUTO OTHER THAN AUTO ONLY:
<br /> EACH ACCIDENT $ I
<br /> AGGREGA7E $
<br /> a���"B��TM U1.5078907 O 1/2 7/9 7 O 1/2 7/9 8 �CH OCCURRENCE $2 �
<br /> $ UMBRELLA FORM AGGREGATE $2 !
<br /> OTHER THAN UMBRELLA FORM $
<br /> WORKERS COMPENSATiON AND WC STATU- OTH-
<br /> T RY L.IMI FR lil
<br /> EMPLOYERS'LIABILRY EL EACH ACCIDENT $ ��
<br /> THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $
<br /> PARiNERSiEXECUTIVE
<br /> OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $
<br /> on+�
<br /> DESCRIPTWN OF OPERATIONS/LOCATIONS/VEHICLESlSPECIAL ITEMS
<br /> Re: 10 parking spaces at 339 E. Washington St. , Decatur, IL; Cit�r of
<br /> Decatur, Illinois, It' s Officers, Agents and Employees are Additional
<br /> Insureds on the General and Excess Liability Insurance Policies
<br /> ;:::.:.:.:::.: :.....:::::::..:.:::.;:.:::.::::;:::.;:::.;:;:::.;::.;::.;:.;:.:;:.:....;..::::.::.:::. ....:::::::.::;::::;::.;::::..:.:::.;::.;;:::«.;:.::::::.;::
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<br /> . .... .
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br /> CltY Of Decatur EXPIRATION DATE THEREOF, THE ISSUINO COMPANY WILL ENDEAVOR TO MAIL
<br /> Risk Management D1V1S1011 � DAYS WRRTEN NOTICE TO THE CERTIFlCATE HOLDER NAMED TO THE LEFT,
<br /> �. �.'1 V 1 C C en t e r P 1 a z a BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO 08LIGATION OR W1BII.ITY
<br /> Decatur IL 62523 OF ANY K�ID UPON COMPANY RS AGENTS OR REPRESENTATIVES.
<br /> AUTHOR�D REPRESENTA v
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