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.......... :':i::::: DATE::.M:::.DD::..::::: ::::: <br /> .:.;�:::......... ............ . ...:::;::ii�::;:;:.>:.>::>:.;:.:;�>:.;;:.;:.;:.;:.::.::.;:.;:.>:.>:.;:.;:.;:.>:.::.:..:>:.;.:::.::.;:.;:.;:.;:.;:.;:.>:.;:.;:.>:.::.;:.>:.>:.>:.;:.;:.;:.;:.;:.;:.>:.;:.;:.:<.;:<.>:.;:.;:.;:.:�:.;:.>:.>:.;:.;:.;:.:;.::.:;:.;:.;:.>:.;:.;:.;:.;:.>:.::.;:.>:.::.::.>:.;:.:.;;:.;:.>:.>:.>:.;:.:<.::.;:.;:.;:.;:.;: <br /> ::::r� .': ...: :.�.: :: : .::. :`:.��::: ��::.: :: ...i::::i::�:.�': .:::::::i:::�:i::: ::: �:::: :��:� ::::i: .: :.:��'.i::::i:: : ��: :..��:�::. : :.��::� ��::: '�: :':.��: ...i::::i:::::::::::i::::i::;::i::::i:::;:::'::'::::::;::: ... AA/ <br /> � � ,; <br /> A RD :>;:.:>: :::: . ::: :::: : ::>:: . :>:.: : ;: .:::::::::>: �: ::>::;::::::> : .�: >::: :::::;::::: : : :::>�; .::.:;:::::::<:::>::::>::::::>::::::>::::::>::<;::;:::.::::>::: <br /> CO �, ::.::�.�.���.���,�'�"�::::.��`:::::��,��:��.�::::.�.��"'`�.�.�,���.�.:::::.:.:::::::::.::.:. ..:::: .::::: <br /> >:.::.:.:<:.::.::.::.:.::.::.:.:::::.::.:�:.::::::.::.:::. ::.:::.::.:<.::.>.::.>:.:::.:.::.::.::.::<.::.:::.:.::::.: :..:::::.::.::.:::.::.::.::.::.::.::.:::.::.::.::.:.::.::.:::.::.::.::.:.:::::::::.::::::::::::::::::::::.:::..:::::::::::::::::::::::::::::::::::::::::::::::::::::::::..:::::. <br /> PRQDUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Behnke & Company, II1C. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> P. O. BOX 14 O ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Decatur, IL 62525 COMPANIES AFFORDINQ COVERAGE <br /> (217) 423-2345 COMPANY <br /> A NEW HAMPSHIRE INSURANCE CO. <br /> INSURED <br /> COMPANY <br /> TOMMY HOUSE TIRE COMPANY B ILLINOIS NATIONAL INSURANCE CO <br /> 3 4 0 �'i. ��.'ON COMPANY <br /> c <br /> DECATUR I L 6 2 5 2 3 COMPANY <br /> D <br /> ::::::::.:::::::::::.:::::::.. ..::..::::::::.:..:.:::::::::::.:.::.::.::::::::::::::::::::. .:::.:..::::::::::::::. <br /> EAA L :::::>::::::>::>::::::>::::::>:::>::>::<:::i:::':::;;':>:::::;::>:>?.::` <:`:::>::>::::.:..>.::::::>::::::>::::::>::::::>::::::>::::>:.:.':::::>::>:::::::>::::::>::::::>:::: <br /> >:::: >::. ;.. <br /> �#�...... � 5�.................................................................. ......................... .............................::::::::.....:.::.:::............... >:..::.:>::: . ::: <br /> ,.:::::::......::.::.:....:.........:.:...:.:.:.:... :..:..:::......... .:......::..::..:..:. . .....:.:...:.:.:.:::......:........:..:..:::.:......:..:..:.............................................................. ......... .. <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 SUB,JECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> CO TypE OF INSURANCE POLICY NUMBER ��Y EFFECTNE POLICY EXPIRATiON LIMITS <br /> LTR DATE(MMIDD/YY� DATE(MMIDD/YY! <br /> pj GENERAL WIBILITY CPP0000512621797 O 1/2 7/9 7 O 1/2 7/9 8 GENERAL AGGREGAiE $ <br /> COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ <br /> CLAIMS MADE �OCCUR PERSONAL 8 ADV INJURY $ <br /> OWNER'S 8 CONiAACTOR'S PROT EACH OCCURRENCE $ <br /> FIRE DAMAGE(My one fire) $ <br />' MED EXP(My one person) S <br /> A AUTOMOBILE WIBILITY CA0000512621897 O 1/2 7/9 7 O 1/2 7/9 8 COMBINED SIN�LE LIMIT S 1000000 <br /> ANY AUTO <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Per person) a <br /> HIRED AUTOS BODILY INJURY <br /> NON-OWNED AUTOS (Per accident) $ <br /> PROPERTY DAMAGE $ <br /> GARAGE W181LITY AUTO ONLY-EA ACCIDENT $ <br /> ANY AUTO OTHER THAN AUTO ONLY: <br /> EACH ACCIDENT $ <br /> AGGREGATE $ <br /> a���B��TM UL5078907 01/2 7/9 7 O 1/2 7/9 8 �CH OCCURRENCE sy <br /> $ UMBRELLA FORM AGGREGATE $ <br /> OTHER THAN UMBRELLA FORM S <br /> WORKERS COMPENSATION AND ORY IMI �R <br /> EMPLOYERS'W181L�TY <br /> EL EACH ACCIDENT $ <br /> THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $ <br /> PARTNERSiEXECUTIVE <br /> OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ <br /> oTM� <br /> DESCRIPTiON OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL REMS <br /> Re: 10 parking spaces located on East side of Tommy House Tire Co. <br /> shop located at 340 E. Macon St. (NW Corner of Macon St. & Industry <br /> Court) City of Decatur, Illinois is additional insured <br /> ;::;:.>,'�i�l:�nc�i;l::::::>::::::::>:::_;<:::>;::<:::>::::>:::<:<:::<:>::::>::::>::::>::::::::>::::;::::::::>::::::::>::::::::>::::::>:::.;::::::»:<>:::::::::::::::::::::;::>::;::::;:<::::>::::;: <br /> >:.::.>::.::.:::::::::::.;.::.;:.::>:;.:>.::.;:.;;::::;:.:::::::.:::.;:::.;:.::.:::.:::::.::::::::::::::.;::::::::.::::.:::.;::::::.;::.::.;:.;:.::..<;:.::.;::.:;::.::.::: <br /> ':>:::::>::�c <br /> ��n��::::�v�a��:«:>:<::::<:>;::::::>::::>::::>:::::<::<:::;:>:>::>::>::<::::>::::::>::::::>::::::>::::::>::::::;::::::>::::::>::::::>::::::;:::::<:::<::::::>>::<:::: .............................................................................. <br /> �..................................................................... .................................................. <br /> ............................................................................... . ... <br /> SHOULD ANY OF TI1E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> C l ty O f Deca tur I�.Z 1I3018 EXPIRATION DATE THEREOF, THE ISSUIN� COMPANY WILL ENDEAVOR TO MAIL <br /> Risk Management D1V1S1011 $0 DAYS WRITTEN NOTICE TO TNE CERTIFlCATE HOLDER NAMED TO THE LEFT, <br /> �1 Gary K. Anderson Plaza BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION_OR LIABILIiY <br /> Decatur IL 62 52 3-119 6 OF ANY KIND UPON E MPANY, RS TS�'OR. 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