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, . . �u ,. . DATE(MMIDD/YY) � <br /> ::�//;111:t1. GERTIFICATE QF tNSURaNICE ��-�0-94 <br /> Paoo�c� . THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> PENCO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE � <br /> 400 WEST WILSON BRIDGE ROAD HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR � <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> SUITE 320 COMPANIES AFFORDING COVERAGE � <br /> PO BOX 6007 COMPaNY � <br /> WORTHINGTON OH 43085 A TWIN CITY FIRE INSURANCE COMPANY ! <br /> INSURED I <br /> COMPANY <br /> MACON COUNTY B i <br /> i <br /> 253 EAST WOOD STREET COMPANY <br /> DECATUR IL 62523 C � <br /> COMPANY ; <br /> D , <br /> � <br /> COVERAGES , ' <br /> ; <br />, THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BEIOW 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 POUCIES 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 , TypE OF INSURANCE POLICY NUMBER ���CY EFFECTIVE POUCY EXPIRATION i LIMITS <br />, LTR', DATE(MMIDD/Yl� I DATE(MMIDD/YY) i <br />' GENEHAL LIABIIITY I j GENERAL AGGREGATE S 2 OOO OOO <br /> j�� X� COMMERCIAL GENERAL LIABIIITY � I PRODUCTS-COMP/OP AGG i $ 2 OOO OOO <br /> CLAIMS MADE � OCCUR I $3 CESQN 6154 4-29-94 I 4-29-95 PERSONAL&ADV INJURY $ ],�������__ <br />, � OWNER'S&CONT PROT �i � ! EACH OCCURRENCE $ 1�0001 OOO__ <br /> � j F ERI OAMAGE(Any one fire) ', $ �jQQ�QQQ _ <br /> ' ; MED EXP(Any one person) i $ lO OOO <br /> AUTOMOBILE LIABILITY ' i <br /> ~i ANY AUTO � ' ;I COMBINED SINGLE LIMIT � $ <br /> � <br /> �� � -- <br /> ' i ALL OWNED AUTOS i I <br /> I BOOI�Y INJURY <br /> �I SCHEDUIED AUTOS ' i i (per person) i $ <br /> i <br /> �� HIRED AUTOS i i i BODIIY INJURY ' $ <br /> �i NON-OWNEO AUTOS I (Per accident) � - - <br /> I�', ' PROPERTY DAMAGE i $ <br /> ��ARAGE LIABILITY �� AUTO ONLY-EA ACCIDENT I $ <br /> ! � ANY AUTO I � OTHER THAN AUTO ONLY: � <br /> i � <br /> �_i EACH ACCIDENT $ __ <br /> i ' ; <br /> � i i AGGREGATE;I $ <br /> ��CESS LIABILITY i I I�H OCCURFiENCE $ _ <br /> �� UMBRELLA FOFiM I � AGGREGATE $ i <br /> OTHER THAN UMBRELLA FORM $ ' <br /> I� WORKERS COMPENSATION AND � STATUTORY LIMITS I <br /> EMPIOYERS'UABILITY I <br /> � EACH ACCIDENT � $ <br /> THE PROPRIETOR/ INCL I � DISEASE-POLICY LIMIT $ I <br /> I PARTNERS/EXECUTIVE � <br /> I OFFICERS ARE: EXCLI j DISEASE•EACH EMPLOYEE' $ , <br /> i OTHER ; ! <br /> I I � I <br /> I I � ; <br /> I � <br /> DESCFiIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL I7EMS { <br /> It is agreed that the Certificate Holder named hereunder is an Additional Insured under this � <br /> policy as defined by the "Who is an insured" provision of this policy (copy attached) for � <br /> operations or premises not excluded. ' <br /> CERTIFICATE HOLDER ', - CANCELLATION <br /> SHOULD ANY OF YNE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE � <br /> CITY OF DECATUR ILLINOIS EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br /> A MUNICIPAL CORPORATION 3O DAYS WRITfEN NOTICE TO THE CERTIFlCATE HOlOER NAMED TO THE LEFT, I <br /> # 1 GARY K ANDERSON PLAZA ! <br /> BUT FAIIURE TO MAIL S E ALL OSE NO OBLIGATION OR IIABILITY <br /> DECATUR IL 62523 OF ANY KIND C PA� AGENTS OR REPRESENTATIVES. � <br /> AUTHORIZED HEPHESE ATIV � <br /> � <br /> ACORD 25-S(3/93) �ACORD CORPORATION 1993� <br />