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9 <br /> .4coRQ� CERTiFICATE OF LIABILITY INSURANCE DATE�MMIDD/YYYY) <br /> �...---'� i i v2o i� 9/2 l/2016 <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(SJ, AUTHORIZED <br /> k REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> � IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policles may require an endorsement. A statement on <br /> i this certificate does not confer rights to the certiticate holder in lieu of such endorsement(s). <br /> i PpODUCER Lockton Insurancc Brokers,LLC <br /> NAME: <br /> � 19800 MacArthur Blvd.,Suite 1250 vKone �i�ax <br /> CA Liccnse#OF15767 ���U� Uuc Nol• <br /> E•MAIL <br /> [rvine 92612 ADDRESS:, __.�.T_ <br /> _ __._._.�W --- <br /> 949-252-4400 INSURER(S)AFFORDING COVERAGE NAIC k <br /> ---- --- _ <br /> u+suReAn:*** SEEAT"I'ACHMENT*** <br /> _ _ _. ___ __ _.____ _..---_ _ __.._ ----- —__._ ._.__ _._.---------- -- _..___.. <br /> INSUHED AECOM INSUHEH B: <br /> L 392522 AECOM Techincal Services,Inc. iHsuaea c: � � � ���� <br /> _.__ —. <br /> URS Corporation INSURER D: <br /> 345 E.Ash Ave. <br /> __——.._._. _� <br /> DCCatUC IL fiZSZ�i INSURER E: _._ .._ . _. .. _.... <br /> INSURER F: � <br /> � COVERAGES AECTE01 CERTIFICATE NUMBER: t4274123 REVISION NUMBER: XXXXXXX <br /> THIS IS TO CEflTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REOUIREMEN7, 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 PO�ICIES 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 '�--..__ .__.....---� ...... .. . . ...._.. <br /> ---d�1,������� . _ — _...._-6ULIG�Y�EFF... P041CY E�-- .__...... . <br /> - -- <br /> LiR TYPE OF INSURANCE � <br /> POLICYNUMBER MM/DD/YYYY MM10O/VYYY �� LIMITS <br /> COMMERCIAL GENERAL LIABILITV NCYf APPLICABLE EACH OCCURRENCE $ XXXXXXX <br /> --- � � �ontaaGE ra a�rv�e� _ __. <br /> CLAIMS-MADE OCCUR .PEjEMfISE$,[Ea occurrenco� $ XXXXXX� <br /> MED EXP IAny one person� $ ]O(�{){}�]{}(� <br /> ._. _._ .._. ._ .__.. ._._�_.___.... ._. <br /> PERSONAL 8 ADV INJURY S XXXXXXX <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ XXXXXXX <br /> -- � <br /> POLICY ,, PRO• ; --. ..,___.___.�.. ..�..._.__--- <br /> ,JECT i �:LOC __...._- <br /> PROOUCTS-GOMP/OP AGG $ �(}(XXXXX <br /> ... ......__..__�-'- ...._._---_.._ .....,.__.. <br /> 07NER: S <br /> AUTOMOBILE 11ABILITY NOT APPL[CAALE BINED SfNGIE 14M1T $ XXXXXXX <br /> iEa4cci4entl __ _______ _____—__.__ <br /> ANV AUTO BODII.Y INJURY(Per person) $ XXXXXXX <br /> _..._�.___. ._..... ____._._.._._..._..-- <br /> � OWNED --� SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY .,, AUTOS I XXXXXXX <br /> HIRED NON-OWNED PROPERTY OAMU� —. -- -_--_. _.__ <br /> AUTOS ONLY ,� AUTOS ONLY (PoracCid¢n�. $ XXXXXXX <br /> $ XX�{XXXX <br /> UMBRELLA LIAB '�.OCCUR NOT APPLICABLE EACH OCCUflFENCE $ XXXXXXX <br /> �-- � �— _..__--_ ........ ......._."�._....--... <br /> EXCESS LIAB CIAIMS-MADE AGGREGATE $ XXXXXXX <br /> -- ......_._........._.._.._.__._.. ____.._.__. <br /> DED � RETENTION S XXXXXXX. <br /> WORKERS COMPENSATION P R OTN- <br /> A ANDEMPLOYERS'IIABILITY N SEEATTACIIEDACORD I�I I/J/20I6 lIi/2017 X 9TATUTE ER <br /> Y/N ___.._..__...,.___...,.,�__..,........� <br /> ANYPROPFi�ETOWPARTNEF/EXECUTIVE E.LEACHACCIDENT _ .$ .�s(�(�(��(J(�(� . <br /> OFFICER/MEMBER EXCLUDED? � N�A ----- - <br /> (Mandatory In NH) '-- E.L,DISEASE-EA EMPLOYEE $ � OQ�QQO <br /> � If yes,descdbe under <br /> _.- -- -_..._ __a._. > ---_.. <br /> DESCRIPTION OF OPERATIONS below E,L DISEASE-POUCY LIMIT $ t QQ�Q Q <br /> DESCRIPTION OF OPEflATION3/LOCATIONS/VEHICLES (ACORD 101,AddlUonal Remarks Schedule,mey be anached H more space is requlred) <br /> Notice of Cancellation applics per a[tached endorsement.RE:City of Decatur Bridge Inspections 2016-Z,Bridge]nspections 2016-2017.Perform bridge <br /> inspections and prcpare Bridge Condition Rcports for the tiillowing structuces�058-6000,058-600L OSR-6002,058-3035,OSS-303b,and 058-3060. <br /> CERTIFICATE HOLDER CANCELLATION See Attachments <br /> 14274123 <br /> City of Decatur SNOULD ANY OF THE ABOVE DESCRIBEO POLICIES BE CANCELLED BEFORE <br /> Matt Newell,City Eng]I1Ce[ THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> One Gary K.Anderson Plaza ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Decatur IL 62523-1196 <br /> AUTHORI2ED REPH <br /> m 1 88-241 C D CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and Iogo are registered marks of ACORD <br />