Laserfiche WebLink
J l ® DATE(MM/DD/YYYY) <br /> A� CERTIFICATE OF LIABILITY INSURANCE 02/13/2017 <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(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> MARSH USA INC. NAME' <br /> 540 W.MADISON PHONE FAXac <br /> No <br /> CHICAGO,IL 60661 EMAIL <br /> Attn:Fax:212-948-0770 or Chicago.Cer Request@marsh.com ADDRESS: <br /> INSURER(S) AFFORDING COVERAGE NAIC# <br /> INSURER A:Liberty Mutual Fire Insurance Company 23035 <br /> INSURED INSURER B:N/A N/A <br /> ADS LLC <br /> 340 The Bridge Street,Suite 204 INSURER C:Liberty Insurance Corporation 42404 <br /> HUNTSVILLE,AL 35806 INSURER D:Indian Harbor Insurance Company 36940 <br /> INSURER E <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER: CHI-007009653-01 REVISION NUMBER:3 <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 SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYpE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDDIYYYY LICY EFF MM/LDDY/YYYY LIMITS <br /> LTR <br /> A X COMMERCIAL GENERAL LIABILITY TB2-681-004088-047 01/01/2017 01/01/2018 EACH OCCURRENCE $ 2,000,000 <br /> DAMAGE TO <br /> CLAIMS-MADE F-TI OCCUR PREMISES EaEoccurrence) $ 1,000,000 <br /> MED EXP(Any one person) $ 10,000 <br /> PERSONAL&ADV INJURY $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 <br /> X POLICY E PRO- <br /> JECT ❑LOC PRODUCTS-COMP/OP AGG $ 4,000,000 <br /> OTHER. $ <br /> A AUTOMOBILE LIABILITY AS2-681-004088-037 01/01/2017 01/01/2018 COMBINEntD SINGLE LIMIT $ 2,000,000 <br /> Ea accide <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> X ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> X NON-OWNED PROPERTY DAMAGE $ <br /> X1HIRED AUTOS AUTOS Per accident <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> C WORKERS COMPENSATION WA7-68D-004088-517(AOS) 01/01/2017 01/01/2018 X STATUTE ORRH <br /> AND EMPLOYERS'LIABILITY <br /> C YIN WC7-681-004088-017 WI,OR 01/01/2017 01101/2018 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE � NIA <br /> A ( ) E.L.EACH ACCIDENT $ 2,000,000 <br /> OFFICER/MEMBER EXCLUDED? 2,000,000 <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ <br /> If yes,describe under 2,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> D Professional and Contractors PECO02263310 12/31/2016 12/31/2017 Each Claim/Aggregate 2,000,000 <br /> Pollution Legal Liability Retro Date:04/01/2007 SIR 100,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> City of Decatur is included as Additional Insured with respect to General and Automobile Liability coverages as required by written contract,subject to policy terms and conditions.Waiver of Subrogation is applicable <br /> where required by written contract.This insurance is Primary and Non-Contributory over any existing insurance and limited to liability arising out of the operations of the Named Insured and where required by written <br /> contract. <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Decatur SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> 1 Gary KAnderson Plaza THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Decatur,IL 62523 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> of Marsh USA Inc. <br /> Manashi Mukherjee _3�RnLuao►�a �Aa�es <br /> @ 1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />