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A ® DATEI
<br /> CERTIFICATE OF LIABILITY INSURANCE 02,20,220/2 x1,17
<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(les)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 1-800-527-9049 CONTACT
<br /> NAME: Traci Stoecker/Linda Bomarito
<br /> Holmes Murphy and Associates I FAX
<br /> Peoria 800-527-9049 AIC No:
<br /> E-MAIL
<br /> 311 S.W. Water Street ADDRESS:
<br /> Suite 211 INSURERS AFFORDING COVERAGE NAIC#
<br /> Peoria, IL 61602-4108 INSURER A: CHARTER OAR FIRE INS CO 25615
<br /> INSURED INSURER B: TRAVELERS IND CO 25658
<br /> Bainbridge, Gee, Milanski & Associates INSURERC: TRAVELERS CAS & SURETY CO 19038
<br /> 5130 Hickory Point Frontage Rd Ste 2 INSURER D:
<br /> INSURER E:
<br /> Decatur, IL 62526 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:49154902 REVISION NUMBER:
<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 I TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP
<br /> LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY 6802748LS65 07/09/16 07/09/17 EACHOCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE �OCCUR DAMAGE TO RENTED :L,000,000
<br /> PREMISES Ea occurrence $
<br /> MED EXP(Any one person) $ 10,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> PRO-
<br /> LOC $ 2,000,000POLICYJCTa
<br /> OTHER: $
<br /> B AUTOMOBILE LIABILITY BA2748L332 07/09/16 07/09/17 COMBINED SINGLE LIMIT $ 1,000,000
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED P
<br /> BODILY INJURY(Per accident
<br /> AUTOS AUTOS ( ) $
<br /> X HIRED AUTOS Ix NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS Per accident
<br /> B X UMBRELLA LIAB X OCCUR CUP674SYS49 07/09/16 07/09/17 EACH OCCURRENCE $ 5,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000
<br /> DED X I RETENTION$10,000 $
<br /> B WORKERS COMPENSATION U86745Y353 07/09/16 07 g PER OTH-
<br /> ANDEMPLOYERS'LIABILITY Y/W /09/17 STATUTE ER
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? FN I N/A
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> C Professional Liability 105304894 07/09/16 07/09/17 Hach Claim 1,000,000
<br /> Claims Made Aggregate 1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> The City of Decatur and its officers and employees are additional insured on a primary and
<br /> non-contributory basis on the general and auto liability as required by written contract per policy
<br /> terms and conditions.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Decatur THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> #1 Gary R Anderson Plaza
<br /> AUTHORIZED REPRESENTATIVE
<br /> Decatur, IL 62523
<br /> USA
<br /> ©1988-2014 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD
<br /> tatoeckeril
<br /> 49154902
<br />
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