2017-23 Consumption of Alcoholic Liquor on Public Rights-of-way French Fried 5K & Street Party

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DECACEL-01 RTAYLOR CERTIFICATE OF LIABILITY INSURANCE DATE 04127/2 Y oarur2Q17 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER A .7 Randy Taylor J.L.Hubbard Insurance and Bonds PHONE O(AICNc,Ext):(217)877-3344 3249 (a c,Not:(217)877-0795 Forsyth IL 2535 th Route 51 Vis.rtaylortwilhubbard.com INSURERS AFFORDING COVERAGE NAIC p INSURER A:West Bend Mutual Insurance CornpgM _ INSURED r INSURERS: -.------Decatur Celebration Inc i INSURER ------------ 160 East Main Suite#200 INSURER D: Decatur,IL 62526 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. (NSR ADDLSUBR POLICY NUMBER ; POUCYEFF ( POLICY EXP ; LIMITS — TR TYPEOFINSURANCE i 1,000,000 A X COMMERCIAL GENERAL LIABILITY ,EAGH OCCURRENCE $ _ ,___ i CLAIMS-MADE u OCCUR X ( 071175909 07/22/2015 07/22/2016 DAMMAGE TO RENTED 200,000 MED EXP(Any one on $ Excluded PERSONAL BADVINJURY $ 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 �p POLICY L� PRODUCTS.COMPIP AGG $ 2,000,000 �JECT { � � I ' —�5 OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $ ANY AUTO j ( BODILY INJURY_Per sod-� OWNED SCHEDULED LBODILY INJURY(Per accident) __ _�AURTE0�30NLY � AUTOS UVN o � I!I ROPERTy AMAGE _ AUTOS ONLY ATOS ONLY I Per acp+lenl $ -I I UMBRELLA LIAR J OCCUR EACH OCCURRENCE $ 1 EXCESS LIARETE O$ CLAIMS-MADE AGGREGATE $ WORKERS COMPENSATION ( i PER 0TH• I$ F. EMPLOYERS'LIABILITY YIN UTA`-- R 1ANYGPROPRIIETOR/PARTNER/EXECUTIVE 1 1 I j E.L.FACH ACCIDENT NF1 andatory WgW)1 EXCLUDED? (N 1 A 4 E.L DISEASE-EA EMPLOYE 8 _-_ _ ____—_ _ If Yes,describe under I DESCRIPTION OF OPERATIONS below ( E.L.DISEASE-POLICY LIMIT i$ A Liquor Liability X A269770 06/03/2017 06/04/2017 Limit i 1,000,000 I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101AddHional Remarks Schedule,may be attached If nwre apace Is required) Re:French Fried 5K Event on 06/03/17(See Attached for Route Information) City of Decatur is named as additional insured under the General Liability and Liquor Llablity;subject to written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Decatur ACCORDANCE WITH THE POLICY PROVISIONS. 1 Gary K Anderson Plaza Decatur,IL 62523 AUTHORIZED REPRESENTATIVE ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD