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DATE (MMIODNYYYI <br />AC -COR", 0912712022 <br />`� CERTIFICATE OF LIABILITY INSURANCE Acct#:2494a6 <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 have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER CONTACT <br />LOCKTON COMPANIES, LLC PHONE FAX <br />2100 ROSS AVE., SUITE 1400 UVC, No, Ea11: 214.771-4411 (AIC, Na}: <br />DALLAS, TX 75201 E-MAILADDRESS <br />W C.&R ESO URCIN DEnCI ECOM <br />INSURED <br />GREEN DEMOLITION CONTRACTORS INC. <br />4840 S ST LOUIS AVE SUITE 100 <br />CHICAGO, IL 60632 <br />INSURER{S} AFFORDING COVERAGE NAI[: n <br />IN RURER Al In (TOM n Hy l ll Buren ca Co. of Norah America 43575 <br />INSURER B <br />tNS UR ER C . <br />INSU R ER D : <br />INSURER E <br />COVFRACCFR C_I`RTiVlr ATK AIIIMFkr D- o1=111¢1nAt ■11 IRMMcn. <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 <br />HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />1NSRR TYPE OF INSURANCE AODL SUER POLICY NUMBER MM IC POLICY EXP <br />INSO YYYO ( ) (MMIGOITYYY) <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE S <br />CLAIMS- F OCCUR <br />_ _ <br />OAMAZiE TOREN'fl_D <br />PREMISES (Ea occe7rencel $ <br />MEA EXP (Any. one poria) $ <br />PERSONAL S ADV INJURY $ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGI4E GATE S <br />[JOC <br />—OLICY�'RO- <br />IFCT <br />PRODIICPS _(XC)MPIOPA68 S <br />T -ER <br />$ <br />AUTOMOBILE <br />LIABILITY <br />DMIT$ <br />-- — <br />fEaBcddenU - <br />ANY AUTO <br />BODILY INJURY (Por person) <br />$ <br />OWNED SCHEDULED <br />AUTOS ONLY _ AUTOS <br />1300ILYINJURY Paracctdl1r11 <br />i I <br />S <br />HIRED NON -OWNED <br />_ <br />f+ROPER71'-[7l4MAGE <br />AUTOSONLY AUTOS ONLY <br />.1Pi[.QOddCAU <br />$ <br />UMBRELLA LIAR I OCCUR <br />EACH OCCURRENCE <br />$ <br />EXCESS LIAR !II CLAIMS -MADE <br />AGGREGATE <br />S <br />EO RETENTf <br />g <br />WORKERSMP N TI N�/ <br />A <br />AND EMPLOYERS' LIABILITY YIN <br />X STATUTE __ ER <br />4NYPROPRIETORIPARTNERIEX <br />�DFFICFWMEMBER EXCLUDFD7 <br />E L. EACH ACCIDENT <br />i 1,OOD,�00 <br />(Mandatory In NH) <br />If yos, describe under <br />NIA <br />051378325 <br />10/01/2022 <br />10101/2023 <br />E.L DISEASE - EA EMPLOYEE <br />�, 1,000,000 <br />DESCRIPTION OF OPERATIONS bolow <br />EL DISEASE- POLICY LIMIT <br />$ 1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) <br />WAIVER OF SUBROGATION IN FAVOR OF CERTIFICATE HOLDER WHEN REQUIRED BY WRITTEN CONTRACT. <br />RE: 7042 LANPHIER HIGH SCHOOL -ADDITIONS L RENOVATIONS -1300 N. 117H ST., SPRINGFIELD, IL 62702 <br />RE: 7042 LANPHIER HIGH SCHOOL.ADDITIONS L RENOVATIONS -1300 N. 11TH ST, SPRINGFIELD, IL 62702 <br />Green De-11don Contract— Inc (2466) le Included as o nomad Insured through endoreamenl. <br />Workan Compensellen coaaregs Is provided to—playsse leased to Green Demolltlen Contnctora Inc through Rasoureing Edge 1, LLC <br />SAMPLE <br />HAROLD O'SHEA BUILDERS, INC. <br />GENERAL CONTRACTOR <br />3401 CONSTITUTION DR. <br />SPRINGFIELD, IL 62711 <br />1 IUIN <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />REPRESENTATIVE <br />®1988-2016 ACORD CORPORATION. All riahtn raservnrl <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />