Opening of Bids - Martin Luther King Jr. Center Demolition Proj No. 121-066 - Green Demolition Contractors, Inc.

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ATE (MMIDDIYYYY) Rte'° CERTIFICATE OF LIABILITY INSURANCE U10/05/2022 1U/OS/2022 PRODUCER THIS CERTfFICATE IS ISSUED AS MATTER OF INFORMATION Mark Mackey Ins Agcy ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3338 W Coster HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Chicago, IL 60625 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Li•••��• •J INSURERS AFFORDING COVERAGE NAIC # INSURED GREEN DEMOLITION CONTRACTORS INC INSURER A: State Farm Mutual Auto Insurance Camparly Company25178 INSURER B: 1 CLAIMS MADE ] OCCUR 4850 South St. Louis Avenue INSURERC: Suite 100 Chicago, Il 60632 INSURER D: INSURER E: COVERAGES 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 CONTRACT OR 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, AGGREGATE LIMITS SHOWN MAY HAVE BFFN RFDUCED BY PAID CLAIMS - LAIMS.INSR it inaAOD'L POLICYEFFECTIVE POLICYEXPIRATION LTR IINORDI TYPE OF INSURANCE POLICY NUMBER DATE MMIDD DATE MMIDD LIMITS GENERAL LIABILITY _C_OMM411CIAL GENERAL LIABILITY EACH OCCURRENCE D/UG OE TD REFIT p.!�E9-1 SFALEIU MED EXP (Any onRpMgr0,_ 1 CLAIMS MADE ] OCCUR PERSONAL B ADV INJU Y GENERAL AGGREGATE GENLAGGREGATEUMrrAPPU(ESPER PR PRODUCTS -COMPIOPAGG S POLICY I LOC A X AUTO MOBILE LIABILITY X ANY AUTO E615564 -B28-13 AUG -31-2.2 AUG -31-23 COMBINED SINGLE LIMIT (Ea accident) $ 5,000, 000 X_ ALL OWNED AUTOS X SCHEDULED AUTOS BODILY INJURY (Per person) $ X HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY A 7 l -F OTHER THAN EA ACC S ANY AUTO AUTO ONLY: AGI; S EXCESSAIMSRELLA LIABILITY EACH OCCURRENCE $ AG TE OCCUR Lij CLAIMS MADE DEDUCTIBLE 3 fi TENTION i WORKERS COMPENSATION AND EMPLOYERS'LIABILITY WC STATU- OTH- TORY LIMIT ER _� ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? E L EACH ACCIDENT _E If yes, describe under - L DISEASE - FA F1vIPLDY S SPECIAL PROVISIONS bBlow EL DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS I LOCATIONS) VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS RE:7042 Lanphier High School -Additions and Renovations -1300 N 11th St, Springfield, 1L 62702 Additional Insured with respect to General Liability and Hired & Non Owned Auto Liability(Umbrella follow form) on a Primary & Non -Contributory basis when required by written contract per TSO Forms CG 2010 10/01 and CG 2037 10/01 for work performed by Green Demolition Contractors, Inc. A Waiver of. Subrogation in favor of Additional Insureds with respect to General Liability an Hired & Non Owned Auto Liability(Umbrella follows form) when required by written contract is included per ISO form CG 2404(05/09) Harold O'$hea Builders, Inc C). Lp"]Z,�eW Public School District 186(Owner); and BLDD(Archi.tect) urm I smCA I E HOLDER ms /A J xn 1-' 1 - H_ CANCELLATION HAROLD O'SHEA BUILDER'S INC GENERAL CONTRACTOR 3401 CONSTITUTION DR SPRINGFLELD IL 62711 rhe registration notices indicate ownership SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 90 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. the marks by their respeclive owners @ACORD CORPORATION 1988, 2007 All rights roserved