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���►���' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) <br />10/05/2022 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION <br />Mark Mackey Ins Agcy ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />3338 W Foster HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Chicago, IL 60625 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURED <br />GREEN DEMOLITION CONTRACTORS INC <br />4840 South St. Louis Avenue <br />Suite 100 <br />Chicago, Il 60632 <br />INSURERS AFFORDING COVERAGE <br />INSURERA:State Farm Mutual Auto Insurance C <br />INSURER B: <br />INSURER C: <br />INSURER D: <br />INSURER E: <br />25P8 <br />NAIC # <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HER FIN IS RJR. IFrT Tn AI I THF TFRAAC FVr1 1IQInldc AKill rnLinrr n io — ­ <br />POLICIES. <br />AGGREGATE LIMITS SHOWN MAY <br />HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />A00% <br />POLICY EFFECTIVE POLICY EXPIRATION <br />LTR <br />INIVTD <br />TYPE OF INSURANCE <br />POLICY NUMBER DATE (MMID2M DATE MMIDD LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />i REIJfEO <br />LIABILITYLAIAGE <br />I -J OCCUR <br />j7.m'=GENERALL=r <br />P sQNA� a �spv Inuu YID <br />; <br />- <br />GENERAL AGGREGATE <br />- <br />GENLAGGREGATEUMITAPPLIESPER <br />PRODUCTS -COMP/OPAGG <br />S <br />PRO-"CJECT <br />POLICY E <br />- <br />A <br />X <br />AUTOMOBILELIABILITY <br />E615564 -B28-13 <br />AUG -31-22 <br />AUG -31-2.3 <br />COMBINED SINGLE LIMIT <br />S 5,000,000 <br />X ANY AUTO <br />(Ee accident) <br />X ALL OWNED AUTOS <br />BODILY INJURY <br />X SCHEDULED AUTOS <br />(Per person) <br />$ <br />X HIRED AUTOS <br />BODILY INJURY <br />$ <br />X NON -OWNED AUTOS <br />(Per accident) <br />PROPERTY DAMAGE <br />$ <br />(Per accident) <br />4, <br />E LIABILITY <br />AUTO ONLY - EA AGI QL; IST _ <br />. $ <br />ANY AUTO <br />OTHER THAN EA ACC <br />S <br />AUTO ONLY: <br />AGG <br />S <br />EXC4SSIUMBHELLA LIABILITY <br />OCCUR CLAIMS <br />EACH OCCURRENCE <br />_ <br />lJ MADE <br />AGGREGATE <br />DEDUCTIBLE <br />E <br />RETENTION $ <br />WORKERS COMPENSATION AND <br />WCY_1JMI- STATUOTH- <br />EMPLOYERS' LIABILfTY <br />T RT _ ER <br />ANY PROPRIETOR/PARTNERIEXECUTIVE <br />E L. EACH ACCIDENT <br />OFFICERIMEMBER EXCLUDED? <br />- -- <br />_ <br />If yes, describe under <br />E L DISEASE - EA.EMPWY <br />s <br />SPECIAL PROVISIONS helow <br />EL DISEASE - POUCY LIMIT <br />OTHER <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />RE:'/042 Lanphier high School -Additions and Renovations -1300 N 11th St, Springfield, IL 62702 <br />Additional Insured with respect to General LiabiliLy and Hired & Non Owned Auto Liability (Umbrella follow <br />form) on a Primary & Non -Contributory basis when required by written contract per TSO Forms CG 2010 10/01 <br />and CG 2037 10/01 for work performed by Green Demolition Contractors, Inc. A Waiver of. Subrogation in <br />favor of Additional_ Insureds with respect to General Liability an Hired & Non Owned Auto <br />LiabiliLy(Umbrella follows form) when required by written contract is included per ISO form CG 2404(05/09) <br />Harold O'Shea Builders, Inc AC)..eZ4 Public School District 186(Owner); and BLDD(Architect) <br />.. M I rrraanr a "WL"cr% UANL:tLL.A I IVN <br />HAROLD O' SHEA BUILDER'S INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />GENERAL CONTRACTOR DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 70 DAYS WRITTEN <br />3401 CONSTlTUTION DR NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />SPRINGN'LELD IL 62711 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR <br />REPRESENTATIVES. <br />ACORD 25 (2001NB) The registration notices indicate ownership of the marks 6y their respective owners OACORD CORPORATON 1988, 2007132849 03-13-2007 I <br />All rghts rosarvud <br />