Opening of Bids - Fellows Booster Pump Station Improvements - Contract A Proj No. 121-070A - EFI-Solutions Inc.

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�`� CERTIFICATE OF LIABILITY INSURANCE DAT/29/2D/YYYY) 11/29/2023 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(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 CONTACT SRM GROUP, LLC NAME: DBA STRATEGIC RISK MANAGEMENT AIc° No Ext: FAX No: E-MAIL P O BOX 445 ADDRESS: Belleville IL 62220 INSURERS AFFORDING COVERAGE NAIC # INSURERA: TRAVELERS INDEMNITY CO. INSURED ENGINEERED FLUID, INC. INSURERB: TRAVELERS INDEMNITY CO. INSURERC: TRAVELER'S PROPERTY CASUALTY COMPAIt DBA EFI-SOLUTIONS, INC. INSURER D : TRAVELERS INDEMNITY CO. 1221 N. ELM ST INSURERE: ILLINOIS UNION INSURANCE COMPANY Centralia IL 62801 INSURERF: TRAVELER'S PROPERTY CASUALTY COMPANY COVERAGES CERTIFICATE NUMBER: LIBERTY SURPLUS INSURAREVISION 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 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INS SUBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I —XI OCCUR Y-630-5X292933-TIA-23 12/1/2023 12/1/2024 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X I POLICY PRO JECT LOC $ B AUTOMOBILE LIABILITY ANY AUTO 810-5X252609-23-14-G 12/1/2023 12/1/2024 COMBINED SINGLE LIMIT Ea accident 1000 $ , ,000 X BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS X AUTOS C X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE CUP-5X294742-23-14 12/1 /2023 12/1 /2024 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED—F7 RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- D AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE UB-5X29224A-23-14-G 12/1/2023 12/1/2024 E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) NIA E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 E POLLUTION LIAB CPY G27169156 010 12/1/2023 12/1/2024 $1M/$1M G INSTALLATION FLTR QT-660-5X357905-TIL-23 12/1/2023 12/1/2024 $500,000 H PROFESSIONAL LIAB SAE5NAANB82012 04/25/2023 04/25/2024 $2M/$2M DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101. Additional Remarks Schedule, if more space is required) ***FOR BIDDING PURPOSES*** - PROOF OF INSURANCE CFRTIFICATF HOI nFR CANCELLATION ENGINEERED FLUID, INC. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 723 ACCORDANCE WITH THE POLICY PROVISIONS. Centralia IL 62801 AUTHORIZED REPRESENTATIVE 9)1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD