cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25...

89

Transcript of cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25...

Page 1: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 2: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 3: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 4: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 5: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 6: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 7: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 8: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 9: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 10: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 11: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 12: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 13: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 14: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 15: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 16: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 17: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 18: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 19: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 20: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 21: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 22: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 23: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 24: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 25: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 26: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 27: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 28: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 29: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 30: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 31: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 32: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 33: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 34: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 35: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 36: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 37: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 38: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 39: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 40: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 41: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 42: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 43: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 44: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 45: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 46: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 47: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 48: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 49: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 50: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 51: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 52: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 53: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 54: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 55: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 56: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 57: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 58: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 59: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 60: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 61: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 62: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 63: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 64: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 65: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 66: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 67: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 68: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 69: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 70: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 71: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 72: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 73: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 74: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 75: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 76: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 77: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 78: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 79: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 80: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 81: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 82: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 83: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 84: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 85: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 86: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 87: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be
Page 88: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be

Navigators Specialty Insurance Company 36056-001

Hartford Underwriters Insurance Company 30104-001

Liberty Mutual Fire Insurance Company 23035-002

877-945-7378 [email protected]

Willis of Illinois, Inc.c/o 26 Century Blvd.P. O. Box 305191Nashville, TN 37230-5191

600 W. Van Buren, Suite 500Chicago, IL 60607

X

X

Professional &X

Pollution LiabilityX

X

1,000,000

300,000

10,000

1,000,000

2,000,000

2,000,000

A CH13NP4030263NC 7/31/2013 7/31/2014

X X$500. CompDed.X $500. Coll

Ded.

1,000,000

X

B 83UECVO6154 7/31/2013 7/31/2014

X

X 5,000,000

5,000,000

A CH13NP4030263NC 7/31/2013 7/31/2014

X

1,000,000

1,000,000

1,000,000

C WC2-Z91-457459-013 7/31/2013 7/31/2014

Re: Contract Award, Contract #11420

The Professional and Pollution Liability Coverages covered on Navigators policy are also coveredunder the Excess policy.

Chicago Housing Authority is included as an Additional Insured as respects to General Liabilityand Auto Liability, where required by contract

Carnow, Conibear & Associates, Ltd.

04/07/2014Page 1 of 2

Y

Y

21480353

Chicago, IL 6060560 E. Van Buren, 13th FloorChicago Housing Authority

Coll:4382990 Tpl:1684239 Cert:21480353

DATE (MM/DD/YYYY)

PRODUCER

INSURED

INSR ADD’L SUBR POLICY EFF POLICY EXPTYPE OF INSURANCE POLICY NUMBER LIMITSLTR INSRD WVD (MM/DD/YYYY) (MM/DD/YYYY)

GENERAL LIABILITY

AUTOMOBILE LIABILITY

UMBRELLA LIAB

EXCESS LIAB

WORKERS COMPENSATIONAND EMPLOYERS’ LIABILITY Y / N

N / A

(Mandatory in NH)

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach Acord 101, Additonal Remarks Schedule, if more space is required)

AUTHORIZED REPRESENTATIVE

CONTACTNAME:PHONE FAX(A/C, NO, EXT): (A/C, NO):E−MAILADDRESS:

INSURER(S)AFFORDING COVERAGE NAIC #

INSURER A:

INSURER B:

INSURER C:

INSURER D:

INSURER E:

INSURER F:

EACH OCCURRENCEDAMAGE TO RENTED

$

COMMERCIAL GENERAL LIABILITY $PREMISES (Ea occurence)

CLAIMS−MADE OCCUR MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GENERAL AGGREGATE $

GEN’L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $PRO-

POLICY LOCJECT $COMBINED SINGLE LIMIT

$(Ea accident)

ANY AUTO

ALL OWNEDAUTOS

BODILY INJURY(Per person) $

SCHEDULEDAUTOS

HIRED AUTOS

BODILY INJURY(Per accident) $

NON-OWNEDAUTOS

PROPERTY DAMAGE$(Per accident)

$

EACH OCCURRENCEOCCUR

CLAIMS−MADE AGGREGATE

$

$

DED $RETENTION $WC STATU- OTH-

TORY LIMITS ER

E.L. EACH ACCIDENT $ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED?

If yes, describe underDESCRIPTION OF OPERATIONS below

E.L. DISEASE - EA EMPLOYEE $

E.L. DISEASE - POLICY LIMIT $

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE 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.

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS.

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. 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 tothe terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to thecertificate holder in lieu of such endorsement(s).

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

CERTIFICATE HOLDER CANCELLATION

ACORD 25 (2010/05)© 1988−2010 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

CERTIFICATE OF LIABILITY INSURANCE

jmaul
Approved
Page 89: cha-assets.s3.us-east-2.amazonaws.com · 600 W. Van Buren, Suite 500 Chicago, IL 60607 25 CERTIFICATE OF LIABILITY INSURANCE General Liability and Auto Liability policies shall be

ADDITIONAL REMARKS SCHEDULE

AGENCY CUSTOMER ID:

LOC#:

ADDITIONAL REMARKS

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,FORM NUMBER: FORM TITLE:

ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD

AGENCY NAMED INSURED

POLICY NUMBER

CARRIER NAIC CODE

EFFECTIVE DATE:

125916

Page 2 of 2

Willis of Illinois, Inc.

See First Page

See First Page See First Page

Carnow, Conibear & Associates, Ltd.600 W. Van Buren, Suite 500Chicago, IL 60607

25 CERTIFICATE OF LIABILITY INSURANCE

General Liability and Auto Liability policies shall be Primary and Non-contributory with any other insurance in force for or which may be purchased by Additional Insured.

Umbrella follows form of the General Liability coverage.

Coll:4382990 Tpl:1684239 Cert:21480353