Laserfiche WebLink
.gC4��za® CERTIFICATE OF LIABILITY INSURANCE <br />GATE (NN/aU/yYYYI <br />DTr15raD1s <br />THIS CERTIFICATE 19 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 INSURERS), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the carfifiCate holder is an ADDITIONAL INSURED, the poPey(les) must he endorsed. if SUBROGATION IS WAIVED, SU4)ect to <br />the terms and Conditions of the policy, Certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder to lieu of such endorsemant(s). <br />PRODUCER <br />ALVIN G DEMPSEY INSURANCE AGENCY INC. <br />$fdtffOfRf 1110 119TH ST- <br />WHITING, IN. 46394 <br />CONTAGTLUCY SCHUSTER LSA5 <br />ry ME: <br />PtiNDo"ryE 219-650-2111 ac NO: :219-659.7139 <br />E DDREss: <br />INSURER($)AFFORCINO COVWAGE <br />NAM <br />KSURERA:State Farm Fire Bntl Casualty Company <br />261a1 <br />INSURED PATH INC <br />5997 CARLSON AVE <br />SUITE. A <br />PORTAGE, IN-40368 <br />INSURERBI <br />MISUREIC: <br />INSURER D: <br />NKIIRER E: <br />NallER F: <br />""'F-CATC NUMBRG• KCVis0.rn Nvmoua <br />MV v�n�iVw vu� .. .�...�.-...•.��... <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 CONOMON 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 HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />TNIRR <br />LTR <br />TYPEOPINSURANCE <br />INXID <br />ma <br />POUCYNUMBER <br />PDu P <br />jMMMDA1TYI <br />POLICY Wr <br />rmmmpNyrn <br />1011212016 <br />LIMITS <br />A <br />X <br />COMMERCIALOENRRALLIABILITY <br />CLAIMS -MADE OCCUR <br />Y <br />94-FG-3230-4 <br />191212015 <br />EACN OCCURRENCE <br />& 1.DD0,066 <br />PREMISES Pauurtera]el <br />s <br />MED EXP (A W Wa p n) <br />$ 5.000 <br />PERSDNALGADVINJURY <br />$ <br />GEN'L <br />AUTOMOBILE <br />AGGREGATE UM)TAPP�UEjS PER. <br />POLICY❑ jEOT F J LOC <br />OTHER <br />LIABILITY <br />ANYATO <br />SCHEDULEDBODILY <br />S MTOS <br />NON -OWNED AUTOS <br />GENERAL AGGREGATE <br />$ Z,000,060 <br />PRODUCTS-COMPIOPAGG <br />$ <br />DaawG SINGLE MIT <br />S <br />$ <br />BODILY INJURY (Per pemn) <br />S <br />INJURY(Par �Md ) <br />S <br />S <br />B <br />R <br />OCCUR <br />CLAIMS -MACE <br />NIA <br />94•GE-U869-D <br />11f0212018 <br />11f0212016 <br />EACH OCCURRENCE <br />AGGREGATENTION <br />_ <br />E R <br />$ <br />MN)RKERSCOMPENSATION <br />ANO EMPLOYERS UANUTY <br />ANY PROPRIETORiPARTNERIEXECUTVE Y❑ <br />OFFIOERINEMBER EXCLUDEOI <br />(Mmdatary's, NN) <br />Ryes'�6 under <br />OESCRIPTION U. OPERATIONS below <br />__LER <br />EL EACHACCIDENT <br />$ 100,090 <br />E.L. DISEASE - EA EMPLOY <br />$ 1DO.1100 <br />$ 600,000 <br />E.L. DISEASE -.POLICY LIMIT <br />DESCRIPTION OPOPERKDONS/ LOCATONS I VEHICLES (LOORD 101, AMNan'A R*MA!4e9eRedulq May be attached Rmom space Is regwmd) <br />ADDL, INSURED: CITY OF SOUTH BENO, 227 WEST JEFFERSON, SOUTH BEND, IN. 46501 <br />HOLDER <br />CITY OF SOUTH BEND <br />227 WEST JEFFERSON <br />SOUTH BEND ,INDIANA 46601 <br />ACORD 25 (201IN01) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS- <br />AUTHORIZED REPRESENTATIVE <br />0 1988-2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and toga are registered Marks of ACORD 1001486 132849.9 02-04-201 <br />TIII-1G-PL11C 1P-AZ C..,.„.- Tn-POTI-I_M[ PP Pam., Pine -thrill P-47X <br />