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08-23-'16 07:36 FROM- 5742396407 T-550 P0003/0006 F-042 <br />"�,;;.` " CERTIFICATE OF LIABILITY INSURANCE DATE (MMIODYYW) <br />7/22/2016 <br />THIS CERTIFICATE IS 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 INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: It the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. It SUBROGATION IS WAIVED, subject 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 />PRODUCER <br />Waldorf Risk Solutions, LLC <br />PO Box 590 <br />Huntington NY 11743 <br />INSURED <br />Church World Service Inc. <br />Business Manager <br />28606 Phillips St, PO Box 968 <br />Elkhart IN 46515 <br />COVERAGES <br />71, <br />rtev lorvry NumneK: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME, ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION 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 />LTA <br />TYPE OF INSURANCE <br />INRn <br />wyn <br />POLICY NUMBER <br />POLICY Epp <br />MMIDWYYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />16W1777 <br />4/7/2016 <br />4,711017 <br />EACH OCCURRENCE <br />61000,000 <br />="t0—RE <br />PREMISES Ea Ocwrmnce <br />$ <br />CLAIMS -MADE X OCCUR <br />MEDEXP An one rson) <br />$ <br />PERSONAL &ADV INJURY <br />IS <br />GEN'L <br />X <br />AGGREGATE LIMIT APPLIES PER; <br />PRO- <br />POLICY❑JECTPRO- ❑ <br />LOC <br />OENERAL AGGREGATE <br />82000.000 <br />PRODUCT S-COMPtOPAG0 <br />$ <br />OTHER: <br />5 <br />AUTOMOBILE <br />LIABILITY <br />ANYAUTO <br />ALLONMED so ULED <br />AUTOS q�T <br />I IN LI I <br />EA a Gdent) <br />$ <br />SOOILY INJURY (Per person) <br />$ <br />BODILY INJURY tPeraccid,M) <br />$ <br />HIREOAUTOS AUTOS EO <br />DAMAGE <br />Peraccidant <br />$ <br />3 <br />UMBRELLA LIAR <br />EXCESS LIAR <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />DED RETENTIONS <br />WORKER5 COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICERNEMBER EXCLUDED? <br />NMI <br />(Myandel*dA ander <br />OESORIP7ON OF OPERATIONS below <br />PER OTH. <br />$ <br />MIA <br />E.L. EACH ACCIOENT <br />5 <br />E.L. DISEASE - EA EMPLOYE <br />S <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATrONS I LOCATIONS 'VEHICLES (ACORD 101. Additional Remarks Sshedt le, may be aaached Ir more epaae I$ required) <br />Coverage certified above extends to include the Certificate Holder as Additional Insured but only with respect to liability arising out of the <br />CROP Walk, <br />St Joseph County - 9/25/2016. Also additionally insured South Bend Parks and Recreation; Board of Park Commissioners South Bend, IN <br />46614, The City of South Bend insured with the South Bend Parks and Recreation and the Board of Park Commissioners. <br />City of South Bend <br />227 West Jefferson Ave <br />South Send IN 44601 <br />aHOULD 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 />A//UTHORIZED REPRESENTATIVE <br />a �y <br />81988-2014 ACORD CORPORATION. All rights rosemed. <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />