Licenses & Permits Block Party-Non-Residential Sunnyside Presbyterian Church S. Frances St. from Washington St. to Jefferson Blvd.

Home Browse Search

A� of CERTIFICATE OF LIABILITY INSURANCE BAN IAAMADD ) THIS CERTIFICATE 1S 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 lo,tr*. certificate holder In lieu of such endorsement(s). PRODUCER NAME: Susan Thompson Leven Insurance Agency Inc. 2628 S. MICHIGAN STREET PHONE (574)291-5510 FAC .(579)291-0505 OnK .suet@laveninsurance. am INSURE AFFORDING COVERAGE NAICM P. O. BOX 2379 msURERAAmeri.cen States Insurance CO. 19704 SOUTH HIM IN 46680 INSURED INSURER B Sunnpsida Presbyterian Church Corp. NSIIRERC: 115 N, Fiances Street INSURER D: NSURER E: South Bend IN 46617 INSURERF: COVERAGES CERTIFICATE NUMBER:16/17 Master REVISION 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 CF 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 MAYHAVE SEEN REDUCED BY PAID CLAIMS. ILSR 'rypE OF INSURANCEAM] SUBM OLICYNUMBER PODCV EFF MWD POLICY UP MMID LIMITS ATIED MERCUILGENERALLIABNTY WMSMADE OOCCUR To 02CESBd17090 1/1/2016 1/1/2017 EACH OCCURRENCE Is 1, 000, ODO 1 Es�A 1@O9fr $ 1,000,000 GEN'LAGGREGATE X MED UP (Any one paten) s 10,000 PERSONAL&ADVINJURY $ 1,000,000 LIMIT APPLIES PER: POUCY0JEd OLOG OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OP AGO $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL AAU OS ED SCHEDULEDAUTOS IAJOOTN� E HIREDAUTOS M 02CUS417090 1/1/2016 1/1/2017 COMBINED SINGLE UM aurdanD $ 1,000,000 BOOILY INJURY(PMpeavn) If BODILY INJURY (Par accident) $ X R01 DAMAGE $ A X UMBRELLA DAB X EXCESS.LIAB OCCUR I CWMS.MADE 01SU39987390 1/1/2016 1/1/2017 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DEO I X I RETENTIONS 01 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILIry YINTUN OFFIC ddEANY IMBERWEXCLNEEDE7ECU� EN (Mandatory In NH) I(ppes. dIPTION OF O DESCRIPTION OF OPERATINS bebw 02RC587069-20 1/1/2016 1/1/2017 X PER - I EL. EACH ACCIDENT $ 500,000 E.L. DISEASE -EA EMPLOYE[ $ 500 00o EL. DISEASE -POLICY LIMIT $ 500 000 DESCRIPTION OF OPERATIONS l LOCATIONS] VEHICLES (ACORD 101. Addltlemal Remarks Schedule, may be atached If mWe space Is required), SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of South Bend THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN South Bend, IN 46601 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOWED REPRESENTATIVE Susan Thompson/SMT I. ®1988;2014ACORD CORPORATION. All rights reserVot ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS026rm14O11