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310178 A� R� CERTIFICATE OF LIABILITY INSURANCE oA6/15/2016YY) 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 endomement(s). PRODUCER Commercial Lines - (404) 923-3700 Wells Fargo Insurance Services USA, Inc. 3475 Piedmont Road NE, Suite 800 CONTACT Kimberlee Kolli NAME:PHONE 404-923-3532 FAX 877-362-9069 I4&C Ho EMI' AlAIC� _ _ E-MAIL kimberlee.m.kolli@welisfargo.com ADDRESS: o.com @ g Atlanta, GA 30305-2886 INSURER(S)AFFORDING COVERAGE NAIC W INSURER A: LM Insurance Corporation 33600 INSURED Kite Realty Group Trust INSURER B: Allied World Assurance Go (US) 19489 30 S. Meridian St., Ste, 1100 NBURER C INSURER 0: INSURER E : Indianapolis IN 46204 1INSURER F: COVERAGES CERTIFICATE NUMBER: 10580924 REVISION NUMBER' S b I ee eow 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, INPOLICY TRR TYPE OF INSURANCE DL SUB POLICY NUMBER EFF MMIDOIYYYY POLICY EXIP MMIDDYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY TB5Z91453740076 3/01/2016 3/01/2017 EACH OCCURRENCE Is 1,00g000 CLAIMS -MADE 1XI OCCUR DAMAGETO PREMISES Ea occurrence 8 300.000 No Deductible/Retention MED EXP (Any one person) g Excluded — Applies t0 GL PERSONAL &ADV INJURY _ $ 1,000,000 G ENLAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- JECT I ^ I LOC PRODUCTS-COMP/OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY AS5Z91453740066 03/01/2016 3/01/2017 COMBINED SINGLE LIMIT a ccident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO No deductible ALL OWNED SCHEDULED AUTOS AUTOS on Auto Liability BODILY INJURY (Per accident) $ HIRED AUTOS X NON MED AUTOS X PROPERTY DAMAGE Peraccident $ $ B X UMBRELLA Lb1B X OCCUR 0308-8008 3/01/2016 3/01/2017 EACH OCCURRENCE $ 25,000,000 AGGREGATE $ 25,000,000 EXCESS LIAB CLAIMS -MADE DED X I RETENTION$ 5,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC5Z91453740086 3/01/2016 3/01/2017 H _ X STATUTE aTR YIN ANY PROPRIETORIPARTNERIEXECUTIVE E.LEACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N� N/A E. L. DISEASE-EAEMPLOVE $ 1,000,wo (Mandatory in NH) If yes describe under E.L. DISEASE -POLICY LIMIT s 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Board of Public Works SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1316 County -City Building THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 227 West Jefferson Boulevard South Bend, IN 46601 AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD © 1988-2014 ACORD CORPORATION_ All rinhts rPsarv,n, ACORD 25 (2014/01) Pre ceN ona 1c11—x repiIcaNx 102031. 1—.d.1 WO16)