Procession - Bike Michiana Coalition

Home Browse Search

® CERTIFICATE OF LIABILITY INSURANCE DATEt1/20YYY) 17 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(les) must he 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 endorsement(s). PRODUCER McKay Insurance Agency, Inc. CONNAME: ACT Lacia Lambert PHONo E.O. (641)842 2135,_ ._lacJAM-M�ot6A1)mB zaL3 106 1':asL- Main Street nonnE-MAIL llambert@mckayinsagency.com 6ss P O Box 151 IIIS JFtl ELAFFORDING COVERAGE NAIC II _— INSURERn West Bend Mutual 15350 Knoxville IA 50138 INSURED INSURER 0: INSURER C: Bike Michiana Coalition, Inc INSURER D: PO BOX 11699 E: _INSURER __ INSURER F: South Bend IN 46634 COVERAGES CERTIFICATE NUMBER:CL1722149761 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 OF ANY CONTRACT OR OTHER DOCUMENT WTI I 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. ffs—ILIR TYPE OF INSURANCE DnLS kn D POLICY NUMBER POLIC/YErr POLppY YXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE r—xl OCCUR X 1071306 6/17/2016 6/17/2017 EACH OCCURRENCE $ 1,000,000 o,�IliwA�i 5�'b-RETNT.D PREMISES IF. occurrence)_ $ 100,000 GENL X MED EXP (Any oneperson) S PERSONAL S ADV INJURY S 1,000,000 AGGREGATE LIMIT APPLIES PER POLICY n PRO- I I JECT LOC OTHER: GENERAL AGGREGATE S 2,000,000 PRODUCTS - COMP/OP AGO $ 2.000,000 Pwn.dy dam.q...igh, hred $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED _ HIRED AUTOS AUTOS COMBINED SINiTLE LIMIT Ea auldant S BODILY INJURY (Per person) S BODILY INJURY(Perwelenl) S PROPERTY DAMAGE Per eccNenq $ $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS MADE EACH OCCURRENCE S._ AGGREGATE S DED RETENTIONS S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNEMEXECUTIVE YIN OFFICEFUMEMBER EXCWDED7 IMandolory In NH) I t yes, desvibs under DESCRIPTION OF OPERATIONS below NIA SC i TE ER E.L. EA CH ACCIDENT $ - E.L. DISEASE - EA EMPLOYEE E.L. DISEASE -POLICY LIMIT S $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD fat, Addi tonal Remarks Schedule, remy be attached Irmero.Paco Ie raqulred) For the Mayor's One Day Bike Ride, May 7, 2017. Certificate holder has been added as an Additional Insured but only in regard to the liability arising out of the operations of the above named insured. City of South Bend 227 W. Jefferson Blvd South Bend, IN 46601 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Hurst/KELLEN t �cz...- ). - .:: sJ- ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) INS025 po mot) The ACORD name and logo are registered (narks of ACORD