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CERTIFICATE OF LIABILITY INSURANCE 13/1/2017 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CETIFICATE DOES NOT I BELAFFIRMATIVELY <br />OW. THIS CERT FIICATEOF IIN URNEGATIVELY <br />AGE <br />ANCE DOES NOT CO CONSTITUTE UTE AEXTEND ALTER CONTTRACTBETW EN OTHER ISSUING AFFORDED NSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER <br />rIMP <br />ORTANT: If the certniicate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed If 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 />nRHificate holder in lieu of such endorsement(s). <br />PRODUCER Nc:� <br />PHONE AX 574)232-2991 <br />ROCKSTROH INSURANCE AGENCY INC wcNGEMY(574)233-5136 AJC. <br />333 N Lafayette Blvd ADD"DRESSrockagcy3@outlook.com <br />South Bend, IN 46601-1208 INSURERIS) AFFORDING COVERAGE NAIL° <br />INSURERA Auto -Owners Insurance <br />INSURED South Bend Cinco LLC INSURER B- <br />DBA Cinco INSURER C. <br />709 S. Carlisle St. INSURER <br />South Bend, IN 46619 NSURER E: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE <br />FOR THE POLIUY VtKluu <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 />AOOL SUOR OL CY E F POL Y P LIMITS <br />INER TYPE OF INSURANCE INS VNO POLICY NUMBER MM/DDM'YY IMMIDDIYYYY <br />LT. <br />EACH OCCURRENCE S 1 000,000 <br />A COMMERCIAL GENERAL LIABILITY <br />PREMISES (Es ) $ 50,000 <br />CLAIMS -MADE X OCCUR <br />10/16/2016 10/16/2017 MEOEXPIAnY oneperson) 5 5,000 <br />09150919 PERSONAL&ADVINJURY S 1,000,000 <br />GENERAL AGGREGATE s 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: 2 OOO OOO <br />PRO- LOC PRODUCTS- COMPIOP AGG $ r r <br />A POLICY JECT S <br />OTHER: (Eaccident- <br />BODILY I 5 <br />AUTOMOBILE LIABILITY(Ea <br />INJURY (Per person) 5 <br />ANYAUTO _ <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />NON -OWNED <br />HIRED AUTOS AUTOS <br />UMBRELLA LIAR OCCUR <br />EXCESS LIAB CLAIMS -MADE <br />BODILY INJURY(Peraccdenn S <br />PR ER D GE S <br />(Per accident) <br />S <br />EACH OCCURRENCE S <br />Ar:r:GFr:ATF 5 <br />AND EMPLOYERS' LIABILITY Y/N E.L EACH ACCIDENT $ <br />MY PRCPRIETORPARTNER:EXECUTIVE NIA OFFICERIMEMBER EXCLUDED' E L. DISEASE - EA EMPLOYEES <br />(Mandatory In NH) <br />if yes describe antler E.L. DISEASE -POLICY LIMIT S <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101 Additional Remarks Schedule. may be attac^edY more space Is reDlIrecl <br />Additional Insured -City of South Bend <br />CERTIFICATE HOLDER GANctLLHllUly <br />Board Of Public Works SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN <br />1316 County -City Building ACCORDANCE WITH THE POLICY PROVISIONS. <br />227 W. Jefferson Boulevard <br />South Bend, Indiana 46601 AUTHORIZED REPRESENTATIVE <br />C 1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD25(2014/01) The ACORD name and logo are registered marks of ACORD <br />