Award Quotation - Leighton Plaza Improvements Phase 2 - Project No. 117-054

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t:llPnt#- 11962fi C&SMASON ACORD.. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 1 5123/20/7 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 endorsement(s). PRODUCER ON] Risk Partners, Inc. P.O. Box 1705 Fort Wayne, IN 46801-1705 CONTACT Connie J. Messer NAME: PRONE 574-314-9190 FAx 866-893-4638 A(C No Ext : AfG, No): EMAIL ADDRESS: INSURER($) AFFORDING COVERAGE NAIC # 260 625-7500 ' INSURER A ; Cincinnati Insurance Co. 10677 INSURED C&S Masonry Restoration, LLC 3725 N. Foundation Ct., Ste. AB South Bend, IN 46628 INSURER 8 : INSURER C : INSURER D ; ENSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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. _ INSRTYPE LTR OF INSURANCE - ADDL INSR SUBR WVO POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP IY MMIDDYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE N OCCUR X PD Ded:500 X EPPEBA0392274 0312712017 03/27/2018 EACC�HH $1,000,000 qOCyCURRENCE �RFMI55 EaEoNocTu ence $ 5DD DOD MED EXP (Any one person) $10,000 PERSONAL &ADV INJURY $1 000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC JEGT PRODUCTS -COMPIOPAGG $2,000,000 $ A AUTOMOBILE LIABILITY X ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS EPPEBA0392274 3/2712017 03/27/201 Faaccld.rtSINGLE L1MIT 1,000,000 BODILY INJURY (Par person) $ BODILY INJURY (Par accident) $ PROPERTY DAMAGE $ $ A X UMBRELLA LIAR EXCESS LIAR Iq OCCUR CLAIMS -MADE EPPEBA0392274 0312712017 03/2712018 EACH OCCURRENCE $5 D0D 000 AGGREGATE s5 ODD 000 DED I X I RETENTION $0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUI Y f N OFFICEWMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A EWC037936201 3127I2017 031271201 X WC STABKJTU-I'S OTH- F.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - FA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) City of South Bend is additional insured to the general liability as pertains to, Job# 117-054 Leighton Plaza. City of South Bend 1316 County City Building 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. AUTHORIZED REPRESENTATIVE MA ACORD 25 (2010/05) 1 of 1 #S14615581M1432377 O 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD FCMES