PSA - Epoch Architecture + Planning - Fire Station No. 9 Design

Home Browse Search

EPOCH-1 OP ID: CH AC�RQ CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIY) YYY07/1012017 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 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 R.S. Miller r� Sons, Inc. P.O. Box 229 109 W. Plymouth Street Bremen, IN 46506 CONTACT Gregory S. Miller, CPCU,CIC Pu"co"N ex1:574-546-3341 Arc No): 674-546-2687 EMAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC N Gregory S. Miller, CPCU,CIC' INSURERA:Liberty Mutual Insurance Co. 24082 INSURED EpochArchitecture+Planning LLC Kyle Copelin 300 W. Jefferson Blvd. INSURER B: Liberty International Underwrl 24082 INSURERC:Pekin Insurance Company 24228 INSURERD: South Bend, IN 46601 INSURER 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 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. INSR LTR TYPE OF INSURANCEAODLSUBR INSD D POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM1DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE T OCCUR BZS 57342600 06/27/2017 06/2712018 PREMISES Eaoccurrence $ 1,000,000 MEO EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY $ INCLUDED GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑ JER° LOC PRODUCTS-COMPIOPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Perperson) $ A ANY AUTO BZS57342600 06/27/2017 06/2712018 ALL OWNED SCHEDULED AUTOS AUTOS J BODILY INJURY (Per accident) $ X NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRiETORIPARTNERJEXECUTIVE YINN OPFICERIMEMBER EXCLUDED? (Mandatory In NH) 1 A CODD4690C 02/06/2017 02/06/2018 PER OTH- STATUTE X ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEq $ 500,000 If yes. describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I $ 500,000 B Professional Liabi 05312016 06/10/2017 06/10/2018 Ea Claim 1,000,000 $5,000 Ded Ann Aggr 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 1111, Additional Remarks Schedule, may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION CITYSBI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of South Bend ACCORDANCE WITH THE POLICY PROVISIONS. 227 W. Jefferson AUTHORIZED REPRESENTATIVE South Bead, IN 46634 Gregory S. Miller, CPCU,CIC ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD