Opening of Quotations - Alley Drywall Install (Near St Vincent and Notre Dame Ave) Proj No 117-101 - HRP Construction Inc.

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acoR®® CERTIFICATE OF LIABILITY INSURANCE DATE[MMIDDfYYYY) 8/28/2017 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 CONTACT Ellie Lloyd NAME: Y Gibson Insurance Agency, Inc. [AlCDNN ,EKt• (800)814-2122 FAX arc No:(aOo)836-212z„ ... ... 130 S Main St, Ste 400 £-MAILADDRESS;elloyd@gibsonins.com PO Box 11177 -.. __--...., ._.. _.... INSURER(S) AFFORDING COVERAGE NAIC # South Bend IN 46601-0177 INSURFRAAmerisure Mut Ins Co 23396 INSURED INSURER B HRP Construction Inc. INSURERC: 5777 Cleveland Rd _ INSURER D : PO Box 266 INSU_RERE: _ South Bend IN 46624-0266 1 INSURER F: -- -- _— rnVFRAnFS r.FRTIFIr:ATFNiIMRFR,9-1-17/18 Liabilitv RFVISIr1NNIIMRI=R- 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. ILTR ADS L $-fTDD .....� PODGY Ni1MBER��.__ ,..-_-.....,-._......_... TYPE OF INSURANCE OLICY EFF POLICY EXP LIMITS MIDDIYYYY MMIDDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A _ CLAIMS -MADE lil OCCUR DAMAGE TO RENTED PREMISES occurrence $ �1 000 D00 • MED EXP (Any one person) $ 10 , 000 XCG CPP20316441202 9/1/2017 9/1/2018 PERSONAL& ADV INJURY $ 1,000,000 X Contractual Liability AGGREGATE €.IM)T APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GEN'L PRO- POLICY X JECT LOC I PRODUCTS - COMPIOPAGG ....._.`- $ 2,000,000 _- -- 5 OTHER, I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea apgden! $ 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS CA20316451202 9/1/2017 9/1/2018 BODILY INJURY (Per accident) $ X NON -OWNED HIRED AUTOS X AUTOS PROPERTY DAMAGE ,[i'er_accidenli_ $ $ X UMBRELLA LIg6 X OCCUR EACH OCCURRENCE $ 10000 000 $ 10 Opp 000 A EXCESS LIAB CLAIMS -MADE DED I X I RETENTION 0 _AGGREGATE $ CU20316431102 9/1/2017 9/1/2018 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN I X PER pTH- STATUTE ER E.L. EACH ACCIDENT .--.,.,_._,_.,..._.,__......-..__.._.,.____ E.L. DISEASE - EA EMPLOYE __.._.._ $ 1,000,000 _..� $ 1 000, 000 A ANY PROPRIETORIPARTNERIEXECUTlVE OFFICERIMEMBER EXCLUDED? n {Mandatory in NHI NIA WC20316421102 I 9/1/2017 9/1/2018 If yes, deswba under DESCRIPTION OF OPERATIONS below States of IN E MI E.L. DISEASE - POLICY LIMIT $ 1 000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached it more space is required) Certificate holder is additional insured with respect to general liability coverages regarding work performed by the insured. CFRTIFICATF Hrll_DFR CANCFI I ATinm (574)235-9171 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of South Bend THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Board of Public Works ACCORDANCE WITH THE POLICY PROVISIONS. 1316 County --City Building AUTHORIZED REPRESENTATIVE 227 West Jefferson South Bend, IN 46601 G Ins Agency/ELLIE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 19014011