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EXHIBIT A.4 - LEHMAN & LEHMAN, INC.
<br />®®® CERTIFICATE OF LIABILITY INSURANCE DATF l0/2/2017YI
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 />cert[ficate holder In lieu of such endorsements).
<br />PRODUCER NAME: T Jessica Crews
<br />Walker & Associates AX
<br />PONE." {3}71353-8000 i,No): (317)351-7149
<br />7364 E. Washington Street ADDR1ESS:7essica@walkeragency.com
<br />Indianapolis IN 46219
<br />INSURED
<br />Lehman & Lehman Inc
<br />510 Linoolnway East Suite C
<br />INSURERIS) AFFORDING COVERAGE NAIC 0
<br />INSURERA:RLI Insurance CO.
<br />WSPRERe:Tra.valers Casualty And Surety Cc of 31194
<br />INSURER C : _
<br />INSURER D :
<br />INSURER E :
<br />IMi.shawaka IN 46544 IINSURERF,s
<br />r1r1VFRAr»PR f'PRTIPIr'.ATP KH IMRFP-CLI731509428 RFVICInM KHIM09:0'
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<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 />INSR. _ _.._--____.._ AobLSUBR _.. _ - - _ - BOLICYEFF ' POLICYFXP'
<br />LTR TYPEOFINSURANCE ppLICYNUMBER IDb Y MM b LIMITS
<br />X COMMERCIAL GENERAL LIABILITY - EACH OCCURRENCE $ 1,000,000
<br />DAMAGE TO RENTED pp0, 1
<br />A CLAIMS-MADEX OCCUR PREMISES tea occurrence) S rOOD
<br />1
<br />PSB0001470 4/3/2017 4/3/2016 MEDEXP(Any one person) $ 10,000
<br />,
<br />PERSONAL &ADV INJURY S 1,000,OD0
<br />GEN'LAGGREGATE LIMIT APPLIES PER: ' GENERAL AGGREGATE S 2,000,000
<br />:.... POLICY X JECT LOC _
<br />.... PRODUCTS-COMPlOpAGG S 2,000,000.
<br />OTHER: $
<br />AUTOM0131LELIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br />(ea accident) . .
<br />X 1 ANY AUTO BODILY INJURY (Perperson) $
<br />ALLOWNED SCHEDULED PSA0001237 4/3/2017 4/3/2018 BODILY INJURY (Per =Iden0 $
<br />AUTOS r—� OS
<br />NOWOOWNED PROPERTY DAMAGE
<br />HIRED AUTOS AUTOS (PeraWdenU $
<br />�8
<br />X UMBRELLA LIAR X OCCUR � ; EACH OCCURRENCE ; $ 3, 000, 000.
<br />A EXCESSUAB CLAIMS,MADE .AGGREGATE $. _ 3,,000.,000
<br />DED RETENTIONS PSIa0001313* 4/3/2017 4/3/2018 S
<br />`WORKERS COMPENSATION - X S ATUTE ER
<br />.AND EMPLOYERS' LIAatLtTY YIN - .
<br />ANY PROPRIEiORtPARTNERIEXECUTIVE - ) E.L. EACH ACCIDENT
<br />OFF10ERtMEMBEREXCLUDED? .N .NIA
<br />A ':(Mandatory in NH) P3w0001306 4/3/2017 4/3/2010 E,LDISEASE-EAEMPLOYEE$ 1,000,000
<br />If yyes tlescrihe umiar
<br />DES�RIPTION OF OPERATIONS etow E.L DISEASE -POLICY LIMIT ' $ 1,000,000
<br />* krofessional Liability 106266079 3/19/2017 3/19/2019 Per ClaimUmit $1,000,000
<br />(claims -made form] - Aggregate Limit $2,000,000
<br />DESCRIPTION OF OPERATIONS f LOCATIONS f VEHICLES (ACORD t Ot, Additional Remarks Schedule, may he attachad if more space Is required)
<br />General Liability, Automobile and Umbrella coverage shown above provides for additional insured when
<br />agreed by contract or agreement. General Liability, Automobile and Umbrella coverage is provided on a
<br />primary, non-contributory basis. General Liability, Automobile and Workers Compensation includes blanket
<br />waiver of subrogation. General liability does not exclude explosion, collapse or underground exposures.
<br />General Liability includes Contractual Liability per the terms of the policy.
<br />*Umbrella liability does NOT extend over professional liability.
<br />South Bend Venues Parks & Arts
<br />1020 High Street
<br />South Bend, IN 46601
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />AUTHOR12E0 REPRESENTATIVE
<br />Jessica Crews/JDC
<br />01988-2014 ACORD CORPORATION, All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />INS026 (201402)
<br />
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