Non Res Block Party - DTSB - Tree Lighting Ceremony and First Fridays

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AC" " CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 7/25/2017 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 1S 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 Stephen Swihart PHONE(800) 814-2122 AfC No; (800)836-2722 Gibson Insurance Agency, Inc. ADDRESS:sswihart@gibsonins.com 130 S Main St, Ste 400 INSURERS AFFORDING COVERAGE NAIC I+ PO Box 11177 INSURERA:Cincinnati. Ins Cc 1.0677 South Bend IN 46601-0177 INSURED INSURER B :Cincinnati Ind Cc 23280 INSURER C : Downtown South Bend, Inc. INSURERD: 217 S Michigan St INSURER E : PO Box 930 [INSURER F: South Bend IN 46624-0930 CCIVPRAnFR CERTIFICATE KII]MRFR17/18 Liab 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADD S POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP DDIYYYY MMI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE � OCCUR AGETO PREM SES (Ea occTurrence) $ 500,000 MED EXP (Anyone person) $ 5,000 EPP0031054 8/2/2017 8/2/2018 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPIOP AGG $ 2,000,000 PRO JECT ❑ LOG pqPOLICY Employee Benefits $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X FNON-OWNED HIRED AUTOSAUTOS EPP0031054 8/2/2017 8/2/2018 BODILY INJURY (Per accident) $ PPe�acadentDAMAGE $ X UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 4 OOO 000 AGGREGATE $ 4,000,000 A EXCESS LIAB CLAIMS -MADE ❑ED X I RETENTION 0 $ EEE0031054 8/2/2017 8/2/2018 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE Y� X PER ER E.L. EACH ACCIDENT $ 100,000 ER H)EXCLUDED? OFFICERIMEM(Mandatory (Mandatary €n NH) NIA EWCO257774 8/2/2016 8/2/2017 E.L.DISEASE - EA EMPLOYE $ 100 000 E,L, DISEASE - POLICY LIMIT $ 500,000 0 yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) City of South Bend is additional insured with respect to General Liability regarding events hosted by Downtown South Bend, Inc. CF'RTIFICATF I-Inl nr-P CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of South Bend THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 227 W . Jefferson ACCORDANCE WITH THE POLICY PROVISIONS. South Bend, IN 46601 AUTHORIZED REPRESENTATIVE G Ins Agency/STSWIH ACORD 25 (2014/01) INS025190i4ntr ©1988-2014 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD