Laserfiche WebLink
Dec 08 1712:23p p.2 <br />GATE {MMIDDrffnY <br />ACOREP CERTIFICATE OF LIABILITY INSURANCE 12/1/2017 <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 />certificate holder in lieu of such endorsement(s). <br />PRODUCER C NNT�"ACT Cat�terine Myers <br />General Insurance Services PHONE (219)879-4581 No = <br />FAx (219)873-7292 <br />SIC_ Na. i_xt : IC <br />421 Franklin Street ADDMSs,cmyers@genins-com <br />P.O. Box 416 INSURER@) AFFORDING COVERAGE NAIC4 <br />Michigan City IN 46361 . tNSURERA:Sel.ective Insurance Ca of Sout 19259 <br />INSURED <br />HORIZON AWNING LLC <br />2227 E US HIGHWAY 12 <br />MICHIGAN CITY IN 46360-2154 <br />r-nVFRAGIFS CFRTIFICATF NLIMRFR-CL1751522136 REVISION NUMBER: <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 />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />IL7g <br />i'yP8 OF ENSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />MMIDD <br />POLICY FRCP <br />IY MMIDDYYY <br />LIMITS <br />}; COMMERCiALGENERALUAWLITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />� <br />AMAGE70 RENTED <br />500 OOD <br />r <br />A CLAIMSdk#ADE 4CCLtR <br />S 1017177 <br />5/22/2017 <br />5/22/2018 <br />MEAEXPIMyor person) <br />$ 15,000 <br />PERSONAL do ADV INJURY <br />$ 1,000,000 <br />GEH'LAGGREGATE LIh11TAPPLIESPER: <br />GENERAL AGGREGATE <br />IS 2,000,000 <br />PRODUCTS- COIVIPIOp A6G <br />$ 2,000,000 <br />2 POLICY ❑ACT : r LOG <br />I <br />$ <br />, <br />r— OTHER: <br />AUTOMOBILE LIABIUTY <br />SINGLE LIMIT <br />lE <br />$ 1 DOD , 000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />A <br />AALLOWNED SCHDSULEO <br />S 1817177 <br />5/22/2017 5/22/2D1R <br />BODILY INJURY (Per W4dW) <br />$ <br />AUT <br />(Per a=identBAfRAGE- <br />S <br />HIRED AUTOS : AUTOSNON-OWNED i <br />$ <br />i <br />I <br />i i1MBRELLA LIAR OCCUR <br />EACH OCCURRENCE <br />S <br />AGGREGATE <br />S <br />EXCESS UA13 CLAIMS -MADE <br />I BED I RETENTIONS <br />S <br />WORKER$ 11O*PEN$A11ON <br />{ <br />g ER OTH" <br />STATUT R <br />AND EMPLOYERS' LIABILITY YfN <br />I <br />INY PROPRIETORIPARTNERIEXECUTIVE <br />E_L. FACFIACC{U_!=_NT <br />5 500000 <br />E.L. DISEASE - FA EmpwyEq <br />$ 500, DOO <br />B <br />OFFICERIMEMBER EXCLUOEM �i NIA <br />IlMartdatory in NH) _ <br />I WC 7974965 <br />5/22/2017 <br />5/22/2010 <br />E-L. DISEASE - POLICYUMIT <br />I S 500 D00 <br />IF yes, desm-w. ruder <br />DESCRIPTION OF OPERA-PONS below <br />II <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional RomarNs Schedute, may be attaehod If more space Is requ€redl <br />CERTIFICATE HOLDER CANCELLATION <br />Board of Public Works <br />131.6 County-Ca.ty Building <br />227 W Jefferson Blvd <br />South Bend, IN 46601 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 5E CANCELLED BEFORE <br />THE LXPIRAiiON DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORLZED REPRESENTATIVE <br />K D. HenriCh, MBA, CP <br />01988-2014 ACORD CORPORATiON. All rights reserved. <br />ACORD 25 (2014101) The ACORD name and log© are registered marks Of ACOR❑ <br />