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HARLLCI OP ID: PG
<br />RATE (MMIODIY
<br />CERTIFICATE OF LIABILITY INSURANCE 12r15r2017
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CE
<br />RTIFICATE
<br />CERTIFICATE CATEFOF INSIURANCE DOES NOTCONSTITUTEY AMEND, EXTEND TBETWEENR ALTER THE OVERAGE AFFORDED BY �
<br />CONSTITUTE A CONTRACT TH I SUING NSURER(S),
<br />HE POLICIES
<br />BELOWAUTHORIZED
<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 />r.artifirate holder in lieu of such endorsements .
<br />PRODUCER
<br />Sale Insurance Agency, Inc.
<br />P.O. Drawer 426
<br />Lakeland, FL 33802-0426
<br />Robert H. Sale
<br />INSURED Harrell's LLC
<br />Harreli's,inc.
<br />5105 New Tampa Highway
<br />Lakeland, FL 33815
<br />CONTACT Robert H. gale
<br />NAME:
<br />rlaoN� 863-682-0363 Atc Nn : 863-682-0086
<br />ieinsurance.com
<br />it
<br />INSURERA:AIG Specialty ins Co
<br />ENSURER 9 : Ins Co of the State of PA
<br />INSURER 0:Commerce & Industry Ins. Co.
<br />INSURER D: Natl Union Fire Ins Co of Pit
<br />INSURER E : Lloyd's of Landon
<br />COVERAGES CERTIFICATE :
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURE
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER I
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBE[
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />a
<br />ILTRSD POLICY EFF POLICY FXP
<br />TYPE OF INSURANCE O R POLICY NUMBER MMlDD dMIDWYYYY
<br />A x COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE � OCCUR EG17937836 01/0112017 01/0112018
<br />X Contractual,ind C
<br />x Pollution
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY T PRO-
<br />JECT LOC
<br />AUTOMOBILE LIABILITY
<br />D I ANY AUTOAALL UTOS NED H
<br />AUTOSSCHEDULED
<br />NON-O W NEO
<br />HIRED AUTOS AUTOS
<br />j( UMBRELLA LIA6 1& OCCUR
<br />A EXCESS LIAR CLAIMS -MADE
<br />10.000
<br />AND EMPLOYERS' LIABILITY
<br />�ANYPROPRIFI
<br />FFICERlMEMi
<br />C (Mandaloryin
<br />If V", describe
<br />821
<br />5146
<br />NtA
<br />:CI2662635 (AOS)
<br />C12862536(CA)
<br />011D112017 1 01f0112018
<br />011011201710110112018
<br />0110112017 01101/2018
<br />01101/2017 10110112018
<br />utbl,Ktr IIull Vr Vrr_s.n„v,.v rv,-• 01/01/2017 011011201s
<br />Professional Liab PGIARLC0347"3
<br />DESCRIPTION OF OPERATIONS! LOCATIONS f VEHICLES (ACCRO 110i, Additional Romarka Sehsdule, may be astaohad it more space is requi
<br />aid Name: Venues Parks & Arts 2018 Chemical Supply
<br />w1/Ih rf\\I \FF ,ILMM ,
<br />'D NAMED ABOVE FOR THE POLICY PERIOD
<br />]OCUMENT WITH RESPECT TO WHICH THIS
<br />HEREIN IS SUBJECT TO ALL THE TERMS.
<br />L€Mrrs
<br />EACH OCCURRENCE
<br />$ 1,ti00,000
<br />A E TO RE T
<br />1,000,000
<br />PREMISES Ee aecurrence
<br />MFD EXP (Any one person)
<br />S 10,00 DO
<br />PERSONAL S ADV INJURY
<br />5 1,000,00
<br />GENERAL AGGREGATE
<br />$ 2,000,00
<br />PRODUCTS-COMPIOP AGG
<br />S 2,000,00
<br />S
<br />COMBINED SINGLE LIMIT
<br />S 1,000,00
<br />Ee accldenl
<br />BODILY INJURY (Per parson)
<br />S
<br />BODILY INJURY (Per acaddenl)
<br />S
<br />PROPERTY DAMAGE
<br />S
<br />Per acclden
<br />PIP (FL) (FL)
<br />s 10,00
<br />EACH OCCURRENCE
<br />$ 10,000,00
<br />AGGREGATE
<br />S 10,000,000
<br />F1F
<br />S
<br />PER OTH-
<br />STA UTE X ER
<br />51- EACH ACCIOI=NT
<br />$ 1,000,00
<br />SE - Fri EMPLOYEE
<br />S 'I,000,0�}0
<br />ESE - POLICY LRUT
<br />5 1 �000,000
<br />Limit ea
<br />1,000,00
<br />Ded
<br />10,00
<br />ad)
<br />CITYlNC3
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />The City of South Bend ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Clerk of the Board of Public
<br />Works,1316 County -City Bldg AUTHORIZED REPRESENTATIVE
<br />227 West Jefferson Blvd
<br />South Bend, IN 46601 7��4 AC=S__
<br />(D1988-2014 ACORN CORPORATION, All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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