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C'TMARrae_n9 I_-F3aRR <br />ACOR�" CERTIFICATE OF LIABILITY INSURANCE <br />DATE IMMr00fYYYYj11/1612017 <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 have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsements . <br />PRODUCER <br />The Healy Group, Inc. <br />17536 Generations Drive <br />South Bend, IN 46635 <br />C CT <br />PHONE 574 271-6000 FAX, Ne : 674 243-3214 <br />(arc, No, Ex11: { } { ) { } <br />EMAIL <br />INSURERS AFFORDING COVERAGE <br />NAIC p <br />INSURER A: Selective Insurance Grou Inc. <br />12672 <br />INSURED <br />INSURER B : <br />INSURER C. <br />St Margaret's House Inc <br />INsuRERO: <br />117 N. LaFayette Blvd. <br />South Bend, IN 46601 <br />INSURER E <br />INSURER F : <br />r+nv=oenec !'.KATIFIt ATF hn IVIREP• 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 CONTRACTOR OTHER DOCUMENT WITH RESPECTTO 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 SY PAID CLAIMS, <br />INSR <br />LTRA <br />TYPE OF INSURANCE <br />AODINSDL <br />SUBR <br />NUMBER <br />POLICY EFF <br />POLICY EXP <br />LIMITS <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE ❑X OCCUR <br />_WVDPOLICY <br />S 2238806 <br />08101/2017 <br />08/0112018 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DARPA SETO aEcNcTE a <br />$ 1,000,000 <br />MED EXP (Any oneperson) <br />$ 20,000 <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY ❑ Tpef LOG <br />il OTHER: <br />GENERAL AGGREGATE <br />$ 3,000,000 <br />PRODUCTS -COMPIOPAGG <br />$ 11000,000 <br />$ <br />AUTOMOBILE LIABILITY <br />ANYAUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />/�N p <br />AUT S ONLY A� O Ot Y <br />Ea eel de =SINGLE LIMIT <br />$ <br />t30DILYINJURY Far arson <br />$ <br />BODILY INJURY Per accident <br />$ <br />P�e�g ' AMAGE <br />IS <br />A <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAIMS -MADE <br />X <br />S 2238806 <br />08/01/2017 <br />08/01/2018 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />M <br />AGGREGATE <br />$ <br />DED RETENTION$ <br />1,000,000 <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PRRROPREIIETggOEERRRIPARTNER/EXECUTIVE Y� <br />M n E'rM nNH) EXCLUDED? <br />if yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />PERT E OTH- <br />ER <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYE <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />S <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may de attached If more space is required) <br />City of South Bend Is listed as Additional insured <br />City of South Bend <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 />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2016103) OO 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />