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.d►ct�Jrio� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 11 /22/2017 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS 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 endorsements . PRODUCER The Horton Group 340 Columbia Place South Bend IN 46601 NAMEA. Michael Turner PHONE 574-334-5500 FAX 574-334-5600 -Rn.r+1 I •Matt michael,turner@thehartongroup,com INSURER(S) AFFORDING COVERAGE NAIC 8 INSURER A; Medical Protective 11843 INSURED BEACHEA-02 INSURER B:Amerisure Mutual Insurance Co, 23396 Beacon Health System, Inc. 615 N. Michigan Street South Bend IN 46601 INSURER C INSURERD: INSURER E ; INSURER F : COVERAGES CERTIFICATE NUMBER: 191173248 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 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR LTR TYPE OF INSURANCE INSD D POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIaDIYYYY - - LIMITS A X COMMERCIAL GENERAL LIABILITY CLA€MS•MAbE FX I OCCUR H002223 12/1/2017 1211/2018 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTEDPREMISES Ea nccurrance $50,000 MED EXP (An one person) $5,000 PERSONAL& ADV INJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER: X POLICY JECT PRO- ❑ LOG GENERAL AGGREGATE $3,000,000 PRODUCTS •COMPIOPAUG $3,000,000 $ OTHER: B AUTOMOBILE LIABILITY CA13212592102 8/13/2017 8/13/2018 COMBINEDJEQ SWOUE LIMIT $1,000,000 XANY AUTO BODILY INJURY (Par person) $ USOSCHEDULED ATOS ONLY AOY AUUTSONL BODILY INJURY (Per accident) $ RODAMAGE c $TOS Comp: $250 X Coll; $500 $ A X UMBRELLA OAB OCCUR E002223 12/112017 1211/2018 EACH OCCURRENCE $25,000,000 AGGREGATE - $25,000,000 EXCESS LIAR X CLAIMS -MADE DEO X RETENT€ONs25,000 - $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFF€CERIMEMBER EXCLUDED? NIA PER OTH- STATUTE ER E.E.. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory In NH) If yes describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ B Garagekeepers CA20983310102 11/13/2017 1/13/2011 Physical Damage 500,000 Cori Ded: 26G Comp Ded: 260/1,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, AddlNanal Remarks Schedule, maybe attached If morn space Is required) Annual Parking Garage license: CMS, Bartlett and Navarre Garages. FAX: 235-9021 Michelle Adams City of South Bend 227 W. Jefferson Blvd. Suite 1400 South South Bend IN 46601 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE i f U 19815-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD