Laserfiche WebLink
RIVEPAR-01 KPAL <br />CERTIFICATE OFLIABILITY INSURANCE DATE cMM,ODlYYYY) <br />0/13012018 <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 BYTHEPOLICIES <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(Ins) 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 Iled of such endorsements . <br />PRODUCER CRgEACT Karen Pat, AINS <br />N: <br />1st Source Insurance, Inc. PRONE PU <br />6909 Grape Road - (AJC, No, lxt): (800) 510-4102 304 (con, rro); (574) 271.5240 <br />Mishawaka, IN 46545 I o ss; palk@1 stsource.corrl <br />INSURERS) AFFORDING COVERAGE NAIL # <br />INSURER A:NSI/West Bend Mutual Insurance <br />INSURED INSURER8: . <br />River Park Business Assoc. Inc. INSURER c: <br />P.O. Box 64$2 INSURER D : <br />South Bend, IN 46660 <br />INSURER E : <br />INSURER F : <br />rnVFF?Ar:FC r:FRTIFIr:ATF NI IMRFR• RFVI.glnM tdI IMRI=0- <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 <br />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 />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR TYPE OF INSURANCE ADDL $UBR POLICY NUMBER POLICY EFF POLICY EXPLTR Mmmo <br />LIMITS <br />A - X COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE S 1,000,000 <br />CLAIMS -MADE K OCCUR X 1936777 0410112010 0410112019 <br />PRC61 SE$ (Ea occurrence) $ 100,000 <br />MED E%P (Any one poison) _ S. 0 <br />PERSONAL S ADV INJURY $ 1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES P[R: <br />GENERAL AGGREGATE $ 2,000,000 <br />X POLICY; Y98T LOG <br />PRODUCTS -COMPIOPAGO S 2,000,000 <br />OTHER: <br />- <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />(Ed accidunl) $ <br />ANY AUTO <br />BODILY INJURY (Par pom>n) S <br />OWNED SCHEDULED <br />AUTOSONLY AUTOS <br />BODILY INJURY (Par actidonl). S <br />yyyy <br />AUTOS ONLY AUTOS ONLY <br />{Poor aecao tDAMAGE $ <br />UMBRELLA LIAR OCCUR <br />EACH OCCURRENCE $ <br />EXCESS LIAR CLAIMS -MADE <br />AGGREGATE S <br />DED RETENTION 5 <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />PER H <br />STATUTE ER <br />Y (N ,,, <br />AANYCPROPRIIETORIPARTNERJEXECUTIVE - <br />NIA <br />E.L,EACH ACCIDENT $ <br />. <br />MBr EXCLUDED? <br />(Mandatcryt <br />E.L. DISEASE - EA EMPLOYEE $ <br />11 yes, describe under <br />DESCRIPTION OF OPERATIONS below i <br />E.L. DISEASE - POLICY LIMIT <br />DESCRIPTION OF OPERATIONS J LOCATIONS I VEHICLE$ (ACORO 101, Additional Remarks Schodute, may be attached I( mars space Is roqulrad) <br />City of South Bend, Indiana <br />227 W. Jefferson Blvd <br />South Bend, IN 46601 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH 7HE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />C 5 �-- <br />ACORD 25 (2016103) Q 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />