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04/09/2018 MON 12:24 FAX 574 258 9177 Synergy Insurance Group, 0002/002 AMER104 OP ID: CP CERTIFICATE OF LINSURANCE DATE (MMIDDIYYYY)ABILITY 04/09/2018 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 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 endorsement(s). PRODUCER Synergy Insurance Group 13800 Jackson Road NA Carol S Perri 574-258.5655 IC No: 574-25$-9177 perri s ner Insurancegroup.com Mishawaka, IN 46544.9195 Nathan D Spite INSURE S AFFORDING COVERAGE NAIL # INSURERA:West Bend Mutual Ins. Co. 15350 INSURED American Legion Riders Post 308 Marvin Walters INSURERB; INSURERC; 122 Lincolnway West, PO Box 36 INSURERD: INSURERE: Osceola, IN 46661-0036 INSURER F : COVERAGES CERTIFICATE NUMBER: 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL INSD a POLICY NUMBERRM—M LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR Y 419807 00 05l20l2018 0512112018 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrenceUAMAUL $ 100,000 MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER'. POLICY ❑ JECT ❑LOC OTHER: GENERALAGOREGATE $ 2,000,000 PRODUCTS - COMPIOPAGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL O NED SCHEDULED HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT aaccfda [ $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ er accident $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMSMADE EACH OCCURRENCE $ AGGREGATE $ DED ftI TENTION $ $ WORKERS COMPENSATION AND EMPLOYERTUTABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICEPJMEMSEREXCLUDED? (Mandatory In NH) lips describeunder DESCRIPTION OF OPERATIONS below NIA TH- S ATUTE FOR E.L. EACH ACCIDENT $ E.L. DISEASE- EA EMPLOYEE1 $ E.L. DISEASE- POLICY LIMIT I $ DESCRIPTION OF OPERATIONS! LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be adached If more space is required) City of South Bend Is named as additional insured with regard to General Liability. FALL HEROS RIDE 5-20-18-5-21-18 CERTIFICATE HOLDPR CANCELLATION CITYSOB SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of South Bend Fax 574 235 9171 AUTHORIZED REPRESENTATAM 227 W Jefferson South Bend, IN 46601 L „ ACORD 25 (2014101) 01988.2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD