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AC"R" CERTIFICATE OF LIABILITY INSURANCE DATE 3/21/2018 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 [tau of Such endorsement(s). PRODUCER Gibson Insurance Agency , Inc.PHONE g Y 130 S Main St, Ste 400 CONTACT aura Van Dyke NAME: Y 574-245-3504 FAX 574-236-6399 AAIC,-Np,EMt}: — A1C NoI ...._... AIL ADDRESS: Lvandyke@gibsonins.com -_ PO Box 11177 INSURERS) AffORDING COVERAGE NAIL # INSURERA:Cincinnati Insurance Co South Bend IN 46601--0177 INSURED INSURER B :CCIRMerCe & Industry Ins Co 1 9410 _ Navarre Hospitality Group, LLC, DBA: Navarre INSURERC:Apcident Fund Ins Co Amer 110166 105 W Colfax Ave INSURER,D: INSURER E South Bend IN 46601 INSURER F : COVERAGES CERTIFICATE NUMBER:17/18 Liability 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. 16.TFt ........ _.. w_...,.,_ TYPE OF INSURANCE — AbDL SUER POLICY NUMBER _ MMIODY EYY MMIDDIYYXYY LIMITS X COMMERCIAL GENERAL LIABILITY ( EACH OCCURRENCE 1,000,000 ------ -- 100,000 A CLAIMS -MADE X OCCUR i DAMAGE TO RENTED,_' f PREM-ISES (Eaoccurrence} EPP0450028 B/1/2017 8/1/201B MED EXP (Any one person) $- 2,000 -' ........... EPERSONAL BADVINJURY ------ �$ 1,000,000 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE is POLICY PIE„ LOC PRODUCTS - GOMPlOP AGG 2D40000 $ r i —%� Is OTHER: E Damage to Premises Rented AUTOMOBILE LIABILITY E I COMBINED SINGLE LIMIT i (Ep,,.aceident) $ f000,000 $ X ANY AUTO BODILY INJURY (Per person) OWNED E I PC24990 170801 8/1/2017 8/1/2018 BODILY INJURY (Per accident) l $ AALL UTOS AUTOSULED W NON OWNED X X -PROPERTY DAMAGE - - $_- HIRED AUTOS AUTOS ;..Per accident} € { Is X UMBRELLA LIAR € OCCUR EACH OCCURRENCE $ 141000,000 B IEXt:ESSLtAB CLAIMS -MADE AGGREGATE - $ 10,000,000- __.}( DID RETENTION$ $ BE 027710972 B/1/2017 e/1/2018 I WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X I PER ERH YIN E_L EACH ACCIDENT $__ 500 000 C IANYPROPRIETORIPARTNERIEXECUTIVE [ OFFICERIMEMBER EXCLUDED? '• 13 I(Mandatory InNH) NlA WCV6148032 8/1/2017 i 8/1/2018 i E.L. DISEASE - EAEMPLOYEI� $ 500-,000 If yes, describe under I DESCRIPTION OF OPERATIONS below E.L. DISEASE.- POLICY LIMIT $ 500,000 E I i 3 E Each Commone Cause $1, 000 , 000 A Liquor Liability � � EPP0450028 B/1/2017 8/1/2018 I Aggregate $2, 000, 000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may he attached If more apace Is required} City of South Bend is additional insured with respect to general liability coverages as required by written contract. /`GDTICIr ATF WAI nr-P !'ONrFI I ATinN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of South Bend THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 227 W Jefferson ACCORDANCE WITH THE POLICY PROVISIONS. South Bend, IN 46601 AUTHORIZED REPRESENTATIVE G Ins Agency/LAURA ACORD 25 (2014101) INS025 (201401) © 1988.2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD