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Apr 1018 04:49p p.2 <br />Vie¢ DATElti11N�6t%�YYY) <br />CERTIFICATE OF LIABILITY INSURANCE w <br />oaJ102a18 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF NFOR&4ATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CETATE DOES NOT BELOW AFFIRMATIVELY <br />THIS CERT C TEO FNNEGATIVELY <br />SDOESURANCE ES NOTCONSTIT TE A CONTCOVERAGE <br />CONTRACT BETWEEN THE ISSUING NSURER($)AUTHORiZED <br />REPRESENTATIVE OR PRODUCER, AND THE GERTIF ICATE' HOLD ER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies� must be endorsed. If SUBROGATIOI3 IS WAIVED, subject to <br />the terms and condillons of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu ofsuch endorsements). CONTACT <br />iOdJCFR <br />NAME'- Steve McNeil <br />Idridk3e Insurance DONEEI� c 574222$232 <br />IL E-MA <br />323 North Ironwood All ss! . ^L <br />outh E <br />ISVR6D <br />WaPC.1.1i Japan4ase Fusion & Bar, Inc. <br />123 W Washington St <br />IN <br />South Bend IN qwu I. I INSURER F _ <br />bVERAGES CERTIFICATE NUMBER= REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUR <br />INDICATED. NOTWETHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDEO BY THE POLICIES DESCRIBE <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE, OEEN REDUCED BY PAID CLAIMS <br />— v C a <br />A <br />COMMERCIAL GENERAL LM ILfrY <br />—1 CLdVMS-MADE 191 OCCUR <br />1`4 1 N I Q97-1154951 1111022017111 AW]018 <br />LAGGREGATE LIMIT APPLIES PER: <br />POLICY ❑ 'EG F1 LOG <br />AUTomosil-E LIABILITY <br />ANY AUTO <br />AALL <br />UTO.rED <br />At1TD5VLE0 <br />NON-OY'+NED <br />HIREOAUTDS <br />AUTOS <br />UMBRELLA UAB I. I occuR <br />EXCESS LIAS I7111 CLAIMS <br />WORKERS COMPENSAIIUN <br />AND EMPLOY ER5 LIABILITY YIN <br />ANY PROF RtETORIPARTNERrEXEGUInVE ❑ N ! A <br />OFFICER, BEREXCLUDED7 <br />DESORIF,noN of OP ERATIONS I LOCATI ONSrVEHICLES (ACOR D IOI, Additianal Remarks Schedule, maybe attached If mare space is r�u <br />123 W Washington S1 South Bend. IN 46601 <br />119 N Michigan St, South Bend, IN 46601 <br />CITY CF SOUTH BEND <br />227 W JEFFER5ON BLVD <br />South Bend <br />Fax: Ernai <br />ACORD 25 (201401) <br />ED NAMED ABOVE FOR THE POLICY PERIOD <br />DOGUMENT WITH RESPECT <br />TO WHICH THIS <br />D HEREIN IS SUBJECT TO ALL THE TERMS, <br />LIMITS <br />EACH OCCURRENCE <br />S 1000000 <br />1.1 <br />PREMISES E acar <br />S 1000000 <br />MEP EXP (An on$ rrm) <br />$5000 <br />PERSON AL&ADVINJURY <br />y 1WOOOD0 <br />GENERALAGGREGATE <br />S 2t)00000 <br />PRODUCTS-COMPIOPAGG <br />$ 20000M <br />S <br />c0?AeINEDSINGLE 1JMIT <br />$ <br />a &cc'adeni <br />BODILY INJURY(PorpnrSan) <br />S <br />BODILY INJURY (Pefg=id¢nt) <br />$ <br />PROPERT Y VAAMA.E <br />a <br />ao 'dent <br />S <br />EACH OCCURRENCE <br />S <br />AGGREGATE <br />S <br />PER OTH- <br />STATM Eft <br />E.L- EACH ACCIDENT <br />$ <br />E.LDISEASE-EAEhiPLOYE <br />S <br />E-L-DISEASE-POLICY LIMIT <br />S <br />fired) <br />SHOULD ANY OF THE ABOVE: DESCRIBED POLICIES BE CANCELLER BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS, <br />AUTHORIZED REPRESEK-TATIW <br />IN 46601 <br />0 1 QM2014 ACORD CORPORATION- All rights reserved. <br />TheACORD name and logo -are registered marks of ACORD <br />