Opening of Bids - Ravina Park Bowman Creek Stabilization Project No 117-073 - HRP Construction

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A -1 ® CERTIFICATE OF LIABILITY INSURANCE DATE (MMrDDr 7Y) 6/2e/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 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 Gibson Insurance Agency, Inc. 130 S Main St, Ste 400 PO BOX 11177 South Bend IN 46601-0177 NAMEACT Ellie Lloyd PHONE . (B0o)B14-2122 AAIC No: (B00)836-2122 _ EMAIL ello d@gibsonins.com ADDRESS: y ...... __ INSURER(S) AFFORDING COVERAGE — NAIC N INSURER AAmerisure Mut Ins Co 23396 INSURED _ HRP Construction Inc. 5717 Cleveland Rd PO Box 266 South Bend IN 46624--0266 INSURER B : _,...-- _ INSURER C INSURER 0 : INSURERE:. INSURERF: CnVERA PS r..1=I7TIFIrATF NI IMRFR 9-1-17/16 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. IfJSR LTR - -mm- TYPE OF INSURANCE AODL SUBR POLICY NUMBER MMIOIPY✓YEYY1f MMlUDYIYYW LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE_ $ 1,000,000 A CLAIMS -MADE I —XI OCCUR PREM SEal aEo=r ante - _ $ 1,000,000 X MED EXP (Any one person) S 10,000 XC[T , CPP20316441202 9/1/2917 9/1/2018 X Contractual Liability _PERSONAISADVINJURY $ 1,Goo, 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPIOP AGO $ 2,000,000 W POLICY JE � El LOCI $ OTHER: AUTOMOBILE LIABILITY COMBINED51NOL£ LIMIT Ea accident) $ 1,000,000 _ _ 80MLY INJURY (Per person) S A X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NONOWNEDPROPERTY X HIRED AUTOS X AUTOS CA20316451202 9/1/2017 9/1/2018 BODILY INJURY (Per accident) S ------ DAMAGE PeraccMent $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10 000 000 AGGREGATE S 10 000, 000 ___. A EXCESS LIAB CLAIMS -MADE - DED X NTION RETES 0 $ cu20316431102 - 9/1/2017 9/1/2018 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER�EXECUTIVE I� ��! N OFFICEtory in ER EXCLUDED? I "` I (Mandatory in NHI N ! A WC20316421102 9/1/2017 9/1/2018 OTH- X STATUTE ER EJ- EACH ACCIDENT $ i , 000, 000 E.L, DISEASE - EA EMPLOYE S 1 000 000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF pPERATfONS below States of 1N 6 I.12 DESCRIPTION OF OPERATIONS ! LOCATIONS I VEHICLES (ACORD 1011, Additional Remarks Schedule, may Be attached If more space Is required) r`r-0rl1Zlr`AT9= uni nF[] rANrFI I.ATInN (574)235-9171 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of South Bend THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Board of Public Works ACCORDANCE WITH THE POLICY PROVISIONS. 227 West Jefferson, 13th Floor AUTHORIZED REPRESENTATIVE South Bend, IN 46601 G Ins Agency/ELLIE V 1 UH8-2014 AI:UKV t;UKYUKA I IUN. All rignts reserveu. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 0014nn