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Date. 5/11/2018 <br />Certificate of Coverage <br />Certificate Holder <br />This Certificate is issued as a matter of information only and <br />The Diocese of Fort Wayne -South Bend, Inc. <br />confers no rights upon the holder of this certificate. This certificate <br />Chancery Office <br />does not amend, extend or alter the coverage afforded below. <br />P0Box 390 <br />Company Affording Coverage <br />Fort Wayne, IN 46801 <br />THE CATHOLIC MUTUAL RELIEF <br />SOCIETY OF AMERICA <br />10843 OLD MILL RD <br />Covered Location <br />St. Joseph Grade School <br />OMAHA, NE 68154 <br />216 North Hill <br />South Bend, IN 46617 <br />Coverages <br />This is to certify that the coverages listed below have been issued to the certificate holder named above for the certificate <br />indicated, notwithstanding any requirement, term or condition of any contract or other document with respect to which this <br />certificate may be issued or may pertain, the coverage afforded described herein is subject to all the terms, exclusions and <br />conditions of such coverage. Limits shown may have been reduced by paid claims. <br />Type of Coverage <br />Certificate Number <br />Coverage Effective <br />Date <br />Coverage Expiration <br />Date <br />Limits <br />Property <br />Real & Personal Property <br />D. General Liability <br />Each Occurrence <br />300,000 <br />General Aggregate <br />2,000,000 <br />Occurrence <br />® Claims Made <br />8679 <br />10! I12017 <br />10/1/2018 <br />Products-Comp/OP Agg <br />Personal & Adv Injury <br />Fire Damage (Any one fire) <br />Med Exp (Any one person) <br />Excess Liability <br />8679 <br />10/1/2017 <br />10/1/2018 <br />Each Occurrence <br />Annual Aggregrate <br />3,000,000 <br />Other <br />Each Occurrence <br />Claims Made <br />Annual Aggregrate <br />rLimitlCoverage <br />Description of Opera tions/LocationsfVehicles/Special <br />Items (the following language supersedes any other language in this endorsement or the Certificate in <br />conflict with this language) <br />Coverage only extends for claims arising out of St. Joseph Grade School's field day in which St. Louis Street will be closed from Colfax <br />to LaSalle on June 6, 2018. <br />Holder of Certificate <br />Cancellation <br />Additional Protected Person(s) <br />Should any of the above described coverages he cancelled <br />before the expiration date thereof, the issuing company will <br />City of South Bend, IN <br />227 West Jefferson Blvd <br />South Bend, IN 46601 <br />endeavor to mail 30 days written notice to the holder of <br />certificate named to the left, but failure to mail such notice shall <br />impose no obligation or liability of any kind upon the company, <br />its agents or representatives. <br />0067003365 <br />Authorized Representative <br />G <br />