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CERTIFICATE OF LIABILITY INSURANCE <br />DATE{ <br />5116t201 YYYY) <br />6I201 a <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT <br />AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT <br />CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, <br />IMPORTANT: If the certificate holder is an ADDITIONAL_ INSURED, the policy(ies) must be endorsed, if SUBROGATION IS WAIVED, subject to the terms <br />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 <br />of such endorsement(s), <br />PRODUCER <br />GIBSON INSURANCE AGENCY, INC. (SOUTH BEND, IN) <br />130 S. Ma€n St., Suite 400 <br />South Bond, IN 46601 <br />CONTACT NAME Angel Karbataeali <br />PHONE (AIC No, Ext): (574) 245-3547 FAX (AIC No): (574) 236-6399 <br />EMAIL ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />Family Justice Center of St. Joseph County <br />INSURER A: Mount Vernon Fire Insurance Company <br />26522 <br />INSUREB B: <br />INSURER C: <br />INSURER D: <br />INSURER E: <br />INSURER F: <br />(:nVPRAGFR CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE <br />ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF <br />SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />AObL <br />INSR <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />(MMIDOIYYYY) <br />POLICY EXP <br />(MMrDONYYY) <br />LIMITS <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE 1,k] OCCUR <br />CL 2730397 <br />6/23/2018 <br />6/2512018 <br />EACH OCCURENCE <br />$1,000.000 <br />pppp ENTED <br />PR IS a occurrence) <br />$100,000 <br />MED EXP (Any one parson) <br />S1,000 <br />PERSONAL & AOV INJURY <br />$1,000.000 <br />GENERAL AGGREGATE <br />$3.000,000 <br />PRODUCTS-COMP/OP AGG <br />See L-535 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />nX POLIGY Fj PRO- LUC <br />t$ <br />AUTOMOBILIE LIABILITY <br />ANY AUTO <br />AU,SYNED R�y6RULED <br />HIRED AUTOS MMWNLD <br />W. eBcIN1F.01 INGLE LIMIT <br />$ <br />BODILY INJURY (Per person) <br />$ <br />INJURY (Per accident <br />$ <br />pBgODILY <br />(PerT.'5enly]pAMAGE <br />$ <br />S <br />UMBRELLA LIAR <br />EXCESS LIAR <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />S <br />AGGREGATE <br />$ <br />b5D I I RETENTION; <br />S <br />WORKERS COMPENSASION <br />AND EMPLOYERS' LIABILITY <br />ANY CCPROPRIhEIT6ORIPARTNERIEXECUTIVE Y!❑N <br />Wa Ida iMV, N r EXCLUDED? <br />�f �h �d <br />UKIIIRR �F 9PERATIONS batow <br />NIA <br />C <br />TORY L�ITS Oi <br />E.L. EACH ACCIDENT <br />S <br />E.L. DISEASE -EA EMPLOYEE <br />$ <br />E.L. DISEASE -POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (See attached Acord 101 for addltlonal IlablIty limits) <br />Additional Insured - City of Soulh Bend <br />f.1-H I11-ICAII- KIIIA -K C.HN[1CLLA1I0IV <br />City of South Bend <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />227 W. Jefferson Blvd. <br />EXPIRATION DATE THEREOF. NOTICE Wil_ . BE DELIVERED IN ACCORDANCE WITH THE <br />South Bend, IN 46601 <br />POLICY PROVISIONS. <br />AUTHORIZED REPRESEIVTATIV�k� JJ� <br />ACORD 25 (2010/05) Copyright 1988-2010 ACORD CORPORATIOV <br />rights reserved, <br />The ACORD name and logo are registered marks of ACORD <br />