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��4...••• CERTIFICATE �F LIABILITY INSURANCE <br />A`��® <br />DATE (MMf001YYYY) <br />06/01/2018 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />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 <br />the terms and conditions 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 of such endorsement(s). <br />PRODUCER <br />Schindler Richard Insurance Agency <br />112 Lincoln Way East <br />NAME, Mary K Willingham <br />PHONE <br />G N Exl 574-232-9999 me No: 574-232-8232 <br />Apo ESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURERA Erie Insurance Exchange <br />26271 <br />Mishawaka IN 46544 <br />INSURED <br />INSURER B <br />INSURER C <br />Gregory A Kil & Associates Inc <br />INSURER D <br />1126 Lincoln Way E <br />INSURER E . <br />1 INSURERF: <br />South Bend IN 46601-3728 <br />COVFRAGES 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 <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 INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />ILSR <br />TYPE OF INSURANCE <br />ADDL <br />SUER <br />POLICY NUMSER <br />POLICY EYF <br />POLICYYXP <br />LIMITS <br />A <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />N <br />N <br />Q97-0641584 <br />04/11/2018 <br />04/11/2019 <br />EACH OCCURRENCE <br />$ 1,000.000 <br />PREMISES Eaoccunence I <br />$ 1,000•000 <br />MED EXP (Anyone person) <br />$ 5000 <br />PERSONAL&ADVINJURY <br />$ 1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER- <br />POLICY PER� LOC <br />OTHER: <br />GENERAL AGGREGATE <br />$ 2.000.000 <br />PRODUCTS-COMPIOP AGO <br />$ 2,000.000 <br />$ <br />A <br />AUTOMOBILE LIABILITY <br />ANYAUTO <br />ALL Or SCHEDULED <br />AUTOS AUTOS <br />NON -OWNED <br />X HIRED AUTOS X AUTOS <br />N <br />N <br />Q97-0641584 <br />04/11/2018 <br />04/11/2019 <br />COM8INED SINGLE LIMIT <br />Ea eccitle nt <br />$ 1,000,000 <br />BODILY €NJURY(Perperson) <br />$ <br />BODILY INJURY(Peraccident) <br />$ <br />PROPERTY DAMAGE <br />Pasaacidanl <br />$ <br />$ <br />A <br />X <br />UMBRELLA LIAB <br />EXCESS LIAB <br />�/ <br />/� <br />OCCUR <br />GLAWS-AIADE <br />N <br />N <br />Q28-1170265 <br />04/11/2018 <br />04/11/2019 <br />EACH OCCURRENCE <br />$ 5000000 <br />AGGREGATE <br />$ <br />DED I RETENTION <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPMETORIPARTNERIEXECUTIVIZ YIN <br />OFRCFRIMEMBEREXCLUDED? <br />(Mandatory in NH) <br />If yes, descnba under <br />DESCRIPTION Of OPERATIONS below <br />NrA <br />N <br />Q88-1100750 <br />04/11/2018 <br />04/11/2019 <br />X PER STATUTE ORH <br />E.L. EACH ACCIDENT <br />$ 500000 <br />EL.DISEASE- EAEMPLOYE <br />$ 500000 <br />E.L. DISEASE -POLICY LIMIT <br />$ 500000 <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS i VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Board of Public Works, City of South Bend, IN <br />1316 County -City Bldg <br />227 W.Jefferson Boulevard <br />South Bend <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />IN 46601 <br />rc-�m�oc ntyt <br />ACORD 25 (2014101) <br />© 1988-2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />