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CERTIFICATE OF LIABILITY INSURANCE DATE 108/2OIYYYY) 05/0812016 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 pollcy(ies) must have ADDITIONAL INSURED provisions or 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 endorsements ; PRODUCER JMS Insurance Inc. 300 Michigan Street Walkerton, Indiana 46574 CONTACT Whard Bishop NAME: PHONE (674) 686-7259 Arc No ; EMAIL D INSURER 3 AFFORDING COVERAGE NAIC # INSURER A: Philadelphia Insurance Corrpany PHI INSURED South Bend Museum of Art 120 Or Martin Luther King Jr Dr S South Bend, I1446601 INSURERB: Unknown Insurance Company 30104 INSURER C : INSURER D: INSURER E INSURER v: COVERAGES CERTIFICATE NUMBER: 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.B.E 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. ILTR TYPE OF INSURANCE A DLSUBR POLICYNUMBER POLICYBFF POLICY MWDD EXp. LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS-MADE P OCCUR Y PHPK1766339 01/0612018 0110612019 EACH OCCURRENCE $ 1,000,000 -DAMAGE TO RENTE15- PREMISES Ea occurrence $ 100,000 MED EXP (Any me Parson) $ 5,000 PERSONAL& ADV INJURY $ 1.000,000 GEN'LAGGREGATE LIMIT APPLIES PER J POLICY ❑ 2CT1:1 LOC OTHER GENERALAGGREGATE $ 2,000,000 PRODUCTS-COMPIOPAGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLYHAUTOS / HIRED NON -OWNED V AUTOS ONLY AUTOS ONLY PHPK1756339 01/06/2018 01/06/2019 COMBINED SINGLE LIMIT Ee seddall_ $ BODILY INJURY (Per person) $. BODILY INJURY.(Peracetdent) $ 1,000,600 PROPERTY DAMAGE Per acrid € $ UMBRELLALIAB EXCESS I" OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEO I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORF'ARTNERIEXECUTIVE — OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, desc4m under DESCRIPTION OF OPERATIONS belay N I A 36VVECPV8073 01/06/2018 01/06/2019 A $ERT TE FORR !r E.L EACH ACCIDENT $ 100,000 E,L DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 50(),000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace is required) The City of South Bend, Board of Park Cornnissioners, and South Bend Venues Parks & Arts are listed as Additional Insured on the General Liability Policy. City of South Bend, Indiana; 227 W Jefferson Blvd, South Bend, Indiana 46601 Board of Park Comrrssioners, 321 E Walter St, South Bend, Indiana 46614 South Bend Venues Arts & Parks, 321 EWalter St, South Bend, Indiana 46614 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of South Bend ACCORDANCE WITH THE POLICY PROVISIONS. 227 W Jefferson Blvd AUTHORIZED REPRESENTATIVE South Bend, IN 466011830 O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD