Non Res Block Party - DTSB, Inc. - Art Beat 2018

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1 0 A�!�o CERTIFICATE OF LIABILITY INSURANCE DATE tM MIDDIYYYYI 02I07I2D18 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 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 Ifeu of such endorsement(s). PRODUCER Gibson Insurance Agency, Inc. 130 S Main St, Ste 400 PO BOX 11177 South Bend IN 40601-0177 CONTACT Stephen Swihaft NAME: PHONE (800) 814-2122 FAIL, No : (800) 836-2122 WC No Ezt EMAIL Sswihart@glbsonins.COm ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL p INSURERA: Cincinnati Ins Co 10677 INSURED Downtown South Bend, Inc. 217 S Michigan St PO BOX 930 South Bend IN 46624-0930 INSURER B : Cincinnati Ind CO 23280 INSURER C : INSURER D : INSURER E: INSURER F : r:r1Vr-RAr'.FS CERTIFICATE NUMBER: 17118 Liab 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. INSR LTR TYPE OF INSURANCE INSD WVD POLICYNUMBER POLICY EFF MMlDD1YYYY POLICY EXP MMIODIYYYY LIMITS X COMMERCIALGENERALLIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR DAMAGE TO PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 5,000 A EPP0031054 08/02/2017 08/02/2018 PERSONAL&ADV INJURY g 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 PRODUCTS -COMPIOPAGG g 2,000,000 POLICY ❑ JEC7 LOC Employee Benefits s 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) S ANYAUTO A OWNED SCHEDULED AUTOSONLY AUTOS HIRED �/ NON-OWNEO !� AUTOS ONLY /� AUTOS ONLY EPP0031054 08/02/2017 08/02/2018 BODILY INJURY (Per accident) S DAMAGE Pe�laccden S Uninsured motorist $ 1,000,000 X UMBRELLA LIAB OCCUR „'E'N'_ •••" EACH OCCURRENCE 4,000,000 $ _ HCLAIMS-MADE AGGREGATE $ 4,000,000 A EXCESS LIAB EPP0031054 08/02/2017 06102/2018 DED I X1 RETENTION $ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? iMandatory in NH) N fA EWCO25777403 08102l2017 OB10212018 �/ PER OTH- /� STATUTE ER E.L.E.ACHACCIDENT $ lOD,000 E.L. DISEASE - FA EMPLOYEE $ 100,000 E.L. DISEASE -POLICY LIMIT 500,000 $ If yes, describe under DESCRIPTION OF OPERAT#ONS below DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORO 101, Additional Remarks Schedule, may be attached if more space Is required) The City of South Bend is additional insured with regard to Art Beat on August 18. r r_0r€Cir`ATC unt nFR r`ANr:FII I ATION 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 46601 @ 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD