|
OP IDDH
<br />CERTIFICATE OF LIABILITY INSURANCE DATE
<br />10/8/208/2IY018
<br />- 108
<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 I'ieu of such endorsements
<br />PRODUCER
<br />S 11er Insurance GroupPHONE.. B an K Nafrad Life 8_
<br />1 800g ackson Road caNxACT f1x.574-258 5555 Arc Ne 574 25 9177
<br />Mishawaka, IN 46544-9195 1EM I s ner nsurance r�1u Com
<br />Bryan K. Nafrady, CLU, ChFC A,DDREss: bnafrady
<br />_..-_!. _ ,,,,....,. ..........PIa'Dl�urI� HT01
<br />,._ ......_. ...... _ ... ..........
<br />INSURED
<br />..... :.:.. _,,,,. .. _........ Auto -Owners .--- ... --- NAIC.#,..
<br />INS .�
<br />RED St Life Inc St CO Right t0 INSURER A: Insurance CO 18988
<br />St Joseph Co Right
<br />I
<br />INSURER A: WnerS
<br />to Life Educational Fund �......, .... _..... , , ,., -- ..... _._.. „ -...F
<br />2004 Ironwood Circle Ste 130 „NsIJRER c
<br />South Bend, IN 46635 i,NSURERD:
<br />..,., .............
<br />NNSURER E
<br />INSURER F
<br />COVERAGES 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 />NNsit _., ----
<br />............
<br />LTR TYPE OF INSURANCE PfSd tCY NUMBER Mr(3pdYMWYY ...MM OCO/YY1P LIMITS
<br />GENERAL LIABILITY EACH OCCN,Id RFNCE $
<br />"a rau�`,ausoavre „ 1,00'50+,00.
<br />'
<br />A OMCARAL LIABILITY Y 96-762-842-00 09/28/2018 09/28/2019
<br />PCr (F$ 50.00(
<br />CLAIMS -MADE OCCUR
<br />__,MERILGENEMEX Agano peaern.-. ...
<br />.. ---------- ............ PERSONAL &ADV,INJURY ._,..., S _.....___.,.....1,000,00.:.
<br />GENERAL AGGREGATE 2,000,00'
<br />GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG„,.S 1,000,000
<br />PR'O« X $
<br />, POfl.IR:Y
<br />AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
<br />ANY AUTO (Ea accident) ,ident) ----- . ,. .-.,....�,.�..__..........
<br />BODILY(Per person) $
<br />,. ALL OWNED AUTOS ., INJURY .__..... ... ........,.. ..... INJURY accident) $
<br />SCHEDULED AUTOS BODILY - .. (Pc --.... ,. . ,.....
<br />.. PIOLROPERTY DAMAGE m......
<br />HIRED AUTOS $
<br />.. (PER ACCIDENT)
<br />NON -OWNED AUTOS $
<br />.. ,..., :.. ......... m .w._...........__ :...
<br />UMBRELLA LIAB OCCUR EACH OCCURRENCE $
<br />,... EXCESS LIAR ,... CLAIMS -MADE :.....---....
<br />.----- ,m
<br />�., AGGREGATE $
<br />DEDUCTIBLE _........... .... „„„
<br />RETF.NTiON S
<br />WORKERS COMPENSATION WC STATpJ- 'OTFI,
<br />AND EMPLOYERS' LIABILITY YIN ... 10HY LIA'i11.' .... .. T ....:.. ,,,. __._......,.._.
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE EACH ACCIDENT $
<br />4; PFICCRAAEMBEIR EXCLUDED? ❑ N/A
<br />EL
<br />(rJlaun story In NH) E1. DIiSEASU FA EMPLOYEEI S
<br />NI�Yes, describeendot ..._..E , ,..-_.... :.... ...
<br />d'1.SCRIPrtON OF OPERATIONS below E L. DISEASE' - POLICY LtMBT'
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101,„ Additional HemaflKs Srhodula. If more space is ouquirod)
<br />ITY OF �ONTRAC'T AS I3,WgDCTSLE ENT Bff ITIONNAL INSURED WHERE REQUIRED BY WRITTEN
<br />HELD
<br />'March for Life Rally'
<br />SOBDPUB
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of South Bend ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Public Works
<br />227 W. Jefferson AUTHORIZED REPRESENTATIVE
<br />South Bend, IN 46601
<br />v T`JtftS-ZUUa ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD
<br />
|