Opening of Bids - Fat Daddy's Building Demolition Proj No 118-066 - Green Demolition Contractors

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CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 11/16/2018 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 lieu of such endorsement(s). PRODUCER CONTA' T David S. Parrilli Parrilli, David PHONE (312) 621-5182 FAX (312) 621-2288 AM. No JAYC No'„ The Rockwood Company IL ADDRESS: dparrilli@rockwoodco.com 20 N Wacker Drive, Suite 960 INSURER(S) AFFORDING COVERAGE NAIC # Chicago IL 60606 INSURER A : Navigators Specialty Ins Co, 36056 INSURED INSURERS: Star tone National Insurance CO„ 25496 Green Demolition Contractors Incorporated, LLC INSURER C : 523 Northbrook Drive INSURER D : INSURER E t.. Michigan City IN 46360 INSURER F : 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 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, WW_ LTR TYPE OF INSURANCE ADM INSIDPOLICY NUMBER POLICY EFF 'Mmmorym PO MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY _ EACH OCCURRENCE 1$ 1,000,000 s PRE h1ISFSw.TCraanca.� $ 50,000 CLAIMS-MADE IROCCUR MED EXP (Anv one person) $ 5,000 A X IS18CGLI328961C 10/01/2018 10/01/2019 1,000,000 PERSONAL &ADV INJURY $ +:OENLAGGREGATE, LIMIT APPLIES PER: GENERAL AGGREGATE $ 2000000 I POLICMIPRO- p LOG u—I� PRODUCTS '.$ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY L.OMFTdNEO Ea �daSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO A OWNED (SCHEDULED AUTOS ONLY '..AUTOS IS18CGL1328981C 10/01/2018 10/01/2019 BODILY INJURY (Per accident) $ HIRED NON -OWNED UJFTOPERT'y DAMAGE 'Pen a.Cdr1[pW14' AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 10,000,000 B EXCESS LIAB CLAIMSMADE 59095B186ALI 10/01/2018 10/01/2019 AGGREGATE $ 10,000,000 10,000 DE'D1X1 RETENTION $ $ WORKERS COMPENSATION ,. . ,,.. PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A "'* E.. L. EACH ACCIDENT $ 0., OFFICERIMEMBER EXCLUDED? „ ., (Mandatory Mandain NH ) w E.L. DISEASE - EA EMPLOYEE $ If yesascribe under DESCRIPTION OF OPERATIONS below" °„ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached ,,.,Oro space is required) Additional Insured when required by written contract per ISO Form CG 2010 (10/01) and CG 2037 (10/01) Oldched) City of South Bend Indiana City of South Bend Indiana Department of Public Works 227 West Jefferson South Bend IN 46601 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 9)1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD