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

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DATE (MMIDDIYYYY) +e✓ [ s CERTIFICATE OF LIABILITY INSURANCE 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 endomement(s). PRODUCER CO E7 NAM.'T David S, Parrllll Parrilli, David PHONE (312) 621-5182 1 � Ne ,, (312) 621-2288 The Rockwood Company FE-MAILS5a dparrilli@rockwoodco.com 20 N Wacker Drive, Suite 960 INSURER($) AFFORDING COVERAGE NAIC # Chicago IL 60606 INSURERA : Navigators Specialty Ins Co., 36056 INSURED .. StarStone National Insurance Co., 25496 Green Demolition Contractors Incorporated, LLC INSURER C 523 Northbrook Drive INSURER D INSURER E t Michigan City !N 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. fiCY 4.:Tfd TYPE OF INSURANCE v..........�M.m-�. I, POLICY NUMBER MY EPF MMIDDIYYYY EXP MMIO DDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE NOCCUR _P PR. MI S E u__rra, nice..... $ 50,000 MED EXP (Any one person) $ 5,000 i Ll A X IS18CGL1326961C 10/01/2018 10/01/2019 PERSONAL& ADV INJURY $ 1,000,000 -'L AGGREg7c LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 I 1„pCy" NaR1,y. LOG R'J PRODUCTS - COMP/OP AGG $ 2,000 000 OTHER: $ AUTOMOBILE LIABILITY �d111'SINGLr UMfT $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED ISI8CGL1326961C 10/01/2018 10/01/2019 BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS PROPERTY DAMAGE, $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Peon aC,e„or�oxat UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 10,000,000 AGGREGATE .... $ 10,000,000 B '.. EXCESS LIAB [1.CLAIMS-MADE 590956186ALI 10/01/2018 10/01/2019 DED I Xi RETENTION S. 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN -.. STATUTE. EORH ANY P'ROPRIETOR)PARTNCRiEkECUTIVE EL EACH ACCIDENT $ EXCLUDED? ❑ N/A {Marrdatoryin NH) EL, DISEASE- EA EMPLOYEE '.... $ ,O1rlrE11IMEM1Jf:R If yes, describe under DESCRIPTION OF OPERATIONS below I E.L. DISEASE- POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Additional Insured when required by written contract per ISO Form CG 2010 (10/01) and CG 2037 (10101) (attached): 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 4 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD