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CERTIFICATE OF LIABILITY INSURANCE DATE (MM/1 or2s/2018 Y) <br />018 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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 have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on <br />this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). <br />PRODUCER NAND Elfe Uoyd <br />Gibson Insurance Agency, Inc. PHONE (800 814.2122 Ne , (800) 836-2122 <br />130 S Main St, Ste 400 do<3RES5:, elloyd(gitascanins.corn <br />PO BOX 11177 INSURER(S) AFFORDING COVERAGE NAIC k <br />South Bend IN 46601-0177 INSURERA: Cincinnati Insurance Co <br />INSURED INSURER B : Cincinnati Cas Co 28665 <br />Lawson -Fisher Associates, PC INSURER C ., <br />525 W Washington Ave INSURER D : <br />Suite 200 INSURER E : <br />South Bend IN 46601 INSURERF: <br />COVERAGES CERTIFICATE NUMBER: 11-1-18119 Liability REVISION NUMBER: <br />THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMEDABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAYBE 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 />KW AWD1.5UHR POLICY EFF <br />LTR TYPE OF INSURANCE D POLICY NUMBER MM/DDIYYYY MMIDDrYYYY LIMITS <br />''" COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s 1,000,000 <br />CLAIMS -MADE OCCUR DAMAGETORENTED PREMISES 1Eaaccumence S 300,000 <br />Contractual Liability MED EXP (Any one person) S 10,000 <br />A XCU Included ECP0462552 11/01/2018 11101/2019 PERSONAL &ADV INJURY S 1,000,000 <br />GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br />POLICY 19 PRO- JECT ❑ LOC PRODUCTS -COMP/OPAGG $ 2,000,000 <br />PRO - <br />OTHER. S <br />AUTOMOBILE UABILITY CCIMBINEffgmdUrE U IT s 1,000,000 <br />Ea acddenQ. <br />X ANYAUTO BODILY INJURY (Per person) S <br />A OWNED SCHEDULED ECP0462552 11/01/2018 11/01/2019 BODILY INJURY (Per accident) $ <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED PROPERTY DAMAGE <br />AUTOS ONLY AUTOS ONLY Pan accldanl s <br />S <br />X UMBRELLAUAB x OCCUR EACH OCCURRENCE $ 5,000,000 <br />A EXCESS LIAB CLAIMS -MADE ECP0462552 11/01I2018 11101/2019 AGGREGATE $ <br />5,000,000 <br />DED I X1 REtiENTVON s s <br />WORKERS COMPENSATION X STATUTE ERH <br />AND EMPLOYERS' LIABILITY ANYPROPRIEfOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT S 1,000,000 <br />B OFFICER/MEMBEREXCLUDED? F1 N/A EWC046255300 11/01/2018 11/01/2019 <br />(Mandatory in NH) E.L.DISEASE - EA EMPLOYEE S 1,000,000 <br />If yes, describe under 1,000,000 <br />DESCRIPTION OF OPERATIONS below E.L.. DISEASE - POLICY LIMIT $ <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) <br />CERTIFICATE HOLDER CANCELLATION <br />City of South Bend Board of Public Works <br />1316 County -City Building <br />South Bend <br />IN 46601 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS, <br />AUTHORIZED REPRESENTATIVE <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />