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" �T'G►0730CERTIFICATE OF LIABILITY INSURANCE DATE /30//01 B2018 Y) ' 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 CONTACT NAME: Laura Van Dyke Gibson Insurance Agency, Inc. PHA E, (574) 245-3504 A No (574,) 236-6399 DRESS: Ivandyke@gibsonins.com 130 S Main St, Ste 400 AD PO Box 11177 INSURERS) AFFORDING COVERAGE NAIC p South Bend IN 46601-0177 INSURERA: Cincinnati Insurance Co INSURED Navarre Hospitality Group, LLC, DBA: Navarre Hospitality 105 W Colfax Ave South Bend IN 46601 INSURERS: Western World Ins Cc INSURER C : Accident Fund Natl Ins Co INSURER D . INSURER E : INSURERF: E12305 COVERAGES CERTIFICATE NUMBER: 18/19 Liability 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 IN R.. .._. A t.. SUBR POLId_YTff_LILY EX'P LTR TYPE OF INSURANCE INSO WVD POLICYNUMBER MM/DDIYYYY MWDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 ._._.. ....._ .................m DAMAGE TO RENT »X'... CLAIMS -MADE OCCUR PREMISES Ea occurrence $ MED EXP (Any one person) S 2,000 A EPP0450028 08/01/2018 08/01/2019 'PERSONAL &ADVINJURY $ 1,000000 GENT AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY FIR JV::�CT LOC PRODUCTS - COMP/OP AGG 2,000,000 $ 07HER: Damage to Premises $ 500,000 ___ ................................... AUTOMOBILE LIABILITY COMe+NE&SINGLE LIMIT ----- $ 1,000,000 .W Ea at:cidenR X ANY AUTO BODILY INJURY (Per person) $ ..........._ A OWNED SCHEDULED EPP0450028 OB/01/2018 08I01/2019 BODILY INJURY (Per accident) .............__.., $ AUTOS ONLY AUTOS HIRED �' NON -OWNED PROPERTY DAMAGE; $ AUTOS ONLY AUTOS ONLY 'Per anIJ a —vac s_. Medical payments $ 5,000 . ........w UMBRELLA LIAR OCCUR EACH OCCURRENCE .......W $ 5,000,000 B EXCESS LAB X CLAIMS -MADE BE 027710972 08/01/2018 08/01/2019 AGGREGATE $ 5,000,000 DED RETENTION $ WORKERS COMPENSATION " PEROTH- AND EMPLOYERS' LIABILITY YIN TUTE R ANY PROPRIETOR/PARTNER/EXECUTIVE C N/A WCV6148032 08/01/2018 08/01/2019 E,.L. EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E,L.. DISEASE - EA EMPLOYEE _ _ $-500,000 If yes describe under .. 500,000 DESCRIPTION OF OPERATIONS below E L.. DISEASE - POLICY LIMIT $ Liquor Liability A EPP0450028 08/01/2018 08/01/2019 Each Common Cause $1,000,000 Aggregate $2,000,000 _.... --- - _._. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ._.._.......... City of South Bend is additional insured with respect to general liability coverages as required by written contract. City of South Bend 227 W Jefferson South Bend ACORD 25 (2016/03) 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 IN 46601 @ 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD