Opening of Qualifications - RFQ - Qualified Contractors for Lead Hazard Reduction Demonstration Grant - Building Millenium Consultant Construction LLC

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• Q0 DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 3/18/2019 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: N .CT NAME: McClain -Matthews Insurance r�H+ N 3ti"7 298 750t3 FAX 317-298-75,13. 6329HollisterDrive - MAIL EaIt1. I .Nil° Indianapolis, IN 46224 swooRESs. INSUfiTF%§J,Affgf JRMdG COVw RAGE NAIC 4 INsuRER A : Western Reserve Mutual Casualt INSURED INSURER B: AC Insurance C�snapa'any._____. Building Millennium Consultant INSURER C Construction LLC INSIUR!T D. P.O. Box 20787 INsuRER,. E:I Indianapolis, IN 46220-0787 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, I TYPE OF INSURANCE ... .... .... .. POLICY N,�- .(-. .J, Y EXIT .. ...... _. _..... 94SR AIPDL"5UBR POLICY EFF POLIC LIMITS LrR UMBER MRDD/YYYY MMRDB7IYYYY 's COMMERCIAL GENERAL LIABILITY WCS 1311055076 3/26/2019 3/26/2020 EACH OCCURRENCE $ 1,000,000 ,A � X X bA-MAGETC1 RENTED CLAIMS -MADE OCCUR PFdEMI$ES (IEa cccurrenP;a) $ 50,000 MED EXP (/any one person) $ _ 5,000 � PERSONAL & ADV INJURY $ 1,000,000 I GEN`L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 " 1101ICY �LOPRODUCTS $T�;�2,II0„00�0 - ........_.- ,—....�.,., _. NSS-....... COMM �eyxpyCINGLE VOMIT .� AUTOMOBILE LIABILITY INSS-1041s6316 1/23/2019 1/23/2020 $ 1,000.0 (ca00 ANY AUTO X BODILY INJURY (Per person) $ B ;OWNED I SCHEDULED BODILY INJURY (Per accident} AUTOS ONLY ,AUTOS HIRED NON -OWNED PO Pr1RT'Y DM'dw9AG = AUTOS ONLY ,. AUTOS ONLY ,(Petr,aarpleaer),n . UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE RETENTION $ $ WORKERS COMPENSATION PER AND EMPLOYERS' LIABILITY Y/ .N STATUTE }R ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A --- - (Mandatory in NH)"" E L. DISEASE - EA EMPLOYEE] $ If yes, describe under -- DESCRIPTION OF OPERATIONS below EL. DISEASE -POLICY LIMIT $ i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) City of South Bend and Saint Joseph County are added as Additional Insured CERTIFICATE IIOLDER CANCELLATION City Of South Bend and Saint Joseph County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 125 S Lafa ete Blvd, Suite 100 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y ACCORDANCE WITH THE POLICY PROVISIONS. Souh Bend, IN 46601 AUTHORIZED REPRESENTATIVE K a rb P B ".P0-W ©1988-2015 ACORD CORPORATION. All rights reserved, ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD