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"ACC>RV CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DDnmrY) <br />04/06C2019 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND 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(les) 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 endomemen s . <br />PRODUCER CON Cl Oayidf Giles <br />The Leadership Insurance Agency, Inc. PHONES 574-277-1611 FAX 574 2734557 <br />52303 Emmons Road -M leadership@leadershi ins.cDm <br />i <br />Suite 31 .. NAIL r ,,,,, <br />uNsuR��ls�►, AFFORDING COVERAGE <br />South Bend �...__ _ mu_ IN 46637 MHUAA, AUTO -OWNERS INS CO _ 18988 <br />INSURED IN B <br />The General Deli LLC INSURER c - <br />609 E Jefferson Blvd INsu ERo: <br />INSURER E <br />South Bend IN 46617 jtip RER P <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE 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 />LTR TYPE OF INSURANCE Y P LIMITS <br />I SR POLICY E POLI <br />X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1000000 <br />CLAIMS MADE a OCCUR -URNMEYMNTEp $ 300000 <br />MED EXP -5 10000 <br />A Y N 109013483 10/09/2018 10/09/2019 PERSONAL d ADv WJURY s 1000000 <br />GERL AGGREGATE ._._. ._ _..._ <br />LOdRAPPLIESPER: GENERAL AGGREGATE S 2000000 <br />POLICY M PR <br />LOC PRODUCTS -COMPIOPAGG S <br />],QTHER', $ <br />AUTOMOBILE LIABILITY OMdiINEO GLE LIMIT S <br />�.... <br />ANY AUTO BODILY INJURY (Per person) S <br />OWNED SCHEDULED BODILY INJURY (Per saddenl) $ <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED PROPERTY DAMAGE S <br />AUTOS ONLY AUTOS ONLY �LOPr(IIIa1_ <br />s <br />UMBRELLA LU1B OCCUR EACH OCCURRENCE S <br />EXCESS LIAR CLAIMS-MAOE AGGREGATE $ <br />ED]RETENTI N $ $ <br />WORKERS COMPENSATION PER AND EMPLOYERS' LIABILITY Y / N S H <br />ANY PROPRIETOWARTNERIEXECUTIVE E.L. EACH ACCIDENT S <br />OFFICERNEMBERE,XCLUDED? NIA <br />(Man dalory In NH) E.L. DISEASE - EA EMPLOYEE $ <br />Ilyes dooWboundar <br />DE C R PTION OF OPERAT12NS kft E.L DISEASE -POLICY LIMIT S <br />Liquor Liability Each Occurence 1000000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be aUashed 11 more space Is required) <br />City of South Bend is additional insured with respect to General Liability. <br />City of South Bend <br />1400 County City Building <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 />.aw <br />a w <br />ACORD 26 (2016/03) <br />01988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />