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WESTBEND <br />A MUTUAL INSURANCE COMPANY' <br />Date: 06/04/2019 <br />Bond Number: 2413278 <br />DAN BERRY INSURANCE AGENCY INC <br />54101 IRONWOOD RD <br />SOUTH BEND, IN 46635 <br />PRINCIPAL INFORMATION: <br />Niezgodski Plumbing, Inc. <br />PO Box 3096 <br />South Bend, IN 46619 <br />Billing Address - if blank, see Principal above: <br />Obligee Information: <br />City of South Bend Board of Public Works <br />227 W Jefferson Blvd <br />South Bend, IN 46601-1830 <br />WB Index: NLF 2413278 0 <br />Bond Eff Date: 07/16/2019 <br />Bond Exp Date: 07/16/2020 <br />THE SILVER LINING' <br />13020 <br />E <br />BOND EXECUTION REPORT <br />Bond Type: -Generic License & Permit Compliance (including Instant Issue) <br />Work Description: License & Permit Compliance <br />Plumbing Contractor <br />Current Bond Limit: 25,000.00 100.00 <br />$ Bond Premium: $ <br />Previous Bond Limit: $ Premium Change: $ 0.00 <br />THIS IS NOT AN INVOICE <br />MICHIGAN ONLY: This policy is exempt from filing requirements of Section 2236 of the Insurance Code of 1956, <br />1956 PA 218 and MCL 500.2236. <br />P.O. Box 620976 1 Middleton, W1 53562 1 Plione: (608) 410-3410 1 Fax: (877) 674-2663 1 www.thesilverlining.com <br />