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<br />"<>"' CERTIFICATE OF LIABILITY INSURANCE °ATE(MMIDDmYY)
<br />wa. 7/26/2019
<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 be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER ��Frank Griffin
<br />PHONE. (617)rAnxAmitY insurance Agency, Inc. 471-1220
<br />la,
<br />500 Victory Rd. L f riffingamit inB.com
<br />A1Ni14ES3. g Y _
<br />Marina Say w_W.._ F") .FF .m ...V __.._. ., ._ �
<br />INSURE 9 AFFORDING COVERAGE NAIL Y
<br />I y 2171 INSURERA Liberty Mutual Fire Insurance 23035
<br />North Quincy mm..... �.... ._......... �,..._...�,. .w_....w, m .__.Y.m.�.
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<br />INSURED INSURER 8: Liberty_ Insurance Corporation 42404
<br />LAZ Parking Midwest, LLC INSURER C:Berkle Insurance Comma 1 32603
<br />33 West Monroe Street INSURERD:Markel AmericanaInsurnce Com an 28932
<br />Suite 2010 WSURERE Federal Insurance Company 20281
<br />Chicago IL 60603 INSURER F: Everest National Insurance Com an 10120
<br />COVERAGES CERTIFICATE NUMBER:19-20 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 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 />-i ..._._—__ ... .......... ..n ... ,.� ....... _ _ _.w,.� . .. 1— ....w.......
<br />TYPE OF INSURANCE .,_. POI IOY YY LIMIT � -
<br />MTSR AODL U�:kR. POLICY NUMBER POLIi,Y EIF.♦," S
<br />y..•.. IGiFAxSCTsHa9.aGtGsG.UJR��otIiiTI�IuUFC;ofiC-C p Y 9U.. -1, 000, 000
<br />SPK9AL ENEtA4 11000,000GENERALLIABILITY
<br />7
<br />A
<br />m, CANIv S4AU V,w f'Ji.XUR r.B2611260451039 /31/2019 '1/31/2020 .,..k.......... .
<br />11fi D uX@ (Any_!,, er.arnp E EXCLUDED
<br />uI U'tS;I at._ Alavl Jl.lwty 1, 000, 0001
<br />t ouET�aI�Aq(',![ d TE h 2,000,000
<br />N C, Af: Iar�Ar L..itt is Aal llrs PER: PR0I1)UCfS-c0lWl10I AGr,� h �2,000,000
<br />.._ _....... m
<br />r oticw 2 X', I.E .
<br />AUTOMOBILE LIABILITY COMPRED 7NOf-1-LIMIT
<br />% ANY AUTO BODILY _...... .,• 1. 1t ?.0 0001�?,.IJQ
<br />E3,�.0
<br />INJURY (Par Pr^rsr nt 1
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<br />.....
<br />ALL OWNED SCHEAUTOUJUI.I�:.u'S I 32611260451019 L19 � /31/2020 U.3or11[.'Y INJU RY U air ercdnnt
<br />AUTOS Ai1TC1G I� 7
<br />._..._ NON-OWNEDVR—OK-R
<br />P•.:3.6.°muSi)AMAGE ww.�•ww_......»,,.,.
<br />R HIRED AUTOS AUTOS
<br />TYD�
<br />$
<br />EE ATTACSEDLIST OF X UMBRELLA LIAR X C3CQ R EACH OCCURRENCE S 100, 000, 000
<br />][ EXCESS LIABrGAIAEKEEPERS
<br />t,l „ 1?OLICIEB 7/31/2019 '1/31/2020 ,A 'CRG iwATE'.. ..� ... ..�
<br />RE'rENUON � 7;
<br />B S COMPENSATION ISTATU- -j OTH-.
<br />LOYERS` LIABILITY Y. N X wI �LI _ ER..... �......... ,„,..„,,............._
<br />RIETOR/PARTNER/EXECUTIVE EL. EACH ACCIDENT $ 1, QQQ QpQ
<br />M EMBER EXCLUDED? NIA .KL EA., .„,
<br />y in NH} PA761D260951029 /31/2019 /31/2020 G I... DU„hAul AEI 0I Q C E 1, 000, 000
<br />cribe under--°^°^ -----°° --- ----
<br />DESCRIP PION OF OPERATIONS below F.U., DI.0..A f I' PU„ICY 4.IMIT $ 1 000,000
<br />-- ...._� ..,..... ,..............._ ...�... .......m.........._ __.....___._ �,.�.�...........
<br />A KEEPERS LIABILITY 32611260451019 /31/2019 7/31/2020 S1,000,000LII`fir
<br />C CRIME/EMPLOYEE DISHONESTY OCCR4500289221 /31/2019 a/31/2020 51,auul,all¢rIIwily
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES IAftech ACORD 101, Additional Remarks Schedule, If more space is required)
<br />If agreed upon in a written contract or agreement, City of South Bend is included as an additional
<br />insured for general liability, but only with respect to the operations of the named insured. Re: 220903 -
<br />Eddy Street Commons at Notre Dame
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of South Bend ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Attn: Michelle Adams
<br />227 W. Jefferson Boulevard AUTHORIZED REPRESENTATIVE
<br />South Bend, IN 46601
<br />1 �Frank Griffin/FG
<br />I�
<br />A CIRD 25 (201OMS) 0 1988-2010 ACORD CORPORATION. All rights Poser
<br />I S25 (201005).01 The ACORD name and logo are registered marks of ACORD
<br />
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