License - Renewal for Public Parking Facility - Episcopal Cathedral of St. James

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SOUTHIND01 A�ORO CERTIFICATE OF LIABILITY INSURANCE DA 111212021 111212021 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. IIVII-UM IAN 1: IT the certiticate 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 CT JJ --8 —00 — The Church Insurance Agency Corp 1-293-3525 Y FAX 210 S out h St, Ste 2 SA1C. Ne E><t}; Bennington, VT 05201-2894 INSURED Cathedral of St James 117 N Lafayette Blvd South Bend, IN 46601-1507 INSURER AFFORDING COVERAGE Church Ins Co of Vermont I INSURER S; INSURER C : 10 RIRD: INSURER E - INSURER F NRIC p 110669V 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. ITR SR i yTYPE OF INSURANCE DDL1$UBR POLICY NUMBER POLICY EFF POLICY EXP - LIMITS A I X J COMMERCIAL GENERAL LIABILITY FACHO999RRENCE_ $ 1,000,0C CLAIMS-MADEExi OCCUR N N P0006095 5/1/2020 5/1/2021 ETaRErir>=1i 1,000,00 P- 55.{Ea occurrenret S 30,00 - — r�RsQM�L &, Aov INJ�IFiY 1,000,00 P11W1LA:GGREGATE LIMIT APPLIES PER: ENERALAGGiiFr,GAFE S 5,000,00 POLICY ❑ PERCT O ❑ LOC r ............... _ ! I 1 nnn ITf1 AUTOMOBILE LIABILITY f PPMOINED SINGLE LIMIT a3.4IIfti1.. ANY AUTO -i$ Ill OWNED SCHEAUTOS AUTOS ONLY j +!f BOOlLYINJURY Per. -[ n S AUTOS ONLY 8 ALl OS�NEY f +I BOOlLYlNJ RY PBralxiden! I P,D_�FY � GE -- -- UMBRELLA LIABOCCUR J FACH - URREN� EXCESS LIAR CLAIMS -MADE + AGGREGATE S DED 71 RETENTION $ WORKERS COMPENSATION S AND EMPLOYERS' LIABILITY Y 1 N PA TE ,�* ANY pp��FIC£R/M MTBOER7PXCtUOEb%ECUTIVE I�1 N/A E-L-EACCHACCIDENT�_ [Mandatory�n NH} �I descrme under E_; DISEASE - EA EMPLOYEE S If s, DE IPTION FOP RAT! N I �v A General Liability - "S"form N N VPPDO06095 51112020 5/112021 Umbrella Cove age I DESCRIPTION OF OPERATIONS' LOCATIONS? VE[ IICLES (ACORD 101. Additional Remarks Schedule, may ne attached if more space is required) Church parking lot used as public facility, city named as an additional insured. 117 N Lafayette Blvd. public parking 309 W Washington publick parking CANCELLATION: THE POLICY IS SUBJECT TO THE PREMIUMS, FORMS, AND RULES IN EFFECT FOR EACH POLICY PERIOD. SHOULD THE POLICY BE TERMINATED, THE COMPANY WILL ENDEAVOR TO GIVE THE ADDITIONAL INTEREST IDENTIFIED 30 DAYS WRITTEN NOTICE, AND WILL SEND NOTIFICATION OF ANY CHANGES TO THE POLICY THAT WOULD EFFECT THAT INTEREST, IN ACCORDANCE WITH THE POLICY PROVISIONS OR REQUIRED BY LAW - TION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of South Bend THE EXPIRAIION DATE THEREOF, NOTICE WILL BE DELIVERED IN 227 W Jefferson Blvd., Ste 1400 South ACCORDANCE WITH THE POLICY PROVISIONS - South Bend, IN 46601 - AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD