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.� A&BEN-1 OP ID: TB <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 />INSR <br />LTR <br />ACORO CERTIFICATE OF LIABILITY INSURANCE <br />lk� <br />DATE(rv1r0JDDlYYYY) <br />1 03/10/2021 <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(ies) 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 endorsement(s). <br />PRODUCER 618-692-9800 <br />Assurance Brokers Ltd. <br />95 North Research Dr Ste 100 <br />Edwardsville, IL 62025 <br />ONTACT _. <br />CNAE <br />PHONNE618-692-9800 FAX 618-692-9865 <br />(AIC, No, Ext): (AIC,No): <br />MMS: <br />INSURER(S) AFFORDING COVERAGE NAIC <br />EACH OCCURRENCE $ 2'000'000 <br />INSURER A:century Insurance Group 36951 <br />MED EXP An one person)$ 10,000 <br />INSURERB:star Insurance Company 18023 <br />INSURED <br />A & B Environmental <br />Construction Inc <br />INSURER C LM Insurance Co 33600 <br />INSURER D: <br />1534 N. Mannheim Rd <br />Stone Park, IL 60165 <br />INSURER E : <br />AUTOMOBILE LIABILITY <br />A14Y AUTO <br />i OWNED SCHEDULED <br />AUTOS ONLY X AUTTOSW E <br />AUTOS ONLY AIJTO�o ONI <br />INSURER F: <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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDLSUB <br />INSD <br />CITY OF SOUTH BEND <br />POLICYNUMBER <br />POLICY EFF <br />MM/DD <br />POLICY EXP <br />MM/DD <br />LIMBS <br />A <br />A <br />A <br />X I COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE � OCCUR <br />LLUTION LIAB <br />X <br />CCP914171 <br />CCP914171 <br />CCP914171 <br />09/06/2020 <br />09/06/2020 <br />09/06/2020 <br />09/06/2021 <br />09/06/2021 <br />09/06/2021 <br />EACH OCCURRENCE $ 2'000'000 <br />DAMAGE TO RENTED 151 (Ea occ France) $ 100 000 <br />MED EXP An one person)$ 10,000 <br />NERAL CONT/LEAD <br />PERSONAL&ADV INJURY $ 2,000,000 <br />ZGE'L GREGATE LIMIT APPLIES PER: <br />ICY 7 JECT EILAC <br />ER <br />GENERAL AGGREGATE 2,000,000 <br />PRODUCTS - COMP/OP AGG $ 2,000,000 <br />B <br />AUTOMOBILE LIABILITY <br />A14Y AUTO <br />i OWNED SCHEDULED <br />AUTOS ONLY X AUTTOSW E <br />AUTOS ONLY AIJTO�o ONI <br />CA0937340 <br />09/06/2020 <br />09/06/2021 <br />COMBINED SINGLE LIMIT $ 1,000,000 <br />BODILY INJURY Per person) $ _ <br />BODILY INJURY Per accident <br />P08Ed. AMAGE <br />o $ <br />A UMBRELLA LIAB <br />X 1 EXCESS LIAB <br />XCCUR <br />CLAIMS -MADE <br />CCP914172 <br />09/06/2020 <br />09/06/2021 <br />EACH OCCURRENCE 1'000'000 <br />AGGREGATE $ <br />DED RETENTION $ <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PE{O� EI MTgO�RR EXC UDED9 CLRIVE Y� <br />andatory In NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N f A <br />I <br />I <br />WC5-39S-344437-030 <br />I <br />06/1212020 <br />06/12/2021 <br />X UATUTE OTH- <br />ER <br />1,000,000 <br />E L. EACH ACCIDENT <br />E L. DISEASE - EA EMPLOYEE $ <br />E L DISEASE - POLICY LIMIT <br />A ,Professional Llab <br />CCP914171 <br />09/0612020109/06/2021 <br />Ea Claim 2,000,000 <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required) <br />CITY OF SOUTH BEND, LEAD HAZARD REDUCTION PROGRAM IS INCLUDED AS AN <br />ADDITIONAL INSURED. <br />CFRTIFICATF 1-101 r)FR CANCELLATION <br />CITYSOU <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />CITY OF SOUTH BEND <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />LEAD HAZARD REDUCTION PROGRAM <br />227 W JEFFERSON BLVD <br />SOUTH BEND, IN 46601 <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />