Special Event - Concours d'Elegance at Copshaholm -July 10

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ACOROJ OF LIABILITY INSURANCE DATE (MMIDD'YYYY) 11CERTIFICATE 06/09/2021 THIS CERTIFICATE IS ISSUED ASA 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. IMPORTANT: If the certificate 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 endomement(s). PRODUCER CONTACT CO FeCher NAME: Cory Gibson InsuranceAgency, Inc. PNONE (800) 814-2122 FAX (800) 836-2122 A/C No E xt: AIC No: 202 S Michigan St, Suite 1400 EMAIL cfecher@thegibsonedge.Cam EACH OCCURRENCE $ 1,000,000 ADDRESS: INSUMP481 AFFORDING COVERAGE NAICN CLAIMS -MADE 19 OCCUR South Bend IN 46601 INSURERA: Mount Vernon Fire Ins Co 26522 INSURED INSURER B Studebaker National Museum INSURER C: 201 Chapin St INSURER D: INSURER E: South Bend IN 46601 INSURERF: COVERAGES CERTIFICATE NUMBER: 07/10/21-07/12/21 EVENT REVISION NIIMRFR 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 CLAIMSINSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF MWDD'YYYY P. MWD ICY EXP UMTS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 UAMi TO HEATED PREMISES Ea ocaunence E CLAIMS -MADE 19 OCCUR MEDEXP onepersan S 1,000 PERSONALSADVINJURY E 1,000,000 A SE 2004943 07/10/2021 07/12/2021 GEN'LAGGREGATE LIMITAPPUES PER: POLICY 1:1 JEF] LOC GENERALAGGREGATE E 5,000,000 PRODUCTS -OOMP,OPAGG $ Dmg Prem Rent to You E OTHER: AUTOMOBILE LIABILITY 6GMBINED SINGLE LIMIT E Ea accidem ANYAUTO BODILY INJURY Per person) E I OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Par acddai $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY q PROPERTY DAMAGE E par PROPEaxidenRTY S UNBRFr r • LU18 OCCUR EACH OCCURRENCE S FJlCESS LaB CLAIMS -MADE AGGREGATE f DED RETENTION E E WORKERS COMPENSATION P R EMPLOYERS' UAMUW YIN STATUTE ER EOR E.L. EACH ACCIDENT E ANY PROPRIETOR/PARTNER/EXECLITIVE OFFICERNAEMBER EXCLUDED? ❑ NIA E.L. DISEASE - EA EMPLOYEE E (Mandatory In NH) If Yes, describe under E.L. DISEASE - POLICY LIMIT E DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AOdRbnal Remarks Schedule, nay he attached H mon, apace U required) Certificate holder is additional insured with respect to general liability coverages as required by written Contract, permit or agreement. The History Museum 808 W Washington St South Bend IN 46601 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Cal 1 QRR.9n15 ACr1Rn Cr1RPrIRATIr1N All .inhre ----A ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD