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ACOROP" CERTIFICATE OF LIABILITY INSURANCE DAT71/3M��YI 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: N the certificate holder is an ADDITIONAL INSURED, the policy(Nes) 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 NAME CT Stephen SvAhart Gibson Insurance Agency, Inc. ac w Err . (BCC) 814-2122 INC Nap (800) 836-2122 202 S Michigan SL Suite 1400 q ueess: sswihart@thegibsonedge.com INSURERISAFFORDING COVERAGE NAICR South Bend IN 46601 INSURER A: Peerless ins Co 24198 INSURED INSURER B: Indiana Ins CO 22659 South Bend Community School Corporation INSURER C: Safety National Cas Co 15105 215 S Dr. Martin Luther King Jr Blvd INSURER 0: INSURER E : South Bend IN 46601 INSURER F: COVERAGES CERTIFICATE NUMBER: 20/21 Liab REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER OD 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 TOALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INIRR LTR TYPE OF INSURANCE AUM IN bust Vnl POUCYNUMBER EFFUP NUr1DDY IMMIOIDV/YYY)( WMTS COMMERCIAL GENERAL LIABILITY CLAIMSAIADE l OCCUR EACH OCCURRENCE S 1.000,000 PREMISES Ea occu,,em=1 S 500,000 MED EXP (Any one Person) S 15,000 PERSONAL&ADV INJURY 5 1.000,000 A CBP8493461 12/01/2020 121012021 GENI.AGGREGATE LIMIT APPLIES PER. PRO POLKY a IECT LOC GENERALAGGREGV,TE 5 2.000,000 PRODUCTS-COMPIOP AGG 5 2.000,000 OTHER: Employee Benefits S 1.000.000 AUTOMOBILE LIASILITY COMBINED SINGLE LIMIT 5 1.000,000 Ea sood m ANYAUTO BODILY INJURY Per person) S A OWNED SCHEDULED AUTOS ONLY AUTOS BA8493457 12/01/2020 12/01/2021 BODILY INJURY (Per aciden) 3 HIRED NON-OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE per aptldan GARAGEKEEPERS - 5 30,000 UMBRELLALIAB OCCUR EACHOCCURRENCE S 10,000,000 B EXCESS LIAR CLAIMS-MAOE CUB493453 12/01/2020 12/01/2021 AGGREGATE s 10.000,000 DED I >< RETENTION 5 10.000 S Q WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNEM11UTNE OFFICERAIEMSER EXCLUDED' NIA SP4059117 07/07/2020 07/07/2021 PER P STATUTE I I ER E L. EACH ACCIDENT 3 1.000,000 E L. DISEASE � EA EMPLOYEE 5 1.000,000 (Mandatory in NHl It yes "come upper DESCRIPTION OF OPERATIONS orlow E DISEASE -POLICY UNIT 5 1,000,000 OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Romorim Schedule, may M attached N more space is required) The CTy of South Bend 227 W Jefferson St. South Bend IN 46601 SHOULD ANY OF THEASOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. YV IMV HILEV HEPHESENIATNE 1988-2015 ACORD CORPORATION, All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD