Opening of Quotes - Water Works Utility Service Line Repair Program Proj No. 122-022 - Bob Frame Plumbing Services, Inc.

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A4CCW? 6r CERTIFICATE OF LIABILITY INSURANCE DAT02111/2021 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. 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 entlorsement s . PRODUCER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 CONTACT E: CLIENT CONIACT CEN ER n/cnxo Ext : 888-333-4949 AIX No); 507A46-4664 ADDRIESS: CLIENTCONTACTCENTER FEDINS.COM OWATONNA, MN 55060 INSURER($) AFFORDING COVERAGE MAIC R 04/01/2021 INSURERA: FEDERATED MUTUAL INSURANCE COMPANY 13935 EACH OCCURRENCE $1,000,000 INSURED 264-429-2 INSURER B: BOB FRAME PLUMBING SERVICES INC 2442 JACLYN CT INSURER C: - - INSURER D: SOUTH BEND, IN 46614-3700 INSURER E: OENERAL AOOREOATE $2,000,000 INSURER F: COVERAGES CERTIFICATE NUMBER: 22 REVISION NUMBER:0 THIB 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. INSR L TYPE OF INSURANCE ADDL Y SUBR - POLICY NUMBER POLICY EFF IOD POLICY EXP IDD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMSMAOElxl OCCUR N 9403507 04/01/2021 04/01/2022 EACH OCCURRENCE $1,000,000 PREMISES TOEa ocwr0renoel $100,000 OEN'L 1t NPOLICY MED EXP (my one Parton) EXCLUDED PERSONAL &ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: ❑JECT ❑LOC OTHER: OENERAL AOOREOATE $2,000,000 PRODUCTS - COMPIOP HOG $2,000,000 A AUTOMOBILE X LIABILITY ANY AUTO OWNED AUTOS ONLY AUTOSULED NON-OHIRED AUTOS ONLY AUTOS ONLY AUTOS ONLY N N 9403507 04/01/2021 04/01/2022 COMBINED SINGLE LIMIT $1,000,000 Ea ac<Ide BODILY INJURY (Per person) BODILY INJURY (Per eoddenq PROPERTY DAMAGE a ec<dent A X UMBRELLA LIARX EXCESS LIAB OCCUR CLAIMS -MADE N N 9403508 04/01/2021 04/01/2022 EACH OCCURRENCE $2,000,000 AGGREGATE $2,000,000 DED I I RETENTION A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOFIPARTNERIEXECUTIVE L OFFICER/MEMBER Exctuoeoy (Merelst.y in NH) II yes, describe under DESCRIPTION OF OPERATIONS below NIA N 9403509 04/01/2021 04/01/2022 OTH- X PER bTATUTE ER E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $500,000 El DISEASE -POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addl0one1 RemeMs Schedule, may be alheheL it more space Is requlred) THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. CERTIFICATE HOLDER CANCELLATION 264-429-2 220 CITY OF SOUTH BEND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 227 W JEFFERSON BLVD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SOUTH BEND, IN 46601-1830 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD