Opening of Bids - 2023 Water Utility Service Line Repair Program - Bob Frame Plumbing Services, Inc.

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ACOR 7 L� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDAYYY) I 02/16rz022 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 hostler is an ADDITIONAL INSURED, the policy(les) 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 hostler in lieu of such endorsements . PRODUCER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 CONTANAME: CT CLIENT CONTACT CENTER n pa/cNo E.t : 888-333-4949 n/c No): 5074464664 OWATQNNA, MN 55060 ADDRESS: CLIENTCONTACTCENTER FEDINS.COM INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 264-429-2 INSURER B: INSURER C: BOB FRAME PLUMBING SERVICES INC 2442 JACLYN CT SOUTH BEND, IN 46614-3700 INSURER D: INSURER E: INSURER F: 22 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. INS L R A X TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR ADDL INSR Y SUBR D N POLICY NUMBER 9403507 POLICY EFF MM/DOIVYYV 04/01/2022 POLICY EXP MMIDDIYVYY 04/Oi/2023 LIMITS EACH OCCURRENCE $1,000,000 DAMAGE TO RENTE PREMISES E occurrence $100,000 LIED EXP (Any one person) EXCLUDED PERSONAL a ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 AGGREC TE LIMIT APPLIES PER: PROJECT ❑LOC POLICY LJ u OTHER: OEN'L X PRODUCTS - COMPIOP AGO $2,000,000 A AUTOMOBILE LIABILITY MY AUTO OWNED AUTOS ONLY 60HEEDULED NON -OWNED HIRED AUTOS ONLY H AUTOS ONLY N N 9403507 04/01/2022 04/01/2023 EOa MBmeD SINGLE LIMIT $1,000,000 X BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY Per accidemil DAMAGE A X UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE N N 940350E 04/01/2022 04/01/2023 EACH OCCURRENCE $2,000,000 AGGREGATE $2,000,000 DED RETENTION A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIE%ECUTIVE OFIFICERIMEMSER E%CLUDEDT (Mandalantlalory in NH) N yea, describe under DESCRIPTION OF OPERATIONS below N/A N 9403509 04/01/2022 04/0112023 X PER STATUTE OTN- ER E.L. EACH ACCIDENT $5OO,000 E.L. DISEASE - EA EMPLOYEE $5001000 E.L DISEASE -POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be aaacnad It more space Is required) 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. 264429-2 220 CITY OF SOUTH BEND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 227 W JEFFEHSON BLVD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SOUTH BEND, IN 46601-1830 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 4" © 1988-2015 ACORD.CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD