License - Renewal for Public Parking Facility - 100 W. Navarre St., 621 Memorial Dr., 707 N. Michigan St.

Home Browse Search

C �e DATE (MM/DDIYYYY) `� CERTIFICATE OF LIABILITY INSURANCE 9/30/2022 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 endorsement(s). PRODUCER CONTACT The Horton Group PHONE FAx 10320 Orland Parkway (� G..No E<sf; 708 845 3000 TAlC,H,1: Orland Park IL 60467 EA pRess: certificates ehortv rou .com INSURER(S) AFFORDING COVERAGE NAIC # INSURED BE, Beacon Health System, Inc; Beacon Medical Group Memorial Hospital of South Bend, Inc.; Elkhart General Hospital Community Hospital of Bremen 615 N Michigan Street South Bend IN 46601 INSURERA: Medical Protective 11843 INSURER B : Selective Insurance Company of America 12572 INSURER C D: COVERAGES CERTIFICATE NIIMRFR-1d7R7QA11R RFVISInN 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 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. y R TYPE OF INSURANCE iADDL SUBR POLICY NUMBER POLLIICY EFF POLICY EXP . LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y H002223 10/1/2022 10/1/2023 EACH OCCURRENCE $1,000,000 CLAIMS -MADE I X J OCCUR P E SE ac L $ 100 000 MED EXP (Any one person) $ 5,000 X 1.000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY PRO ❑ LOC X JECT PRODUCTS-COMP/OPAGG $3,000,000 $ MER: B AUTOMOBILE LIABILITY ANY AUTO Y Y S 2547491 8/13/2022 8/13/2023 COMBINEDCEatSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ OWNED X SCHEDULED AUTOS ONLY AUTOS tid Per accident) BODILY INJURY ( ) $ X I HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTYDAMAGE PAr $ $ A UMBRELLA LIAB 1 OCCUR E002223 10/1/2022 10/1/2023 EACH OCCURRENCE $ 15,000,000 X EXCESS LIAB X yl CLAIMS -MADE AGGREGATE $ 15,000,000 DED X RETENTION $ $ WORKERS COMPENSATION PER - AND EMPLOYERS' LIABILITY Y i N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? NIA STATUTE J ER E.L. EACH ACCIDENT $ EL DISEASE - EA EMPLOYE (Mandatoryin NH) $ If yes, describe under DESCRIPTION OF OPERATIONS below $ E.L. DISEASE - POLICY LIMIT A A Medical Malpractice Shared Limits Med Malpractice Separate Limits H002223 10/1/2022 H002223 10/1/2022 10/1/2023 10/1/2023 Inddent Aggregate Incident/Aggregate 500,000 15,000,000 500,000/ 1,500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Annual Parking Garage License: CMS, Bartlett and Navarre Garages. CERTIFICATE HOLDER CANCELLATION City of South Bend 227 W. Jefferson Blvd. Suite 1400 South 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD