License - Renewal for Public Parking Facility - LAZ Parking Midwest, LLC

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AV CERTIFICATE OF LIABILITY INSURANCE ;;2 (MMIDD12 Y) 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 poiicy(ies) must 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 Frank Griffin NAME: Amity Ins., a Division of Brown & Brown of MA, LLC PHONE (617)471-1220 NO (617)479-5147 500 Victory Rd. ADDRESS: fgriffin@amityins.com Marina Bay INSURERS AFFORDING COVERAGE NAIC # North Quincy MA 02171 _ INSURER A: Liberty Mutual Fire Insurance 23035 INSURED INSURER B : LM Insurance Corporation 33600 LAZ Parking Midwest, LLC INSURER C: BerkleyInsurance Company 2603 33 West Monroe Street INSURERD:Markel American Insurance Com an 8932 Suite 2010 INSURER E: Federal Insurance Com an �J 0281 Chicago IL 60603 INSURER F: Everest National Insurance Comioanv L0120 COVERAGES CERTIFICATE NUMBER:22-23 REVISION NUMBER: 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 CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICYNUMBER POLICY EFF MWDDIYYYY POLICY EXP MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE 5 1, OOO, OOC PREMISES Ea occurrence $ 1,000,00C A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR EEB2611260451032 7/31/2022 7/31/2023 MED EXP (Any one person) S EXCLUDEL PERSONAL & ADV INJURY $ 1 , 000, OOC 7c Contractual Liability GENERAL AGGREGATE $ 2, 000, OOC GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,OOC POLICY X PRO- X LOG $ AUTOMOBILE LIABILITY G MBI NED SINGLE LIMIT Ea accident $ 5,000,000 BODILY INJURY (Per person) $ A X ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS IkS2611260451072 7/31/2022 .7/31/2023 BODILY INJURY (Per accident) $ X NON -OWNED HIREDAUTOS AUTOS PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB OCCUR SEE ATTACHED LIST OF EACH OCCURRENCE $ 100,000,000 X N AGGREGATE 5 100, 000, 000 EXCESS LIAB CLAIMS -MADE POLICIES I/31/2022 .1/31/2023 DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N X WC STATU- OTH- EEL E.L. EACH ACCIDENT S 1,000,00 ANY PROPRIETOR/PARTNER/EXECUTI. OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 4A561D260451052 ,1/31/2022 .7/31/2023 E.L. DISEASE - EA EMPLOYEE $ 1 000 000 If yes, describe under DESCRIPTION OF OPERATIONS below EL. DISEASE -POLICY LIMIT i S 1,000,00 A GARAGEKEEPERS LIABILITY 152611260451072 •1/31/2022 ,7/31/2023 $1,000,000 LIMIT C CRIME/EMPLOYEE DISHONESTY 3CCR45002892 7/31/2022 7/31/2023 I $5,000,000 LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) If agreed upon in a written contract or agreement, City of South Bend is included as an additional insured for general liability, but only with respect to the operations of the named insured. Re: 220903 - Eddy Street Commons at Notre Dame CERTIFICATE HOLDER CANCELLATION City of South Bend Attn: Michelle Adams 227 W JEFFERSON BLVD 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 Griffin/KATHY ACORD 25 (2010/05) INSn25 r7n1nnsin1 © 1988-2010 ACORD CORPORATION. All rights reserved. 716- At-f%On —1— .-i Arnon