Opening of Quotes - Century Center Parking Lot Seal and Stripe Proj No. 122-060B - National Pavement Maintenance

Home Browse Search

�►� CERTIFICATE OF LIABILITY INSURANCE DATE /13/2 23 003/13/2023 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 be endorsed. N 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 Brandy Shotts McCammon Agency Corp PO BOX 418 Cloverdale, IN 46120 ACT NAME: Brandy Shotts-Jay PHONE 217-251 4043 A/C No No A- a6: brandys@mccammonagency.com INSURERS AFFORDING COVERAGE NAIL # INSURER A ; Hastings Mutual INSURED National Pavement Maintenance LLC 1928 N Campbell Ave Indianapolis, IN 46218 INSURERS: INSURER C : INSURER D : INSURER E; INSURER F : nwre An_e& c092'"Fif TE NUMBER: 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 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. ILTRTYPE LTR OF INSURANCE �� SUBR POLICY NUMBER MMIDPOLICY EFF UM Y EXP LIMA GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1000,000 DAMA E TO RENTED PREMISES Ea occunence $ 1000,000 MED EXP (Any one person) $ 5,000 A CLAIMS -MADE IF;N;;] OCCUR X 6165438 08/10/2022 08/10/2023 PERSONAL & ADV INJURY $ 1000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY PRO- JECTLOC COMBINED SINGLE LIMIT 1,000,000 AUTOMOBILE LIABILITY Ea accident BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ A ALL OWNED SCHEDULED X AUTOS AUTOS X HIRED AUTOS X qNON-OWNED X 6185615 03/12/2023 03/12/2024 PROPERTY DAMAGE Per accident $ $ A X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE X 6290555 07/29/2022 07/29/2023 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 -.EDT-[RIENTION$ $ WORKERS COMPENSATION - WC STATUS OTHR ER TS AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N/A E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) GEH I IVIGA I L NULULK MIYV GLLN I rvrr SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of South Bend THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Brandy Shotts-Jay ACORD 25 (2010/05) l0 I`J2f0-,dUIU A%.UrSU l vnrvntarwlr. 'au nynw rcaclrcU. The ACORD name and logo are registered marks of ACORD