Permit - Sidewalk Cafe - The View Tavern

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AcoR" CERTIFICATE OF LIABILITY INSURANCE DATE (M Y) 01 /17/I2023 023 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 Mindi Conrad NAME: WalkerHughes Insurance ?A ONN (260) 244-6174 (260) 994-0442 AIX No ADDRESS: m.conrad@walkerhughes.com 425 Park Place Circle INSURER(S) AFFORDING COVERAGE NAIC # Suite 400 Mishawaka IN 46545 INSURERA : Auto -Owners Insurance Co 18988 INSURED INSURER B' T Lee Llc INSURER C The View Tavern INSURER D : 515 E Jefferson Blvd INSURER E : South Bend IN 46617-2704 JNSURERF: COVERAGES CERTIFICATE NUMBER: 22-23 Master 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 INSIR LTR I TYPE OF INSURANCE AIJUL INSD SUB" WVO POLICY NUMBER POLICYPFF POLICY MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000.000 CLAIMS -MADE Fx_1 OCCUR PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ EXCLUDED PERSONAL& ADV INJURY $ 1,000.000 A 09030636 10/06/2022 10/06/2023 GGEEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑ P0. ❑ JRRO- LOC PRODUCTS-COMP/OP AGG 2,000,000 v $ _ $ OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LINT Ea acciden $ BODILY INJURY (Per person) _ $ ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per acciden $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DIED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) NIA 09021126 10I06I2022 10/06/2023 PER OTH- STATUTE ER E-L EACH ACCIDENT $ 500,000 E-L- DISEASE - EA EMPLOYEE $ 500,000 Ifyes, describe under DESCRIPTION OF OPERATIONS below EL. DISEASE - POLICY LIMIT , 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Board of Public Works/City of South Bend IN ACCORDANCE WITH THE POLICY PROVISIONS. Theresa Heffner, Clerk AUTHORIZED REPRESENTATIVE 227 W. Jefferson Blvd South Bend IN 46601 !1n a _ /) @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD