PSA - Industrial Water Softener Century Center Proj No. 123-041 – ME Design Services

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AC RO O® CERTIFICATE OF LIABILITY INSURANCE DATE Sawn 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. IMPORTANP. It the certi mate holder is an ADDITIONAL INSURED, the po icy Ie5 must be endorsed. It 5UBROGATION 15 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 endomement(s(. PRODUCER Priority Risk Management 2628 South Mi,h,,a Street South Bend IN 46614 CeRRACT NAME: Certificate Department AIC No Exf: 574291-5510 C,Xc: 574291-8505 p00RE43: So AEG Priodrm kcom INSURER(S) AFFORDING COVERAGE NAICN INSURER A: FRANKENMMI MUT INS CO 13986 INSURED Thomas R.& Kathy Cook dba ME Design Services PO Box 1028 Mishawaka IN 46546 INSURER B: CNA INSURER C: INSURER D: INSURER E. INSURER F: COVERAGES CERTIFICATE 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,Mae SUIR AODL. LTR TYPE OF INSURANCE IxSo POLICY NUMBER MMND MMmDIYYYY L1MR8 X COMMERCIAL GENERAWABILITY CLAIM$-MA°E EX: OCCUR X Contractual Liability Included E611128 1/1/2023 1/IRON OCCURRENCE $ 1'mi �LEEAACCHHH PI .OMI5E5(Ee OCC ,e) E 5001000 MEDEXP(Anymepenan) $ S'mD A ` GENL AGGREGATE LIMIT APRIES PER: �X POLICYL IECDT �LOC OTHER: PERSONAL&ADVIWURY It 1,WOp00 GENERALAGGREGATE $ 2,000,000 PROGUGT&-COMP/OP AGG $ 2,000,000 Employment Practices Llabll Is 1W,000 AUTOMOSIMUMBIURY ANY AUTO A ~ALL OWNED SCHEDULED ALTOS AUToris MONNOX AUTOS HIRED AUTOS X EO AUTOS E611129 1/1/2023 1/1/2024 Eaecddenl $ loci BODILY INJURY (Parin ) $ BODILY IWURY(Per acddem, $ Peravaden0 $ S X UMBRELLA LIAR A r EXCESS LIAS X OOWR CLAIMS-M4DE 6611130 111/20B 1/1/2024 EACH OCCURRENCE SX XO AGGREGATE E S,MAD 0 $ DED I X I RETENTIONS 10,000 Is WORKERS COMPENSATION AND EMPLOYERS' LIABIURY YIN ANY PROPRIETOPIPARTNER�SEECUTIVE A OFFICEWMEMBER"CWDE°± ❑N (Mandatory In NH) OFSCd scribe Under RI WION OF OPERATIONS otlow NIA M11127 1/1/2023 1/1/2024 X BONNTE ER TA EL EACH ACCIDENT Is 500.000 EL. DISEASE - EA EMPLOYE $ 500=0 E.L. DISEASE- PoLICY LIMIT 1 $ 500,000 8 Professional Liability Policy AEH114141107 1/l/2023 111IM24 $1,000,00 Ea ClaIM52,000,000 Aggregate/$5,000 Del DESCRIPTIONOFOPE TIONSILOGATONSIVEHICLES(ACORD 101,Addltlmal Remarks Schedule, maybe a hed If am apx'e le re9ulre0) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City oTSouth Bend ACCORDANCE WITH THE POLICY PROVISIONS, 227 ME Jefferson Blvd, Ste 1316 AUTHORIZED REPRESENTATIVE South Bend IN 46601 5.'. ��( (� ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD