Opening of Applications - 2024 Sewer Insurance Lateral Repair Program - Bob Frame

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Accimij, (MMIDD/YYYY) CERTIFICATELIABILITY INSURANCE 02/16/2023 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 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 FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 OWATONNA, MN 55060 ,�Td17 INSURED 264-429-2 INSURER B: BOB FRAME PLUMBING SERVICES INC INSURER C: 2442 JACLYN CT SOUTH BEND, IN 46614-3700 INSURER M INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 22 REVISION NUMBER: 0 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. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER gam POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR Y N 9403507 04/01/2023 04/01/2024 EACH OCCURRENCE $1,000,000 DA oAGE Tccorrenee ELATED PREMISES $100,000 MED EXP(Any one person) EXCLUDED PERSONAL &ADV INJURY $1000000 GENERAL AGGREGATE $2,000,000 GENL AGGREGATE LIMIT APPLIES PER: POLICY DECT LOG OTHER: PRODUCTS & COMP/OP ACC $2100%000 X AOWNED AUTOMOBILE LIABILITY JANYAUTO AUTOS ONLY HIREDAUTOS OWNLYHASCTEDHULED NOONQOWNLDY AUT(Per N N 9403507 04/01/2023 04/01/2024 E a BIaEeIDS INGLE LIMIT $11000,000 BODILY INJURY (Per Person) BODILY INJURY(Per Accidenq PROPERTY DAMAGE Acciduntl A X UMBRELLA LIAB EXCESS LIA6 X OCCUR CLAIMS -MADE N N 9403508 04/01/2023 04/01/2024 EACH OCCURRENCE $2,0002000 AGGREGATE $2,000,000 DED RETENTION A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERI EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A N 9403509 04/01/2023 04/01/2024 X I PER STATUTE I OTHER E.L EACH ACCIDENT $500,000 E.L DISEASE EA EMPLOYEE $500,000 E.L DISEASE POLICY LIMIT $500,000 rERION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Atldidanal Remarks Schedule, may be afhchetl if more space is required) RTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. CERTIFICATE HOLDER CANCELLATION CITY OF SOUTH BEND SOUTH BEND, IN 46601-1830 227 W JEFFERSON BLVD 220I 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