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Opening of Applications - 2024 Sewer Insurance Lateral Repair Program - Bob Frame
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Opening of Applications - 2024 Sewer Insurance Lateral Repair Program - Bob Frame
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2/13/2024 2:59:50 PM
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2/13/2024 2:58:17 PM
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Board of Public Works
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Projects
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2/13/2024
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Accimij, (MMIDD/YYYY) <br />CERTIFICATELIABILITY INSURANCE 02/16/2023 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE <br />DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF <br />INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE <br />CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />FEDERATED MUTUAL INSURANCE COMPANY <br />HOME OFFICE: P.O. BOX 328 <br />OWATONNA, MN 55060 <br />,�Td17 <br />INSURED 264-429-2 INSURER B: <br />BOB FRAME PLUMBING SERVICES INC INSURER C: <br />2442 JACLYN CT <br />SOUTH BEND, IN 46614-3700 INSURER M <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 22 REVISION NUMBER: 0 <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE <br />ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF <br />SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />TYPE OF INSURANCE <br />ADDL <br />SUER <br />POLICY NUMBER <br />gam <br />POLICY EXP <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE OCCUR <br />Y <br />N <br />9403507 <br />04/01/2023 <br />04/01/2024 <br />EACH OCCURRENCE <br />$1,000,000 <br />DA oAGE Tccorrenee ELATED PREMISES <br />$100,000 <br />MED EXP(Any one person) <br />EXCLUDED <br />PERSONAL &ADV INJURY <br />$1000000 <br />GENERAL AGGREGATE <br />$2,000,000 <br />GENL <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY DECT LOG <br />OTHER: <br />PRODUCTS & COMP/OP ACC <br />$2100%000 <br />X <br />AOWNED <br />AUTOMOBILE LIABILITY <br />JANYAUTO <br />AUTOS ONLY <br />HIREDAUTOS OWNLYHASCTEDHULED <br />NOONQOWNLDY <br />AUT(Per <br />N <br />N <br />9403507 <br />04/01/2023 <br />04/01/2024 <br />E a BIaEeIDS INGLE LIMIT <br />$11000,000 <br />BODILY INJURY (Per Person) <br />BODILY INJURY(Per Accidenq <br />PROPERTY DAMAGE <br />Acciduntl <br />A <br />X <br />UMBRELLA LIAB <br />EXCESS LIA6 <br />X <br />OCCUR <br />CLAIMS -MADE <br />N <br />N <br />9403508 <br />04/01/2023 <br />04/01/2024 <br />EACH OCCURRENCE <br />$2,0002000 <br />AGGREGATE <br />$2,000,000 <br />DED <br />RETENTION <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORIPARTNERI EXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N/A <br />N <br />9403509 <br />04/01/2023 <br />04/01/2024 <br />X <br />I PER STATUTE <br />I <br />OTHER <br />E.L EACH ACCIDENT <br />$500,000 <br />E.L DISEASE EA EMPLOYEE <br />$500,000 <br />E.L DISEASE POLICY LIMIT <br />$500,000 <br />rERION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Atldidanal Remarks Schedule, may be afhchetl if more space is required) <br />RTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. <br />CERTIFICATE HOLDER CANCELLATION <br />CITY OF SOUTH BEND <br />SOUTH BEND, IN 46601-1830 <br />227 W JEFFERSON BLVD <br />220I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />© 1988-2015 <br />ACORD <br />CORPORATION. <br />All <br />rights <br />reserved. <br />ACORD 25 (2016/03) <br />The <br />ACORD <br />name and logo <br />are registered <br />marks of <br />ACORD <br />
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