Special Event - Bacon Around the Bend 5K - June 22

Home Browse Search

A�Ro® CERTIFICATE OF LIABILITY INSURANCE DATE (sIWD zD) 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 endorsements . PRODUCER Gibson Insurance Agency Inc 202 South Michigan St., Suite 1400io South Bend IN 46601 CONTACT Kim Parsons NAME:PHONE . 574245.3500 FAX xo:574236-B389 n IESS: liparsonsUthegibsonedge.com INSURIERS AFFORDING COVERAGE NAIC0 INSURER A: Mount Vernon Fire Insurance Company 26522 INSURED FAMUIIS-01 Family Justice Center of St Joseph County, Inc. 533 North Niles Avenue INSURER S: INSURERC: South Bend IN 46617-1919 INSURERD: NSURER E: INSURER F: CERTIFICATE 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 L TYPE OFINSURANCE ADDL SUBR POUCY NUMBER POLICY OFF MMIDDIYYYY POLICY EXP MMID LIMITS A X COMMERCIAL GENERAL LIABILITY SE2022234 6/22/2024 6/23/2024 EACH OCCURRENCE S 1.000,1)00 PREMISES Me o%cumi $100,000 CLAIMS -MADE OCCUR MED EXP Any one person) $1,000 PERSONAL S ADV INJURY $1.000,000 AGGREGATE LIMIT APPLIES PER: POLICY JECOTD LOC GENERAL AGGREGATE S2,000,000 GEN'L PRODUCTS-COMPIOPAGG $ $ OTHER: AUTOMOSILELMBILF. M BIN ND SINGLE LIMIT a sMent f ANY AUTO BODILY INJURY (Per person) S OWNED SCHEDULED AUTOS ONLY AUTO$ BODILY INJURY (Per accident) $ HIRED NON-0WNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per ac9dent S s , UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS�MADE AGGREGATE f I $ DED RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNEWEXECUTIVE OFFICEPoNIEMBER EXCLUDED? ❑ NIA PE O STATUTE ER E.L. EACH ACCIDENT S E.L. DISEASE- EA EMPLOYEE S (Mandatory in NH) If yes, 1,egbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101, AddNional Remarks Schedule, may a atlached H mom apace is rK usmj) Certificate holder is additional insured with respect to general liability coverages as required by written contract. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. The City of South Bend AUTHORIZED REPRESENTATIVE &thsai, nwrawar lyc�i�1r ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD