Laserfiche WebLink
/'se"'ll BARNTUD-01 <br />A�RO CERTIFICATE OF LIABILITY INSURANCE DA5/20/2025 YI <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rahts to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />tat Source Insurance, Inc. <br />6909 Grape Road <br />Mishawaka, IN 46545 <br />INSURED <br />Tudor Inns, Inc. dba/Barnaby's <br />713 E Jefferson Blvd <br />South Bend, IN 46617 <br />COVFRAnFR CFRTIFICATE NUMBER: REVISION NUMBER: <br />271-5240 <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />TYPE OF INSURANCE <br />ADDL <br />INSO <br />SUBR <br />VIVIDA <br />POLICY NUMBER <br />POLICY EFF <br />POLICY EXP LIMITS <br />COMMERCIAL GENERAL LABILITY <br />CIAIME-MADE OCCUR <br />BOP1009649 <br />i EACH OCCURRENCE <br />111f2025 1j112026 _PRMAEMSES( RENTaoccu <br />MEO EXP (Any am arson <br />PERSONAL S AM INJURY <br />GENERAL AGGREGATE <br />PRODUCTS -COMPIOPAGG <br />S 1'000'000 <br />E <br />S 5,000 <br />S 1,000,000 <br />GENL AGGREGATE pLRIM�IT APPLIES PER: <br />POLICY JECT LOC <br />OTHER: <br />2000000 <br />21000,000 <br />AUTOMOBILE LIABILITY <br />_ ANY AUTO <br />OVMED SGHEDULEO <br />_ AUINE ONLY AUUpTOSH1�EDWW EEpp <br />ALTOS ONLY AUTOU ONNLV <br />COMBINED EDSINGLE LIMIT <br />BODILY INJURY Per anon <br />BODILY INJURY Per acodem <br />_CPO,PROIR�I MAGE <br />S <br />E <br />E <br />$ <br />A X UMBRELLA UAB X OCCUR <br />EXCESS LIAR CLAIMS -NUDE CUP1005717 1/112025 <br />DED X I RETENTIONS 5,000 <br />EACH OCCURRENCE <br />111/2026 AGGREGATE <br />1,000,000 <br />S 1,000,000 <br />S <br />Is 1,000,000 <br />PE <br />A MWERSCOMNSATION <br />AND EMPLOYERS' LIABILITY W CP 1010392 1 /112025 1M/2026 <br />I ANY PROPRIIETgOERIPARTNEIVEXECUTIVE YIN <br />IrnanSEW In NHI EXCLUDED? NIA <br />If yyes, tescnbe antler <br />DESCRIPTION OF OPERATIONS below <br />PER <br />TUTE OTH- <br />E.L. EACH ACCIDENT <br />b 500,000 <br />E.L. DISEASE -EA EMPLOYE <br />E 500,000 <br />E.L. DISEASE -POLICY LI IT <br />500,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, A4011mmil Remarks Schedule, may be attached If more space is required) <br />Indiana Alcohol 8 Tobacco Commission <br />302 W Washington St. Room E-114 <br />Indianapolis, IN 46204 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />ACORD 25 (2016/03) 01988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />