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A �a DATE (MMIDDIYYYY) <br />CERTIFICATE OF LIABILITY INSURANCE 1m2025 <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 rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER CONTACT <br />NAME: Susie Guarino <br />McGriff Insurance Services LLC PHONE FAX <br />150 S. Warner Road, Suite 460 tyc. No. F,91): 610-233-4846 to C, No): <br />King Of Prussia PA 19406 E 1ES& susan.guarino m riff.com <br />INSURED <br />LAZ Parking Midwest, LLC <br />500 S. Front St., Suite 210 <br />Columbus OH 43215 <br />INSURERS AFFORDING COVERAGE I NAIC# <br />INSURER A: National Union Fire Ins Co of Pitt. PA 19445 <br />151LAZKARP INSURERB: AIU Insurance Company 19399 <br />INSURER C : Allianz Global Risks US Insurance Co 35300 <br />INSURER D : <br />F: <br />CAVFRAnI=Q RFRTIFIRATF Ni IMRFR• 7Rnn7RRRR RFVISION NUMBER - <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 />MISR <br />TYPE OF INSURANCE 'ADD <br />ER MMDIDY/YYYY <br />13609369 <br />MMIDDIYYYY I LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />Y <br />7/31/2024 <br />7/31/2025 1 EACH OCCURRENCE <br />$1,000,000 <br />51,000,00o <br />CLAIMS -MADE X I OCCUR <br />u <br />$ 10.000 <br />I <br />MED EXP (Any one person) <br />S1,000,000 <br />III <br />PERSONAL & ADV INJURY <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />S 2.000.000 <br />GENERAL AGGREGATE <br />POLICY E jE f X] LOC <br />PRODUCTS - COMP/OP AGG <br />$ 2.000,000 <br />$ <br />OTHER: <br />A AUTOMOBILELIABILITY <br />Y <br />Y <br />3135689 7/31/2024 7/31/2025 COMBINED STNGLEL <br />Ea acciden <br />s5,000,000 <br />$ <br />X ANY AUTO <br />BODILY INJURY (Per person) <br />OWNED SCHEDULED <br />AUTOS ONLY H AUTOS <br />i HIRED NON -OWNED <br />AUTOS ONLY r—_ AUTOS ONLY <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE <br />Per acciderill <br />$ <br />$ <br />$ <br />I <br />C X UMBRELLA LIAB OCCUR <br />Y <br />Y <br />SEE SCHEDULE <br />7/31/2024 <br />7/31/2025 EACH OCCURRENCE <br />S100,000,000 <br />S 100,000,000 <br />X 1 EXCESS LIAR I CLAIMS -MADE <br />AGGREGATE <br />S <br />DFD I RETENTION S <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Ym <br />ANYPROPRIETOR/PARTNER/EXECUTIVE <br />Y <br />WC014111735 <br />7/31/2024 <br />7/31/2025 rX PER OTH_ <br />STATUTE I ER <br />E.L. EACH ACCIDENT <br />S 1,000,000 <br />OFFICER/MEMBEREXCLUDED? � <br />(Mandatoryin NH) <br />N I A <br />E.L DISEASE -fA EMPLOYEE <br />$ 1,000,000 <br />$ 1 000.000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />A I Garagekeepers Liability Y Y <br />B I+ Stop Gap Liability f <br />3135689 7/31/2024 <br />WC014111735 7/31/2024 <br />7/31/2025 1,000,000 <br />7/31/2025 Limits 1M/1M/1M <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />If agreed upon in a written contract or agreement, The City of South Bend is included as an additional insured for general liability, auto liability and umbrella, but <br />only with respect to the operations of the named insured. Re: M22121 - South Bend Leighton, 109 W Jefferson Blvd, South Bend, Indiana, 46601 — Parking <br />Spaces 500 <br />f`CDTICl/`ATC LJP11 r%CD rAnlrv=l I ATIr1KI <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of South Bend, Indiana, Attn: Executive Director <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Venues Parks & <br />301 S. St. Louis Blvd <br />AUTHORIZED REPRESENTATIVE <br />2 <br />South Bend IN 46617 <br />USA <br />U 1988-2015 AGURD GORPURA I IUN. All rlgnts reservea. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />