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HomeMy WebLinkAboutNon Res Block Party - Kite Realty - Car ShowA 5 i } [ g L 1 ,F pp ! P I' ca . a I r f , 1 ray $7S - I � I m 1� 71 ., .; 7 -71`�"�'�•� ...:i4 '�A.:��" � �"°� _ 4ww n"'* .•L.-+.. as�1.u-. ..�•A.i,ry.. _.ySt MJ ,foy:. Ve.Cia aF MYs /,!! !"'� •, VF T`Foi _.7•"1f�T _.Tr9'Y TY'� P+� ..,.�1 .. :' 5 71 -7 �` •, yYW�gn°'�'►'- "��� may... �`�.+i"�<. '37*' Iitifi�iGG. rT �����,-p�- �ii�il&"'�"�S"�t" ��6i�r'+ 1:�'�"�� �'°-• �--�r��`5'4'j�- �4" A. k h_ sy�'�B` �r�'"� � �# `. �.i'iiF;�'N-� '�' � il- 7i�� A•l: �+�7i li i. e rm ism r 1- H n li i� a S _ —ftt,— — d h eT F • ". x f; ,, o-- l 61m i t. sm fi i ai - 77 - POW..0 -~ 'i,H '.'•_ r 6 c .�}.. e _ ... 310178 A� " CERTIFICATE QF LIABILITY INSURANCE DAT5/912'0 7YYY) 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 Commercial Lines - (404) 923-3700 Wells Fargo Insurance Services USA, Inc. CONTACT Kimberlee KOM NAME: PHONE 404-923-3532 FAX 877-362-9069 A!C NoExl : A1C No E-MAIL O.comllik l b meree.m.owellsfar ADDRESS: kiGay g INSURERS AFFOROING COVERAGE NAIL # 3475 Piedmont Road NE, Suite 800 INSURER A. LM Insurance Corporation _ 33600 Atlanta, GA 30305-2886 _ INSURED INSURER B: Allied World National Assurance Co. 10690 Kite Realty Group Trust INSURER C INSURERD: 30 S. Meridian St., Ste. 1100 INSURER E : INSURER F : Indianapolis IN 46204 COVERAGES CERTIFICATE NUMBER: 11760500 REVISION NUMBER: See below 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 LTR TYPE OF INSURANCE AUDL NSD SUHR WVD POLICY NUMBER POLICY EFF MM1D0fYYYY POLICY EXP MMfnD1YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR 1- - 1 TB5791453740077 No Deductible/Retention 03/01/2017 03/01/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO PREMISES Ea Doccur RENTED nce S 500,000 MED EXP (Any one person) S Excluded Applies to GL -- PERSONAL & ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE S 2.000,000 POLICY PRO LOC JECT PRODUCTS - COMPIOP AGG S 2.000,000 .,._- 5 OT HER: A AUTOMOBILELIA131LITY AS5Z91453740067 03/01/2017 03/01/2018 COMBiNEDSINGL.ELIMIr Ea eocdenl g 1,DDo,rsoD BODILY INJURY (Per person) 5 X ANY AUTO NO deductible OWNED SCHEDULED AUTOS ONLY AUTOS on Auto Liability y BODILY INJURY (Per accidenl) 5 PROPERTY DAMAGE Per accident $ X HIRED X NON AUTOS ONLY AUTOS ONLY $ B X UMBRELL.ALIAa X OCCUR 3088008 03/01/2017 03/01/2018 EACH OCCURRENCE S 25,000,000 AGGREGATE S 25.000,000 EXCESS LIAR CLAWS -MADE DED I X RETENTION$ 5,000 S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETORfPARTNERfEXECUTIVE Y 1 N OFFICERIMEMBEREXCLUOED7 C (Mandatory In NH) NIA WC5Z91453740087 03/01/2017 03/01/2018 X STATUTE ERH E.L. EACH ACCIDENT $ 1,OOD,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT S 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Re: KRG Eddy Street Commons, LLC , Eddy Street Commons 1044-1234 Eddy Street, South Bend, IN 46601 CERTIFICATE HOLDER CANCELLATION City of South Bend Department of Public Works, Engineering Division SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 227 W Jefferson Blvd., Suite 1316 AUTHORIZED REPRESENTATIVE South Bend, IN 46601 9e 01 The ACORD name and logo are registered marks of ACORD ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) (rhls cer0fiwte replsos ce4fralak 11740495 issuad on 51912047l