HomeMy WebLinkAboutProcession - Living Stones ChurchI
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INTER -OFFICE MEMORANDUM
BOARD OF PUBLIC WORKS
DATE SENT: 6/28/2017
TO: Fatt
eckler, Traffic& Lighting
dco Rodriguez, Fire Department
Longfellow, Engineering
Kara Wood, Park Department
ene Eyster, Police Department
i I Sciccitano, Downtown South Bend
L,M'arcia Qualls, Streets
Legal Department
FROM: Linda M. Martin, Clerk
SUBJECT: PROCESSION RECO MENDATION-Ready Set School!
Parade
SPONSOR: LivingStones Church
DATE OF EVENT: August 5th, 2017 9,00 am to 10:00am
DATE DUE: July 3 2017
FAX OR E-MAIL TO: 235-917'i/lmartin(a)_southbendin.gov
RECOMMENDATIONS AND COMMENTS:
By Date
E
MR 7'- N 1^
mis
a
rrI DIANrA FARM. BUREAU 1AISURANCE0
NAMED INSURED AND ADDRESS:
LIVING STONES CHURCH
718 DONMOY13R AVE
SOUTH BEND IN 46614
CERTIFICATE OF INSURANCE
CERWICNI V ISSUED TO:
CITY OF SOUTH BEND
1316 COUNTY CITY BUILDING
227 W JEFFERSON BLVI)
SOUTH BEND, IN 46601
This is to coriify that the policies fisted In this CcrliFicale hive been Issued to file Named lusu red by
❑A UFA CASUAUCY INSURANCE COMPANY ® UNITED FARM FAMILY MUTUAL INSUIIANCE COMPANY
The policies of insurance Its led on this certificate have been issued to 411e insurgd named above for Into policy period Indicated. Notwithstruiding any
requhmntent, term or condifian ofany contractor other document ►v111t respect to which this Certificate may be issued or may portain, Ilia hisunulce nfiorded
by the policies described Is subject to all terms, exclusions and condlilons of such policies. Aggregate limits shown may have been reduced by Paid claims, This
Cerfificalc of Insurance does aolconstitute a contract between file issuing Insurer(s), authorized represcolative or producer, and the certificate balder, nor (loos
it affirmatively or ieegativoly ahead, extend, or after the coverngo afrorded by the policies listed thereon.
'I�Tc ar Insurance
Policy Number
Company
Effective
Expiration
Limits of Llnbility
(AIB)
Date
Dnte
COMMERCIAL LIABILITY
CHU870159205
B
12/05/2016
1210512017
General Aggregate
$3,000,000
( X] Commorcial General Liability
Prod,•Comp/OPS Aggregate
$3,000,000
[ X) Occurrence
Persona! Advertisinglnjuty
$1,000,000
Each Occurrenco
$1,000,000
Fire.Dama$e (Any one fire)
Med Expanse (Any one person)
S5,000
FARM LIABILITY
Each Occurrence
[ ] Rgldlle
Ned Expense (Ally olio porson)
[ } Occurrence
COMM, AUTO LIABILITY
CIliU870159205
B
12/0512016
12/05/2017
Each AcOdenf
[ ] Scheduled Autos
Mod Expense
] X] I-Ilred Autos
[ ] Non -Owned Autos
FARM AUID LIABILITY
Each Aceident
[ ] Scheduled Autos
Mad rquilse
[ ) Hired Autos
[ ] Non -Owned Autos
UMBRELLA LIABILITY
UMB860267805
11
1210512 116
1210512017
Each Occurrence
Aggregate
51,004,000
WORKERS,
Stalutory - bidimaa
COMPENSATION
Each Accident
AND
Disease Policy Limit
RIVIPLOYERS' LIABILITY
Disease Dealt Employee
OTHER
DESCRIPTION OFOPERATIONS,
10CATIONS. VEHICLES,
RESTRICTIONS,
AND
SPECIAL ITEMS
Additional Insured: City of Soulli Rend
Irsubrogalion is waived, subject to tare terms and conditions of ilia policy, eorWit policies may require an endorsement. A statement on this Certificate noes not
confer rights to flrccertificale holder in lieu orsuch cadorsement(s),
Should tiny of the described policies be canceled before the expiration date, tile, Issuing Insurer wig make an ellort to notify the certificate holder named, but
flifure to do so shall impose no obligaflon or liability of any kind upon the insurer, its agents or representatives,
JON H BACKSTROM 06/2612017
Agent Dale
574-291-3840
PIIUIIe
06.996 3-12 [ ] Ceriificate Holder's Copy [ ] Home OMac Copy [ ) Agency Copy [ ] insurcd's Copy Page I of I
Printed: 06/2612017 03:28:56 PM
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