HomeMy WebLinkAboutPublic Parking Facility- 126 N Main, 121 E Wayne, 109 W Jefferson - LAZ Parking1316 COUNTY -CITY BUILDING
227 W. JEFFERSON BOULEVARD
SOUTH BEND, INDIANA 46601-1830
PHONE 574/235-9251
FAx 574/235-9171
CITY OF SOUTH BEND JAMES MUELLER, MAYOR
BOARD OF PUBLIC WORKS
November 28, 2023
Mr. Alan Lazowski
LAZ Parking Midwest, LLC
1228 N. Eddy St.
South Bend, IN 46617
compliancemail@la4parking.co
RE: Approval of Public Parking Facility License Three (3) Locations
Dear Ms. Lazowski:
At its November 28, 2023 meeting, the Board of Public Works approved your request for the Public
Parking Facility License at 126 N. Main St., 109 W. Jefferson Blvd., 121 E. Wayne St.
Upon further review by a City Inspector, it came to our attention that the current signage for the
Parkin lot is missing the Hours of Operation, Rates Charged, Current 2023 City License
Number, and Font Sizes in Accordance with Municipal Code Section 4-39 at 109 W. Jefferson
Blvd.
The signs shall give the license # PBP2023-009, # PBP2023-010, # PBP2023-011 under which
the lot is operated.
Kindly update the current signage at 109 W. Jefferson Blvd. with hours of operation, rates
charged, current 2023 city license number and email a photo to lhensleyksouthbendin.-og_v. The Board
has approved this license, contingent upon this remedy. Should you have any questions, please contact
this office at (574) 235-9251.
If you have any further questions, please call this office at (574) 235-9251.
Sincerely,
Is/Theresa Heffner
Theresa Heffner, Clerk
Enclosures
TH/lh
ELIZABETH A. MARADIK JOSEPH R. MOLNAR GARY A. GILOT MURRAY L. MILLER BREANA N. MIcou
INTEROFFICE MEMORANDUM
BOARD OF PUBLIC WORKS
DATE: 09/28/2023
TO: Jim Wood, Neighborhood Services and Enforcement
Chris Dressel, Community Investment
Gerald Ellis, Fire Department
Kyle Ludlow, Engineering
FROM: Theresa Heffner, Clerk
SUBJECT: Annual License Application for Public Parking Facility
LOCATION: LAZ Parking Midwest, LLC
126 N. Main St, 109 W. Jefferson Blvd., 121 E Wayne St.
Public Parking Facilities are regulated by municipal code section 4-39. (Copy attached).
Please review the attached public parking license application and provide your
recommendations in the spaces below.
NEIGHBORHOOD SERVICES AND ENFORCEMENT: Favorable
COMMUNITY INVESTMENT:
Favorable
FIRE: Section 4-39(k) Favorable
ENGINEERING: Section 4-39(b)
126 Main St- Favorable
121 Wayne St- Favorable
109 Jefferson Blvd- No Rates located on 1st floor entrances (North and South)
Sec. 4-39. - Public parking facility.
(a) Definition. Public parking facility shall mean any plot, piece or parcel of land or any building or structure
used for the purpose of storing motor vehicles where the owners or persons storing such vehicles are
charged a fee and which are open to the public.
(b) Signs required:
(1) Each licensee under this section shall maintain at each entrance to the licensed public parking
facility a permanently affixed sign suitable to apprise persons using the public parking facility of
the name of the licensee, the hours of the day or night during which such places are open for
storing motor vehicles, the rates charged and the closing hours of such lot.
(2) When more than one rate is charged for parking, the figures of each rate shall be of the same
size and dimensions. The figures shall measure not less than eight (8) inches in height. The letters
and figures indicating the closing hours shall not be less than four (4) inches in height.
(3) The sign shall give the number of the City license under which the lot is operated.
(4) Where the licensee operates a receiving lot in which cars are accepted with the understanding
that such cars may be removed to another lot, the licensee shall post on such sign, in letters not
less than four (4) inches in height, the following information: "Receiving Lot —Cars Parked Here
May Be Moved To No. Street," (giving the address to which such cars are moved).
(5) All signs shall be subject to the approval of the Building Commissioner of the City.
(6) Where separate rates or charges are made for day parking and for night parking, notice shall be
posted on the signs described in subsection (b)(1) of this section.
(c) License required. No person shall maintain or conduct a public parking facility within the City without
first having obtained the approval from the Board of Public Works and a license issued by the
Controller.
(d) Application:
(1) Applications for licenses for public parking facilities shall be made by the person intending to
operate a public parking facility.
(2) The application shall set forth the following:
a. The name under which and the place where the open parking lot is to be operated.
b. Whether the applicant is an individual, partnership or corporation. If an individual, the name
and business and residence address of the applicant shall be given; if a partnership, the
name and business and residence address of each partner shall be given; if a corporation,
the name, date and state under which such corporation was organized, and the name and
business address, resident agent, and a certified copy of article of incorporation, if requested
by the Board of Public Works, shall be furnished.
c. Whether the premises are owned or leased by the applicant, and, if leased, the name and
residence and business address of each owner, or part owner thereof.
d. The number of motor vehicles which may, at any one time, be stored upon the premises.
e. The hours during which motor vehicles may be stored.
f. A complete schedule of the rates to be charged for storing motor vehicles and the hours at
which changes in rate take place.
g. Such other information as the Board of Public Works may deem advisable.
(3) The application shall be signed and verified under oath by the applicant, if an individual, or by a
duly authorized agent, if a partnership or corporation.
(e) Public parking facility. A fee of eighty dollars ($80.00) shall be paid for each license issued under this
section.
(f) Bond or property liability insurance:
(1) No license shall be issued pursuant to this section and public parking facility shall be operated
until and unless the licensee under this section has deposited with the Board a bond or property
liability insurance policy in the amount scheduled in this section. The bond or insurance policy
shall be with one or more adequate sureties or a surety company acceptable to the Board and
conditioned that the licensee will pay all final judgments rendered against him for damages arising
during the period such bond or insurance policy is in force from the operation of the motor vehicle
in such public parking facility, or from loss, damage, theft or conversion of any motor vehicle.
(2) Any person who sustains damage by reason of the violation of any provision of such bond or
insurance by a licensee may institute suit upon the same and recover any judgment that may be
obtained by reason of such suit.
(3) The bond or insurance policy shall meet the following requirements:
a. It shall contain a provision that it shall continue in force until ten (10) days after written notice
of cancellation has been delivered to the Board of Public Works or until the license of the
applicant has been revoked.
b. The obligation of the bond or insurance policy shall not exceed the principal amount of the
bond.
c. The bond or insurance policy shall be in the following amounts:
1. Where the licensee conducts one (1) lot, ten thousand dollars ($10,000.00).
2. Where the licensee conducts two (2) lots, fifteen thousand dollars ($15,000.00).
3. Where the licensee conducts three (3) lots, the sum of twenty thousand dollars
($20,000.00).
4. Where the licensee conducts four (4) or more lots, the sum of twenty-five thousand
dollars ($25,000.00).
(g) Investigation of applicants; issuance of license:
(1) If, after investigation, the Board of Public Works determines that the applicant for a license meets
the requirements of the section, the Board shall report the same to the Controller.
(2) The Controller shall issue to the applicant a license for a public parking facility upon payment of
the proper fee.
(h) Claimchecks or tags:
(1) At the time of accepting a motor vehicle for storage or parking in any public parking facility the
person conducting the lot, or his agent, servant or employee, shall furnish to the person parking
his motor vehicle a distinctive check.
(2) The check shall be numbered to correspond to a coupon placed upon such motor vehicle and
contain the name and address of the place and the owner operating such public parking facility.
Upon such check shall be written, printed, cut out or stamped the date, and, if parking is charged
for on an hourly basis, the time of acceptance of such motor vehicle.
(3) The above provision shall not be applied where cars are stored on a monthly fee basis.
(i) Rate changes:
(1) No licensee under this section shall make any charge for storing any motor vehicle in a public
parking facility in excess of that set forth in his application for a license, unless he has:
a. Notified the Board of Public Works in writing of the change.
b. Posted signs showing such change in the same manner as set forth in subsection (b).
0) Claims against lot; reports; liability after hours:
(1) Each licensee under this section shall immediately notify the Controller of any claim over twenty-
five dollars ($25.00) made by reason of any loss, theft or conversion occurring upon his premises
or of any claim for damages arising from the operation of his public parking facility.
(2) The obligation of any person operating or conducting a public parking facility under the terms of
this section to the owner of a motor vehicle parked therein shall not extend beyond the regular
posted hours of attendance, as posted upon the open parking lot and printed upon the regular
receipt check furnished to the motor vehicle owner.
(k) Fire equipment required; cars to be accessible:
(1) Public parking facilities shall be equipped with proper fire extinguishing apparatus subject to the
approval of the Fire Department.
(2) All motor vehicles shall be stored in such a manner that they may be reached readily in case of
fire or other emergencies.
(1) Temporary lots; restrictions:
(1) Nothing contained in this section shall be deemed to require the licensing of temporary lots
operated for the accommodation of motorists attending public functions, such as football games
or circuses, even though a fee may be charged the patrons of such temporary lots. No such
temporary lots, however, shall be operated more than two (2) days in any week.
(2) At the entrances of the temporary lots there shall be placed a sign on which is printed the words,
in letters of sufficient size to be legible to all patrons "Temporary Parking Lot —Not Licensed."
(m) Exemptions. All governmental owned and operated public parking facilities shall be exempt from the
licensing provisions of this chapter.
(Ord. No. 6998-81, § 1; Ord. No. 7723-86, § 2; Ord. No. 9093-00, § XII)
Para I I rnunlclpaI business license questions, contact: City of South Bend • Department of Corn munity Investment
227 West Jefferson Blvd • Suite 1400 5 *South Bend, Indiana 46601 •574.235.591ry Fr: 574.215,9 Z 5�
CAS 11
LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY
MUNICIPAL CODE SECTION - 4-39
I, APPLICATION TYPE Check One: New Yes Renewal
II. BUSINESS DATA
A. Business Name: LAZ Parking �Lui,
B. Business Address: 126 N. Main St.
City. South Bend
_State: I M Zip: 46601
C. Mailing Address (if different from above): 1 Financial Plaza, 141111 Floor
City: Hartford State: CT Zip: 06103
D. Business Telephone Number: 860-522-7641
E. Business Fax Number:
F. E-Mail Address: compliancemail@lazparking.com
G. Maximum Number of Vehicles that can be parked at facility at onetime: 500
H. Total Number of Parking Spaces at facility: 500
I, Hours during which vehicles may bestored: 2417
H. Premises are {check one}: Leased by Applicant Owned by Applicant Yes
If Leased:
Owner's Name:
Owner's Business Address:
City: State: Zip:
Owner's Residential Address:
City: State: Zip:
J. Jnsurance Carrier and Amount of Liability Insurance OR Bonding Agent and Amount of Bond:
For Office Use Only
Application Filed SEP 2 6 2023 Public Works Approval
Application Fee Paid SEP 2 7 2073 License Fee Paid SEP
Sent to Dept. �P 2 7 2023 License Number
CITY OF SOUTH BEND, INDIANA
Not Approved _ BOARD OF PUBLIC WORKS
Reason viaa M
Elizabeth A. Maradik, President
�— v GfsJ+it�
Gary A. Gilot, Member
Pz—, 1- 7111,
Murray L. Miller, Member
Joseph R. Molnar, Vice President
L
Briana Micou, Member
Attest: Theresa M. Heffner, Clerk
Date: November 28, 2023
For all mounts business license questions, centan: City of south Bend • Detainment of Community Investment
227 West Jefferson red! • Suite 1400 5 -South Bend, Indiana 46601 •574.235.5912 • F: 574.235.9021
LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY
MUNICIPAL CODE SECTION - 4-39
III. PERSONAL DATA
A. Applicant's Legal Name: Alan Lazowski
B. Residential Address: 170 Scarborough St
ritu. Hartford cta+o. CT 06105
C. Residential Telephone Number: 860-522-7641
D. Residential Fax Number:
E. Cellphone Number:
F. Position with Business: t
IV. OWNERSHIP
A. Type of ownership (check one):
Sole Proprietorship (If sole proprietorship, proceed to 1).
Partnership (if partnership, proceed to2).
Yes Corporation (If corporation, proceed to 3).
1. Sale Proprietor
Name:
Residential Address:
City:
Telephone Number:
2. Partnership (List at leasttwo (2) partners)
Name q1:
Residential Address:
City:
Telephone Number:
Name N2:
Residential Address:
City?
Telephone Number:
3. Corporation
Legal name of corporation: LAZ Parking Indiana, LLC
Date and state of incorooration;
For all municipal business license questions, contest: City of South Bend • Department of Community Invastment
227 WestJefferson BIM • SUn¢ 14W 5 South Bend, Indiana 46501 1574.235.5912 • F. 574.235.9021
LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY
MUNICIPAL CODE SECTION - 4-39
IV. OWNERSHIP (Continued)
A. Type of ownership (continued):
3. Corporation (continued)
Resident Agent:
Name:Alan Lazowski
Title: Chairman/CEO
Business Address: 1 Financial Plaza, 14th Floor
City: Hartford State: CT
Zip:
06103
Officers:
Name #1: Jeffrey Karp
Title: President/Secretary
Business Address: 4 Copley Place
City: Boston State: MA
Zip;
02116
Residential Address:
City: State:
Zip:
Name #2: Michael Kuziak
Title, COO
Business Address: 1 Financial Plaza, 14th Floor
City: Hartford State: CT
Zlp,
06103
Residential Address:
City: State:
Zip:
Name#3: Nathan Owen
Title: CEO
Business Address: 1 Financial Plaza, 14th Floor
City: Hartford State: CT
Zip:
06103
Residential Address:
City: State:
Zip:
3
For all municipal business license questions, cantact: city of South Bentl • Department a Community Investment
227Wert Jefferson BIW Suite 1900 S -South Bend, Indiana 06603 190.235.5912 • F:574235.9021
LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY
MUNICIPAL CODE SECTION - 4-39
V. INCLUDE COMPLETE RATE AND HOUR SCHEDULE WITH APPLICATION
VI. INCLUDE A CURRENT INSURANCE POLICY OR BOND
VIL INCLUDE $5.00 PROCESSING FEE WITH APPLICATION
Vill. AFFIRMATION
I, hereby, certify and affirm that all of the Information I have given in this application is true and
accurate to the best of my knowledge. I further certify that I have in no way attempted to
mislead the City in this application by omitting facts known to me. I have read and understand
the regulations of the Public Parking Facility license found in the City of South Bend Municipal
de, Section 4-39. /t, ��
D` Ap -33
lgnature Date
A` Rti CERTIFICATE OF LIABILITY INSURANCE 9/13/2023
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 DOER NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER
IMPORTANT: N the cerUlicate holder N an ADDITIONAL INSURED, the policy(ies)must Be endowed. IfSUBROGATION IS WAIVED, subject to
the forms and conditions Of the policy, certain polichs may rmlulre an endorsement. A alltomM on HIS coNfic a does net confer rights to NOT
ceMficater holder In INu of such endowemengs).
PRODUCER
Brown B Brown of NA, LLC
SOO Victory Rd.
Marina Bay
North Quincy MA 02171
CAMP CTFraok Griffin
PHOTO (617)401-1220 1FAAX NO) (6111479-5"7
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INSPOSESTS AFFORuING COVERAGE
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INSURIERA: Liberty Mutual Fire Insurance
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INSURED
Les Parking Chicago, LLC
33 Nest Monroe Street
Suite 2010
Chicago IL 60603
INW�B.LM Insurance 0021POVALIACKEL
33600
appeausuc,Bworkley Insurance Conarmay,
32603
INSUIRERD MI S]MSCiMltY Insurance Come
16131
IMPMERE: Federal Insurance Company
20281
INSURERF: ZVerest National Insurance Company
10120
COVERAGES CERTIFICATE NUMBER:23-24 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED WTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTINTTHSTANDINGANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT MALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMSPILL
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If agreed upon in a written Contract or agreement, City of South Bead is included as an additional
insured for general liability, auto liability and umbrella, but only with respect to the operations of
the Famed insured.
Re; 720126 - City of South Bamd - Min - 201 N Main Street, South Bend, IN 46601 - Parking Spaces 500
City of South Bend, Indiana
Attn: Executive Director Venues Parke E
Arta
301 S. St. Louie Blvd
South Send, IN 46617
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
N PRESENTATINE
Carey/PACARE ' C J
INSD25 woop m The ACORD more and logo are reglsfored marks of ACORD
AGENCY CUSNMER ID: 2604
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AOOITIONALREMARKS
TH16 ADDITIONAL REMARKS FORM IS ASCHEDULE TO ACORD FORM,
FORMNUMBER: ACCRD25 FORM TITLE: Certificate of LiaGlty Insurance
INSURE S AFFORDING COVERAGE
NAICS
INSURER G: AmeAcan Guaanfee a UI lnswr Cormpaity
26247
INSURER H: MsIBMA Specialty Insurance Con'pny
low
INSURER I: GroetAmerken Aawronm COm�ny
389M
INSURER J'
ADDITIONAL POLICIES Ror" below Ades not Include lmh lMamalbn, refer to the coneseontine policy on the ACORD carlftate townfa poley
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$25,000.000
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AmaO lm nwmn em®Am DMw ATIOR NI nanD meon ,
The ACOAD W16 wdiw, a, ,lame 1eI ACORD
CITY OF SOUTH BEND
VENUES PARKS S A
DAILY P
0-2
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2-3
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3-5
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5-3hrs
= 4 hrs
REE!
II
Lost Ticket $10MM
For more information visit:
South SendParking.com
574-261-2900
CITY OF SOUTH BEND
VENUES PARKS 6 ARTS
MONTHLY
rKING
ndard Parking
Premium/Reserved
Reo;� Jo ntia e
$55 / Month
$90 / Month
$40 / Month
Part -Time $35 / Month
To purchase or for more information visit:
SouthBendParking.com or ca11574-232-3843
lk
For all municipal business license questions, contact: City of South Bend • Department of Community Investment �}
227 West Jefferson Blvd • Suite 1400 S -South Bend, Indiana 46601 • 574.235.5912 • F:,5]f}.91�
LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY
MUNICIPAL CODE SECTION - 4-39
I. APPLICATION TYPE Check One:
II. BUSINESS DATA
New Yes Renewal
A. Business Name: LAZ Parking4ftdiatta-tL£�����
B. Business Address: 109 W Jefferson Blvd
City: South Bend State: IN Zip: 46601
C. Mailing Address (If different from above): 1 Financial Plaza, 14th Floor
City; Hartford State: CT Zip: 06103
D. Business Telephone Number: 860-522-7641
E. Business Fax Number:
F. E-Mail Address: compliancemail@lazparking.com
G. Maximum Number of Vehicles that can be parked at facility at onetime: 500
H. Total Number of Parking Spaces at facility: 500
I. Hours during which vehicles may be stored: 24/7
H. Premises are (check one): Leased by Applicant Owned by Applicant Yes
If Leased:
Owner's Name:
Owner's Business Address:
City:
Owner's Residential Address:
City:
State:
State:
Zip:
Zip:
J. Insurance Carrier and Amount of Liability Insurance OR Bonding Agent and Amount of Bond:
For Office Use Only
Application Filed SEP 2 6 2023 Public Works Approval
Application Fee Paid SFP 2 7 7093 License Fee Paid
Sent to Dept. S P_SE^2 7 2073 License Number }'da1oy)-ol I
CITY OF SOUTH BEND, 1NDIANA
Not Approved_ BOARD OF PUBLIC WORKS
Reason laaa �M
Elizabeth A. Maradik, President
Gary A. Gilot, Member
Murray L. Miller, Member
Joseph R. Molnar, Vice President
Brian Micou, Member
�4
Attest: Theresa M. Heffner, Clerk
Date: November 28, 2023
For all municipal business license questions, contact: City of South Bend • Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021
LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY
MUNICIPAL CODE SECTION - 4-39
III. PERSONAL DATA
A. Applicant's Legal Name: Alan Lazowski
B. Residential Address: 170 Scarborough St
City: Hartford State: CT Zip: 06105
C. Residential Telephone Number: 860-522-7641
D. Residential Fax Number:
E. Cellphone Number:
F. Position with Business: CEO
IV. OWNERSHIP
A. Type of ownership (check one):
Sole Proprietorship (If sole proprietorship, proceed to 1).
Partnership (If partnership, proceed to 2).
Yes Corporation (If corporation, proceed to 3).
1. Sole Proprietor
Name:
Residential Address:
City:
Telephone Number:
2. Partnership (List at least two (2) partners)
Name #1:
Residential Address:
City:
Telephone Number:
Name #2:
Residential Address:
City:
Telephone Number:_
State:
State:
State:
3. Corporation
Legal name of corporation: LAZ Parking Indiana, LLC
Date and state of incorporation:
2
Zip:
;Lip:
Zip:
For all municipal business license questions, contact: City of South Bend -Department of Community Investment
227 West Jefferson Blvd - Suite 1400 S -South Bend, Indiana 46601 - 574.235.5912 - F: 574.235.9021
LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY
MUNICIPAL CODE SECTION - 4-39
IV. OWNERSHIP (Continued)
A. Type of ownership (continued):
3. Corporation (continued)
Resident Agent:
Name: Alan Lazowski
Title: Chairman/CEO
Business Address: 1 Financial Plaza, 14th Floor
City: }-Hartford State: CT
Officers:
Name #1: Jeffrey Karp
Title: President/Secretary
Business Address: 4 Copley Place
City: Boston
Residential Address:
City:
Name #2: Michael Kuziak
State: MA
State:
Title: COO
Business Address: 1 Financial Plaza, 14th Floor
ip: 06103
Zip: 02116
City: Hartford State: CT Zip: 06103
Residential Address:
City: State: Zip:
Name #3: Nathan Owen
Title: CEO
Business Address: 1 Financial Plaza, 14th Floor
City: Hartford State: CT
Residential Address:
City: State:
3
ip: 06103
Zip:
For all municipal business license questions, contact: City of South Bend -Department of Community Investment
227 West Jefferson Blvd - Suite 1400 S •South Bend, Indiana 46601 - 574.235.5912 - F: 574.235.9021
LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY
MUNICIPAL CODE SECTION - 4-39
V. INCLUDE COMPLETE RATE AND HOUR SCHEDULE WITH APPLICATION
VI. INCLUDE A CURRENT INSURANCE POLICY OR BOND
VII. INCLUDE $5.00 PROCESSING FEE WITH APPLICATION
Vill. AFFIRMATION
I, hereby, certify and affirm that all of the information I have given in this application is true and
accurate to the best of my knowledge. I further certify that I have in no way attempted to
mislead the City in this application by omitting facts known to me. I have read and understand
the regulations of the Public Parking Facility license found in the City of South Bend Municipal
C e, Section 4-39,
L2
ignatu re Date
4
.4cvR►r3� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
�~•` 9/13/2023
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(les) must 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
Brown & Brown of MA, LLC
500 Victory Rd.
Marina Bay
North Quincy MA 02171
CONTACT NAME' Frank Griffin
PHONE FX (617)471-1220 no: (617)479-5147
E-MAILADnRF 9; frank. griffin@bbrown.com
INSURER 3 AFFORDING COVERAGE
NAIC 9
INSURER A: LibeKty Mutual Fire Insurance
:23035
INSURED
Laz Parking Chicago, LLC
33 West Monroe Street
Suite 2010
Chicago IL 60603
INSURERB:LM Insurance Corporation
:33600
INSURFRC:Berkkey Insurance Company
:32 60 3
INSURERD:HDI g2ecialty Insurance Company
:16131
INSURERE: Federal Insurance Company
20281
wsuRERF:Everest National Insurance Company
10120
GUVLRAGE5 (:LRIIFIGAIL NUMBE11:2J-24 REVISION NUMBER:
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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE 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.
IINSR
lJDIYYYY
TYPE OF INSURANCE
.ADDL
8 BR
POLICY NUMBER
EFF
MMIDD YYYY
1
MM/6POLICY
LIMITS
GENERAL LIAMUTY
EACH OCCURRENCE
$ 11000,000
X COMMERCIAL GENERAL LIABILITY
PREMISEAMAGETORENTED
S Ca=Wronce
$ 1,000,000
A
CLAIMS -MADE Fx� OCCUR
1EB2621260451033
7/31/2023
7/31/2024
MED EXP (Any one person)
$ EXCLUDED
PERSONAL &ADVINJURY
$ 1,000,000
X Contractual Liability
GENERALAGGREGATE
$ 2,000,000
GEN'L AGGREGATE
LIMIT APPLIES PER:
PRODUCTS -COMP/OPAGG
$ 2,000,000
POLICY X
PRO• X LOC
$
AUTOMOBILE
LIABILITY
COMB[NtD SINGLE LIMIT
acodfing
5, 00,000
BODILY INJURY (Per person)
$
A
ANYAUTO
BODILY INJURY (Per accident)
$
ALL OWNED SCHEDULED
ikS2611260451013
7/31/2023
7/31/2024
Ix
AUTOS AUTOS
aerOPER
$
N
ANONGOWNED
HIRED AUTOS
ac tlenDAMAGE
X
UMBRELLA LIAB
X
OCCUR
SEE ATTACKED LIST OF
EACH OCCURRENCE
$ 100, 000, 000
XEXCESS
AGGREGATE
$ 100, 000, 000
LIAB
CLAIMS -MADE
'POLICIES
7/31/2023
7/31/2024
DED RETENTION $
$
B
WORKERS COMPENSATION
X WC ATU- CTH-
AND EMPLOYERS' LIABILITY Y / N
E.L. EACH ACCIDENT
ANY PROPRIETOR/PARTNER/EXECUTIVE
$ 1,000,000
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH) �
N /A
iA561D260951053
7/31/2023
.1/31/2024
E.L. DISEASE - EA EMPLOYEE
$ 11000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 11000,000
A
GARAGEREEPERS LIABILITY
LS2611260451013
7/31/2023
7/31/2024
$1,000,000 LIMIT
C
CRIME/EMPLOYEE DISHONESTY
ICCR4500289226
7/31/2023
7/31/2024
15,000,000 LIMIT
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
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 only with respect to the operations of
the named insured.
Re: 720121 - South Bend Leighton, 109 W Jefferson Blvd, South Bend, Indiana, 46601 - Parking Spaces 500
CERTIFICATE HOLDER CANCELLATION
City of South Bend, Indiana
Attn: Executive Director Venues Parks &
Arts
301 S. St. Louis Blvd
South Bend, IN 46617
1
Ar-nRr) 25 (2n1n1rls)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Fallon Carey/FACARE
Ce19QAR-9nin Af nPrI ('f1RPnR1LTIAW All rinh4e rarar nrl
INS025 (201005).Ol The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: 25084
LOC a: See ACORD 25
ADDITIONAL REMARKS SCHEDULE
Page of
AGENCY
NAMED rNSURED
Amity Insurance A Division of Brown & Brown of MA LLC
POLICYNUMBER
See ACORD 25
Bn Certificate
CARRI£a
NAIL CODE
SC Certificate
EFFECTIVE DATE: 713112023
rrnl, W91r►w:T#7JASN-9
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liablllly Insurance
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER G: American Guarantee & Liability Insurance Company
26247
INSURER H: Westfield Specialty Insurance Company
16992
INSURER I: Great American Assurance Company
26344
INSURER J:
ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy
limits
INSR
LTR
TYPE OF INSURANCE
ADDL
INSD
WRFI
WVD
POLICY NUMBER
P'OL Y
EFFECTIVE
DATE
(mm/ddWy)
POLICY
EXPIRATION
DATE
(mm/d&M)
LIMITS
D
EXCESS GENERAL
LIABILITY
XLX06109900S
7/31/2023
7/31/2024
AGGREGATE
$4,000,000
E
UMBRELLA LIABILITY
79863543
7/31/2023
7/31/2024
AGGREGATE
$26,000.000
F
EXCESS LIABILITY
XC9EX00286231
7/31/2023
7/31/2024
AGGREGATE
$15,000.000
G
EXCESS LIABILITY
AEC011173109
7/31/2023
7/31/2024
AGGREGATE
$15.000.000
R
EXCESS LIABILITY
XSL345214K00
7/31/2023
7/31/2024
AGGREGATE
$10.000,000
EXCESS LIABILITY
EXC5125913
7/31/2023
7/31/2024
AGGREGATE
$10.000,000
E
EXCESS LIABILITY
78187246
7/31/2023
7/31/2024
AGGREGATE
$25,000,04
ILI
I
I
--J
ACORD 101 (2008/01) 02008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
C!'TY OF SOUTH BEND
VENUES FARMS R ARTS
.... _.........
0 2 hrs
2-3 h rs-
3 — 5 hrs,j-
Lost Ticket
ING
REE!
For more information visit:
SouthBend Parking. com
�7d_9M _�o4nn
CITY OF SOUTH SEND
VENUES PARRS 6 ARTS
ONTHLY
-I-, -. =--7
R K I N G
Standard Parking $55 /Month
Premium/ e�serec$90 Month
Residential
Part -Time
$40 ! Month
$35 / Month
To purchase or for more information visit:
Sou
th .com or call 574-232-3843
h,
For all municipal business license questions, contact: City of South Bend • Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S -South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.90b_—/5 O5�
LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY
MUNICIPAL CODE SECTION - 4-39
I. APPLICATION TYPE Check One: New Yes Renewal
II. BUSINESS DATA
A. Business Name: LAZ Parking4ndiana—,EE$ �`� WC
B. Business Address: 121 E Wayne St
City: South Bend State: IN Zip: 46601
C. Mailing Address (If different from above): 1 Financial Plaza, 14th Floor
City: Hartford State: CT Zip: 06103
D. Business Telephone Number: 860-522-7641
E. Business Fax Number:
F. E-Mail Address: compliancemail@lazparking.com
G. Maximum Number of Vehicles that can be parked at facility at onetime: 500
H. Total Number of Parking Spaces at facility: 500
I. Hours during which vehicles may be stored: 24/7
H. Premises are (check one): Leased by Applicant Owned by Applicant Yes
If Leased:
Owner's Name:
Owner's Business Address:
City: State: Zip:
Owner's Residential Address:
City:
Zip:
J. Insurance Carrier and Amount of Liability Insurance OR Bonding Agent and Amount of Bond:
For Office Use Only
Application Filed SEP 6 2093 Public Works Approval
Application Fee Paid 2023 License Fee Paid ti % 7 2023
Sent to Dept.SEP 2 7 2023 License Number PB�'�-O0(�21�
CITY OF SOUTH BEND, INDIANA
Not Approved _ BOARD OF PUBLIC WORKS
Reason jajLa liol-P1
Elizabeth A. Maratik, President
�� a_t_t_-
Gary A. Gilot, Member
Murray L. Miller, Member
Joseph R. Molnar, Vice President
B`riaannaaMiiccou, Member
Attest: Theresa M. Heffner, Clerk
Date; November 28, 2023
For all municipal business license questions, contact: City of South Bend • Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021
LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY
MUNICIPAL CODE SECTION - 4-39
III. PERSONAL DATA
A. Applicant's Legal Name: Alan Lazowski
B. Residential Address: 170 Scarborough St
City: Hartford State: CT Zip. 06105
C. Residential Telephone Number: 860-522-7641
D. Residential Fax Number:
E. Cellphone Number:
F. Position with Business: CEO
IV. OWNERSHIP
A. Type of ownership (check one):
Sole Proprietorship (If sole proprietorship, proceed to 1).
Partnership (If partnership, proceed to 2).
Yes Corporation (If corporation, proceed to 3).
1. Sole Proprietor
Name:
Residential Address:
City:
Telephone Number:.
2. Partnership (List at least two (2) partners)
Name #1:
Residential Address:
City:
Telephone Number:
Name #2:
Residential Address:
Citv:
Telephone Number:,
State:
State:
3. Corporation
Legal name of corporation: LAZ Parking Indiana, LLC
Date and state of incorporation:
2
p:
Tip:
171
For all municipal business license questions, contact: City of South Bend • Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S -South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021
LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY
MUNICIPAL CODE SECTION - 4-39
IV. OWNERSHIP (Continued)
A. Type of ownership (continued):
3. Corporation (continued)
Resident Agent:
Name: Alan Lazowski
Title: Chairman/CEO
Business Address: 1 Financial Plaza, 14th Floor
City: Hartford State: CT
Officers:
Name #1: Jeffrey Karp
Title: President/Secretary
Business Address: 4 Copley Place
City: Boston State: MA
Residential Address:
City: State:
Name #2: Michael Kuziak
Title: COO
Business Address: 1 Financial Plaza, 14th Floor
City: Hartford State: CT
Residential Address:
City: State:
Name #3: Nathan Owen
Title: CEO
zip: 06103
zip: 02116
zi p:
Zip: 06103
Zip:
Business Address: 1 Financial Plaza, 14th Floor
City: Hartford State: CT Zip: 06103
Residential Address:
City: State: Zip:
For all municipal business license questions, contact: City of South Bend • Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021
LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY
MUNICIPAL CODE SECTION - 4-39
V. INCLUDE COMPLETE RATE AND HOUR SCHEDULE WITH APPLICATION
VI. INCLUDE A CURRENT INSURANCE POLICY OR BOND
VII. INCLUDE $5.00 PROCESSING FEE WITH APPLICATION
Vill. AFFIRMATION
I, hereby, certify and affirm that all of the information I have given in this application is true and
accurate to the best of my knowledge. I further certify that I have in no way attempted to
mislead the City in this application by omitting facts known to me. I have read and understand
the regulations of the Public Parking Facility license found in the City of South Bend Municipal
Nde, Section 4-39.
Signature
4
�_b _Z
Date
ACC)W a CERTIFICATE OF LIABILITY INSURANCE 9DATE /13/20 3YY)
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 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
NAME: Frank Griffin
Brown & Brown of MA, LLC PHONE (617)471-1220 FAX (617)479-5147
INC No .
500 Victory Rd. ADDRESS: f rank. grif f inobbrown. cam
Marina Bay INSURERS AFFORDING COVERAGE NAIC #
North Quincy MA 02171 INSURERA: Liberty Mutual Fire Insurance 23035
INSURED INSURERB:LM Insurance Corporation :33600
Laz Parking Chicago, LLC INSURER C: BerkleyInsurance Company :32603
33 West Monroe Street INSURERD:HDI Specialty Insurance Company :16131
Suite 2010 INSURER E: Federal Insurance Com an 20281
Chicago IL 60603 INSURER F: Everest National Insurance Company 10120
COVERAGES CERTIFICATE NUMBER:23-24 REVISION NUMBER:
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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE 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.
°LTR
TYPE OF INSURANCE
AODL
S BR
POLICY NUMBER
POLICY EFF
MMIDD/YYYY
POLICY EXP
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
S 1,000,000
A
X COMMERCIALGENERALUABILITY
CLAJMS-MADE [X OCCUR
PRB2611260451033
I/31/2023
17/31/2024
PREM SES lEaou rrence
$ 1,000,000
MED EXP (Any one person)
$ EXCLUDED
PERSONAL & ADV INJURY
$ 11000,000
x Contractual Liability
GENERAL AGGREGATE
$ 2,000,000
GENIAGGREGATE LIMITAPPLIES PER:
PRODUCTS - COMP/OPAGG
$ 2,000,000
POLICY X �O- Fx_j Lac
$
AUTOMOBILE LIABILITY
COMBIN ED SINGLE LIMIT
Ea acrJelanki
5,000,000
BODILY INJURY (Per person)
$
A
X ANYAUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
kS2611260451013
7/31/2023
.P/31/2024
BODILY INJURY (Per accident)
$
NON -OWNED
X HIRED AUTOS N AUTOS
PROPERTY DAMAGE
Per
$
X
UMBRELLA LIAB X OCCUR
SEE ATTACHED LIST OF
EACH OCCURRENCE
$ 100, 000, 000
X
AGGREGATE
$ 100, 000, 000
EXCESS LIAB CLAIMS -MADE
POLICIES
'7/31/2023
P/31/2024
DED I I RETENTION S
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH)
NIA
VAS61D260451053
7/31/2023
.P/31/2024
x WC STATU- OTH-
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
I
I
I
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
A
GARAGEKEEPERS LIABILITY
102611260452013
]/31/2023
7/31/2024
$1.000,000 LIMIT
C
CRIME/EMPLOYEE DISHONESTY
4CCR4500289226
1/31/2023
.1/31/2024
$5.000.000 LIMIT
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
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 only with respect to the operations of
the named insured.
Re: 720125 - City of Southbend - Wayne - 121 E Wayne Street, South Bend, IN, 46601 - Parking Spaces 50
CERTIFICATE HOLDER
City of South Bend, Indiana
Attn: Executive Director Venues Parka &
Arts
301 S. St. Louis Blvd
South Bend, IN 46617
I
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Fallon Carey/FACARE
AUUHU e5 (ZUIUIUa) V 1933-2010 AGORD CORPORATION. All rights reserved.
INS025 (201005).01 The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: 25084
LOC #: See ACORD 25
ADDITIONAL REMARKS SCHEDULE Page of
AGENCY NAMEDINSURED
Amity Insurance A Division of Brown & Brown of MA LLC
POLICY NUMBER
See Certificate See ACORD 26
CARRIER NAIC CODE
Sea Certificate EFFECTIVE DATE: 713112023
ADDIYiONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER G: American Guarantee & Liability Insurance Company
26247
INSURER H: Westfield Specialty Insurance Company
16992
INSURER I: Great American Assurance Company
26344
SURER J:
JDITIONAL POLICIES If a policy below does not include iimit information, War to the corresponding policy on the ACORD Certificate form for policy
Ilmlls
INSR
LTR
TYPE OF INSURANCE
ADDL
INSD
SUER
WVD
POLICY NUMBER
POLICY
EFFECTIVE
DATE
(mm/dd/yW)
POLICY
EXPIRATION
DATE
(mm/ddryyy)
LIMITS
D
EXCESS GENERAL
LIABILITY
XLXD6109900S
7/31/2023
7/31/2024
AGGREGATE
$4.000.000
F,
UMBRELLA LIABILITY
179863543
7/31/2023
7/31/2024
AGGREGATE
$25,000,000
F
(EXCESS LIABILITY
XC9EX00286231
7/31/2023
7/31/2024
AGGREGATE
$15,000,000
G
1EXCESS LIABILITY
AEC011173109
7/31/2023
7/31/2024
AGGREGATE
$15,000,000
R
EXCESS LIABILITY
XSL345214K00
7/31/2023
7/31/2024
AGGREGATE
$10,000,000
I
EXCESS LIABILITY
EXC5125913
7/31/2023
7/31/2024
AGGREGATE
$10,000,000
E
EXCESS LIABILITY
78187246
7/31/2023
7/31/2024
AGGREGATE
$25,000,000
ACORD 101 (2000101) C 2000 ACORD CORPORATION All rights reserved,
The ACORD name and logo are regislered marks of ACORD
CITY Of SOUTH SENO
VENUES PARKS S ARTS
DAILY PARKING
0-2hrs* �REE!
2 — 3 h rso 4
3-5hr$6
5—$ h rs $8
8 2 4� h rs $10
For more information visit:
South Bend Parking. com
574-261-2900
C4TY OF SOUTH BEND
VENUES PARRS & ARTS
ONTHLY
Standard Parking
PrZmiurn/Reserved
Residential
Part -Time
I NG
$55 Month
$90 / Month
$40 / Month
$35 / Month
To purchase or for more information visit:
South Bend 9
Parkin .coin or call 574-232-3843