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HomeMy WebLinkAboutLicense - Public Parking Facility Renewal - LAZ Parking Midwest Inc.1316 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 July 22, 2025 Ms. Heather Parker LAZ Parking Midwest, LLC 1 Financial Plaza, 141h Floor Hartford, CT 06103 compliancemailklazparking com RE: Approval of Public Parking Facility License Dear Ms. Parker: At its July 22, 2025 meeting, the Board of Public Works approved your request for the Public Parking Facility License at 126 N. Main St., 109 W. Jefferson Blvd., and 121 E. Wayne St. contingent on egress lighting in SE Stairway in the parking facility at 121 E. Wayne St. If you have any further questions, please call this office at (574) 235-9251. Sincerely, /s/HiIlary Horvath Hillary Horvath, Clerk Enclosures HH ELIZABETH A. MARADIK JOSEPH R. MOLNAR GARY A. GILOT MURRAY L. MILLER BREANA N. MIcou INTEROFFICE MEMORANDUM BOARD OF PUBLIC WORKS DATE: 1 /16/2025 TO: Jim Wood, Neighborhood Services and Enforcement Chris Dressel, Community Investment Derek Erquhart, Fire Department Kyle Ludlow, Engineering FROM: Theresa Heffner, Clerk SUBJECT: Annual License Application for Public Parking Facility LAZ Parking Midwest, LLC LOCATIONS: 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: 121 E Wayne needs SE stairway to be lit- once this happens, favorable recommendation. Favorable recommendation on all others. COMMUNITY INVESTMENT: Favorable recommendation. FIRE: Section 4-39(k): Favorable Recommendation ENGINEERING: Section 4-39(b) Favorable, 121 Wayne contingent on egress lighting in SE Stairwell 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) fw"L4 -0 164, 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 I. APPLICATION TYPE Check One: New Renewal X II. BUSINESS DATA A. Business Na Laz Parking Midwest, LLC B. Business Ad/t�res:'' N Main St City: South Bend State: IN Zip: 46601 C. Mailing Address (If different from above): 1 Financial Plaza, 14th FL City: Hartford State: CT zip: 06103 D. Business Telephone Number: 860.522.7641 E. Business Fax Number: F. E-Mail Address: compllanCemail@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 X Owned by Applicant If Leased: Owner's Name: City of South Bend Ownership Owner's Business Address: 227 W Jefferson Blvd Suite 455 City: South Bend State: IN Zip: 46601 Owner's Residential Address: City: tate: Zip: J. Insurance Carrier and Amount of Liability Insurance OR Bonding Agent and Amount of Bond. For Office Use Only Application Filed J AN 1 4 2025 Public Works Approval Application Fee Paid j AN 1 4 7W, License Fee Paid jell] i 4 � , 1, Sent to Dept. 4 711? License Number u CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS Not Approved 2 Reason Elizabeth A. Maradik, President Joseph R. Molnar, Vice President Gary A. Gilot, Member Breana Micou, Member Murray L. Miller, Member Attest: Madeline Hostetler, Acting Clerk Date: July 22, 2025 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: Heather Parker B. Residential Address: 1 Financial Plaza, 14th FL City: Hartford -State-.- C. Residential Telephone Number: 860.522.7641 D. Residential Fax Number: E. Cellphone Number: F. Position with Business: CT Zip-, 06103 IV. OWNERSHIP A. Type of ownership (check one): Sole Proprietorship (If sole proprietorship, proceed to 1). Partnership (If partnership, proceed to 2). X 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: 3. Corporation State State: Legal name of corporation: LAZ Parking Midwest, LLC Date and state of incorporation: Connecticut 2 Zip: Zip: W For all municipal business license questions, contact: City of South Bend • Department of Community Investment 227 West Jefferson Blvd • Suite 1400S -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: CEO Officers Business Address: 1 Financial Plaza, 14th FL City: Hartford State: CT Name #1: Title: Business Address: City: State: Residential Address; City: State: Name #2: Title: Business Address: City: State: Residential Address: City: State: Name #3: Title: Business Address: Citv: Residential Address: City: 3 State: Zip: 06103 Zip: Zip: p: Zip: Zip: State: Zip: For all municipal business license questions, contact: City of South Bend -Department of Community Investment 227 West Jefferson Blvd -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 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 VIII. 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 Code, Section 4-39. lea4A4' 01 /07/2025 Signature 4 Date DATE /YYYY) A CRRLL!! CERTIFICATE OF LIABILITY INSURANCE 1T7/20m2o25 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 CONTACT NAME: $llSl@ GuarinD _ McGriff Insurance Services LLC PiioiuE — FAX 150 S. Warner Road, Suite 460 .(A(,P,AQ, 610 233-4846 tr;c, Npj E-MAIL King Of Prussia PA 19406 ADDRE". sugar[. uarina m liff.com INRUREWSI AFFORDING COVERAGE NAIC # INSURER A: National Union Fire Ins Co of Pitt. PA 19445 INSURED 151LAZKARP INSURERB: AIU Insurance Company 19399 LAZ Parking Midwest, LLC 500 S. Front St., Suite 210 INsulzERc: Allianz Global Risks US Insurance Co 35300 Columbus OH 43215 INSURERD: INSURER E: INSURER F : rnucr,rrro 1%C0rIC1f Ar= Kit leenCo•nennsnee7 RFVISION NIIMRFR. 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 TYPE OF INSURANCE ADDL U9R: 1 POLICY EFFPOLiCY E_XP LTR POLICYNUMBER MMIDDIYYYY MMID LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 3609369 7/31/2024 7/31/2025 1 EACH OCCURRENCE $1,000,000 CLAIMS -MADE XI OCCUR TED P EMI 0'"anwl S 1.000,000 MED EXP (Any one person) $ 10.000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L.AGGREGATELIMIT APPLIES PER: GENERAL AGGREGATE $2000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY _ X _ PRO 7X] LOC JECT $ OTHER: A AUTOMOBILE LIABILITY Y Y 3135689 7/31/2024 7/3112025 COMBVNEO&INGLE LIMIT C+1 denl $ 5,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED -� SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) - $ PROPER;� l AMAGE $ C X UMBRELLA LIAB X OCCUR Y Y SEE SCHEDULE 7/31/2024 7/31/2025 EACH OCCURRENCE $ 100,000.000 AGGREGATE $ 100,000,000 X EXCESS LIAB ` CLAIMS -MADE, $ DED TENTION S I B I WORKERS COMPENSATION I AND EMPLOYERS' LIABILITY YIN Y WC014111735 7/31/2024 7/31/2025 A STA7U E ER $ 1.000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUE Fq, N / A (Mandatory in NH) E L. DISEASE - EA EMPLOYEE $ 1.000,000 It yes, describe under DESCRIPTION OF OPERATIONS below E L. DISEASE - POLICY LIMIT A Garagekeepers Liability Y Y 3135689 7131/2024 7/31/2025 B Stop Gap Liability WC014111735 7/31/2024 { 7/31/2025 1,000.000 Limits 1M/1M/1M I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) If agreed upon in a written contract or agreement, City of South Bend, Indiana is included as an additional insured with a waiver of subrogation in their favor for general liability, but only with respect to the operations of the named insured. Re: M22126 - 126 N. Main St, South Bend, IN 46601 r:FRTIFICATE HOLDER CANCELLATION City of South Bend, Indiana, Attn: Executive Director Venues 301 S. St. Louis Blvd South Bend IN 46617 USA 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 A201_4t ©1988-2015 ACORD CORPORATION. All rights reservea. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 151LAZKARP LOC #: See COI (Acord 25) ACC> V ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY (NAMED INSURED McGriff Insurance Services, LLC POLICY NUMBER See COI (Acord 25) See COI (Acord 25) CARRIER NAIC CODE See COI (Acord 25) EFFECTIVE DATE: 7/31/2024 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: Acord 25 FORM TITLE: Certificate of Liability Insurance Additional Insurers Affording Coverage: Insurer letter C: Allianz Global Risk US Insurance Company (NAIC 35300) Insurer letter D: Federal Insurance Company (Chubb) (NAIC 20281) Insurer letter E: Everest National Insurance Company (NAIC 10120) Insurer letter F: Endurance Assurance Corporation (NAIC 11551) Insurer letter G: American Guarantee and Liability Insurance Company (Zurich) (NAIC 26247) Insurer letter H: Westfield Specialty Insurance Company (NAIC 16992) Insurer letter I: Great American Assurance Company (NAIC 26344) C: Excess General Liability USL03085024 7/31/2024-7/31/2025 Aggregate $4,000,000 D: Primary Umbrella Liability 79863543 7/31/2024-7/31/2025 Aggregate $25,000,000 E: Excess Liability XC5EX02069241 7/31/2024-7/31/2025 Aggregate $7,500,000 F: Excess Liability EXC30065353300 7/31/2024-7/31/2025 Aggregate $7,500,000 G: Excess Liability AEC011173110 7/31/2024-7/31/2025 Aggregate $15,000,000 H: Excess Liability XSL345214K01 7/31/2024-7/31/2025 Aggregate $10,000,000 I: Excess Liability EXC5772941 7/31/2024-7/31/2025 Aggregate $10,000,000 D: Excess Liability 78187246 7/31/2024-7/31/2025 Aggregate $25,000,000 ML,VKu I I tcuuoiu11 © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DAILY RATES MONTHLY PARKING 0 - 2 Hours $ FREE STANDARD 2 - 3 Hours 4.00 PARKING 3 - 5 Hours 6.00 PREMIUM 1 RESERVED 5 - 8 Hours 8.00 RESIDENTIAL 8 - 24 Hours 10.00 PART TIME LOST TICKET = $10-00 $551 MONTH $901 MONTH $401 MONTH $351 MONTH F P,,P202.y - o110 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 C'Pre— ECG. UDt -TO 4 g� ' LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY MUNICIPAL CODE SECTION - 4-39 I. APPLICATION TYPE Check One: II. BUSINESS DATA New Renewal A. Business Name: Laz Parking Midwest, LLC X B. Business Address: 109 W Jefferson Blvd ( Ni�Y VICIIl kn GK) City: South Bend State: IN Zip: 46601 C. Mailing Address (If differentfrom above): 1 Financial Plaza, 14th FL City: Hartford State: CT D. Business Telephone Number: 860.522.7641 E. Business Fax Number: p: 06103 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 atfacility: 500 I. Hours during which vehicles may be stored: 24/7 H. Premises are (check one): Leased by Applicant% Owned by Applicant If Leased: Owner's Name: City of South Bend Owner's Business Address: 301 S St Louis Blvd City: South Bend State: IN Zip. 46617 Owner's Residential Address: City: te: p: J. Insurance Carrier and Amount of Liability Insurance OR Bonding Agent and Amount of Bond: For Office Use Only Application Filed >I AN 1 4 2025 Public Works Approval Application Fee Paid t i .1 License Fee Paid j A @14 2 n2,F Sent to Dept. .FA1,1 1 4 2ti11 License Number _P 64)W5—Q0 7 Not Approved Reason CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS VtLa Elizabeth A. Maradik, President �-•� aft Gary A. Gilm, Member 7,Z—, A 9zue1, Murray L. Miller, Member Joseph R. Molnar, Vice President Breana Micro, Member Attest: Madeline Hostetler, Acting Clerk Date: July 22, 2025 For all municipal business license questions, contact: City of5outh 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: Heather Parker B. Residential Address: 1 Financial Plaza, 14th FL City: Hartford State: CT C. Residential Telephone Number: 860.522.7641 D. Residential Fax Number: E. Cellphone Number: F. Position with Business: Director of compliance p: 06103 IV. OWNERSHIP A. Type of ownership (check one): Sole Proprietorship (If sole proprietorship, proceed to 1). Partnership (If partnership, proceed to 2). X 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: Zip: State: Zip: State: 3. Corporation Legal name of corporation: LAZ Parking Midwest, LLC Date and state of incorporation: Connecticut K P 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. CEO Business Address: 1 Financial Plaza, 14th FL City: Hartford State: CT Officers: Name #1: Title: Business Address: City: Residential Address: City. Name #2: Title: Business Address: City: Residential Address City: Name #3: Title: Business Address: City: Residential Address: City: 3 State: State. - Zip: 06103 Zip: Zip: State: Zip: State: Zip: Zip: 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 Code, Section 4-39. 1-4"66m, Aa4A,4, 1 /7/2025 Signature Date A �a DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 1m2025 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 CONTACT NAME: Susie Guarino McGriff Insurance Services LLC PHONE FAX 150 S. Warner Road, Suite 460 tyc. No. F,91): 610-233-4846 to C, No): King Of Prussia PA 19406 E 1ES& susan.guarino m riff.com INSURED LAZ Parking Midwest, LLC 500 S. Front St., Suite 210 Columbus OH 43215 INSURERS AFFORDING COVERAGE I NAIC# INSURER A: National Union Fire Ins Co of Pitt. PA 19445 151LAZKARP INSURERB: AIU Insurance Company 19399 INSURER C : Allianz Global Risks US Insurance Co 35300 INSURER D : F: CAVFRAnI=Q RFRTIFIRATF Ni IMRFR• 7Rnn7RRRR RFVISION 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 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. MISR TYPE OF INSURANCE 'ADD ER MMDIDY/YYYY 13609369 MMIDDIYYYY I LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 7/31/2024 7/31/2025 1 EACH OCCURRENCE $1,000,000 51,000,00o CLAIMS -MADE X I OCCUR u $ 10.000 I MED EXP (Any one person) S1,000,000 III PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: S 2.000.000 GENERAL AGGREGATE POLICY E jE f X] LOC PRODUCTS - COMP/OP AGG $ 2.000,000 $ OTHER: A AUTOMOBILELIABILITY Y Y 3135689 7/31/2024 7/31/2025 COMBINED STNGLEL Ea acciden s5,000,000 $ X ANY AUTO BODILY INJURY (Per person) OWNED SCHEDULED AUTOS ONLY H AUTOS i HIRED NON -OWNED AUTOS ONLY r—_ AUTOS ONLY BODILY INJURY (Per accident) PROPERTY DAMAGE Per acciderill $ $ $ I C X UMBRELLA LIAB OCCUR Y Y SEE SCHEDULE 7/31/2024 7/31/2025 EACH OCCURRENCE S100,000,000 S 100,000,000 X 1 EXCESS LIAR I CLAIMS -MADE AGGREGATE S DFD I RETENTION S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Ym ANYPROPRIETOR/PARTNER/EXECUTIVE Y WC014111735 7/31/2024 7/31/2025 rX PER OTH_ STATUTE I ER E.L. EACH ACCIDENT S 1,000,000 OFFICER/MEMBEREXCLUDED? � (Mandatoryin NH) N I A E.L DISEASE -fA EMPLOYEE $ 1,000,000 $ 1 000.000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT A I Garagekeepers Liability Y Y B I+ Stop Gap Liability f 3135689 7/31/2024 WC014111735 7/31/2024 7/31/2025 1,000,000 7/31/2025 Limits 1M/1M/1M DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 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: M22121 - South Bend Leighton, 109 W Jefferson Blvd, South Bend, Indiana, 46601 — Parking Spaces 500 f`CDTICl/`ATC LJP11 r%CD rAnlrv=l I ATIr1KI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of South Bend, Indiana, Attn: Executive Director ACCORDANCE WITH THE POLICY PROVISIONS. Venues Parks & 301 S. St. Louis Blvd AUTHORIZED REPRESENTATIVE 2 South Bend IN 46617 USA U 1988-2015 AGURD GORPURA I IUN. All rlgnts reservea. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 151LAZKARP LOC #: See COI (Acord 25) ADDITIONAL REMARKS SCHEDULE AGENCY McGriff Insurance Services, LLC POLICY NUMBER See COI (Acord 25) CARRIER NAIC CODE See COI (Acord 25) IYUUI I IUNML- KGfVIHKR.7 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: Acord 25 FORM TITLE: Certificate of Liability Insurance NAMED INSURED See COI (Acord 25) EFFECTIVE DATE: 7/31 /2024 Additional Insurers Affording Coverage: Insurer letter C: Allianz Global Risk US Insurance Company (NAIC 35300) Insurer letter D: Federal Insurance Company (Chubb) (NAIC 20281) Insurer letter E: Everest National Insurance Company (NAIC 10120) Insurer letter F: Endurance Assurance Corporation (NAIC 11551) Insurer letter G: American Guarantee and Liability Insurance Company (Zurich) (NAIC 26247) Insurer letter H: Westfield Specialty Insurance Company (NAIC 16992) Insurer letter I: Great American Assurance Company (NAIC 26344) C: Excess General Liability USL03085024 7131/2024-7/31/2025 Aggregate $4,000,000 D: Primary Umbrella Liability 79863543 7/31/2024-7/31/2025 Aggregate $25,000,000 E: Excess Liability XC5EX02069241 7/31/2024-7/31/2025 Aggregate $7,500,000 F: Excess Liability EXC30065353300 7/31/2024-7/31/2025 Aggregate $7,500,000 G: Excess Liability AEC011173110 7/31/2024-7/31/2025 Aggregate $15,000,000 H: Excess Liability XSL345214K01 7/31/2024-7/31/2025 Aggregate $10,000,000 I: Excess Liability EXC5772941 7/31/2024-7/31/2025 Aggregate $10.000,000 D: Excess Liability 78187246 7/31/2024-7/31/2025 Aggregate $25,000,000 Page 2 Of 2 A(;UKU 101 ("L003/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD � ter--• � . LL C � --` 11 — L ...tee... DAILY RATES . 2 Hours FREE 3 Hours 4.00 - 5 H001 y 6,00 wr . 8 Hours 8100 S - 24 HOWS 10.00 Alto"; LOST TIC'r'.ET = $10.00 MR, 1p?'Ifir:LY PARKITVG } STANDAni1 5551 MONTH PARKING PREmni�.' 590 1 MONTH itE5Ec3L'r is >RA 1 RESiDLWHAL S401blONTH - - PART TIME S351 MONTH 0� WLQL4-0Ll 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.$912 FF`-�5{74235.9021 QQh AD LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY MUNICIPAL CODE SECTION - 4-39 I. APPLICATION TYPE Check One II. BUSINESS DATA New Renewal A. Business Name: Laz Parking Midwest, LLC X B. Business Address: 121 E Wayne St (Nt,( q ) City: South Bend State: IN Zip: 46617 C. Mailing Address (If different from above): 1 Financial Plaza, 14th FL 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 ApplicantX Owned by Applicant If Leased: Owner's Name: City of South Bend Ownership Owner's Business Address: 227 W Jefferson Blvd Suite 455 City: South Bend State: IN Zip: 4620446601 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 J'AN 1 ¢ 2025 Public Works Approval Application Fee Paid `i MR1 1 4 1U1_;) License Fee Paid Sent to Dept. ! V i 4 20r. License Number rwgo.a S_ OCK Not Approved Reason CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS M Elizabeth A. Maradik, President �—•� Qsl-rit�t Gary A. Gilot, Member Murray L. Miller, Member Off' Joseph R. Molnar, Vice President Breana Micou, Member �,eatClrX Attest: Madeline Hostetler, Acting Clerk Date: July 22, 2025 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: Heather Parker B. Residential Address: 1 Financial Plaza, 14th FL City: Hartford State: CT Zip: 06103 C. Residential Telephone Number: 860.522.7641 D. Residential Fax Number: E. Cellphone Number: F. Position with Business: Director of compliance IV. OWNERSHIP A. Type of ownership (check one): Sole Proprietorship (If sole proprietorship, proceed to 1). Partnership (If partnership, proceed to 2). X Corporation (If corporation, proceed to 3). 1. Sole Proprietor Name: Residential Address: State: Lip: Telephone Number 2. Partnership (List at least two (2) partners) Name #1: Residential Address: City: Telephone Number: Name #2: Residential Address: City: Telephone Number:. 3. Corporation M. Zip: Legal name of corporation: LAZ Parking Midwest, LLC Date and state of incorporation: Connecticut 2 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: CEO Business Address: 1 Financial Plaza, 14th FL City: Hartford State: CT Zip: 06103 Officers Name #1: Title: Business Address: City: Residential Address: City: Name #2: Title: Business Address: City. Residential Address: City: Name #3: Title: Business Address: City: Residential Address: City: 3 State: State: p: a State: Zip: State: p: U lip: For all municipal business license questions, contact: City of South Bend • Department of Community Investment 227 West Jefferson Blvd • 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 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 VIII. 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 Code, Section 4-39. 'e�taz, Aa4A4' 1 /7/2025 Signature 4 Date A ® DATE (MYYY) ���IlllllllLJJ CERTIFICATE OF LIABILITY INSURANCE 1/7/2025/2025 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 pollcy(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 CONTACT NAME: Susie Guarino McGriff Insurance Services LLC PHONE 610-233 4846 FAC.NnI: 150 S. Warner Road, Suite 460 E'L King Of Prussia PA 19406 AeDxtss: susamguarinD.lMmcgriffcom INSURER A: National Union Fire Ins Co of Pitt. PA 19445 INSURED 151LAZKARP WSURERB: AIU Insurance Company 19399 LAZ Parking Midwest, LLC ua 500 S. Front St., Suite 210 suRER c : Allianz Global Risks US Insurance Co 35300 Columbus OH 43215 INSURER6: f INSURER E: ` r MIICMAnce t'=0711=1f`ATC kil IIIAM=D- 01aa0caz7 RFVISI()N NIIMRFR-- 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 TYPE OF INSURANCE AODL SUBR POLICY EFF PpL1CYEXP L7 WV POLICY NUMBER MID M LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 3609369 7/31/2024 7/31/2025 EACH OCCURRENCE $1,000,000 CLAIMS -MADE F - - OCCUR DAMAGE TO RENTI='D---7 PREMIAE-StEa omuffencel S 1,000,000 MED EXP (Any oneperson) $ 10.000 PERSONAL & ADV INJURY $ 1,000.000 GEML AGGREGATE LIMIT APPLIES PER: . GENERAL AGGREGATE $2,000.000 - POLICY PECOTFX LOC PRODUCTS -COMP/OP AGG S 2.000,000 .. OTHER: $ A AUTOMOBILE LIABILITY Y Y 3135689 7/31/2024 7/31/2025 COMBINEDSiNGLELIMIT $5,000,000 [Ea accidanl] X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED BODILY INJURY (Per person) S BODILY INJURY (Per accident) $ FIR EfiTY DAMAGE $ AUTOS ONLY AUTOS ONLY c t )$ C X UMBRELLA LIAB X OCCUR Y Y SEE SCHEDULE 7/31/2024 7/31/2025 EACH OCCURRENCE $ 100,000,000 $ 100,000,000 X EXCESS LIAB CLAIMS -MADE I ,AGGREGATE $ . QED T TJLlAf5 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y N Y WC014111735 7/31/2024 I 7/31/2025 CTH- IX STATUTE ER EL EACH ACCIDENT $ 1,000,o00 E.L. DISEASE - EA EMPLOYEE $ 1,000.000 OFFICER/M EMBER EXCLUDED? ] (Mandatory in NH) NIA If yes, describe under DESCRIPTION OF OPERATIONS below I EL. DISEASE - POLICY LIMIT S 1,000,000 A Garagekeepers Liability B Stop Gap Liability I Y Y 3135689 , WC014111735 1 024 024 772 1.000,000 7I31I7/31/2025 2025 I I Limits 1M/1MI1M DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) If agreed upon in a written contract or agreement, City of South Bend, Indiana is included as an additional insured with a waiver of subrogation in their favor for general liability, but only with respect to the operations of the named insured. Re: M22125: 121 E Wayne St, South Bend, IN 46601 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of South Bend, Indiana, Attn: Executive Director ACCORDANCE WITH THE POLICY PROVISIONS. Venues 301 S. St. Louis Blvd AUTHORIZED REPRESENTATIVE South Bend IN 46617 USA © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ACC O AGENCY CUSTOMER ID: 151LAZKARP LOC #: See COI (Acord 25) Annl'r1f%KIA1 OCRAA01ZO @f-LJCM111 C AGENCY NAMED INSURED McGriff Insurance Services, LLC POLICY NUMBER See COI (Acord 25) See COI (Acord 25) CARRIER NAIC CODE See COI (Acord 25) EFFECTIVE DATE: 7/31/2024 AUUI I IUNAL Rt=MARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: Acord 25 FORM TITLE: Certificate of Liability Insurance Additional Insurers Affording Coverage: Insurer letter C: Allianz Global Risk US Insurance Company (NAIC 35300) Insurer letter D: Federal Insurance Company (Chubb) (NAIC 20281) Insurer letter E: Everest National Insurance Company (NAIC 10120) Insurer letter F: Endurance Assurance Corporation (NAIC 11551) Insurer letter G: American Guarantee and Liability Insurance Company (Zurich) (NAIC 26247) Insurer letter H: Westfield Specialty Insurance Company (NAIC 16992) Insurer letter I: Great American Assurance Company (NAIC 26344) C: Excess General Liability USL03085024 7/31/2024-7/31/2025 Aggregate $4,000,000 D: Primary Umbrella Liability 79863543 7/31/2024-7/31/2025 Aggregate $25,000,000 E: Excess Liability XC5EX02069241 7/31/2024-7/31/2025 Aggregate $7,500,000 F: Excess Liability EXC30065353300 7/31/2024-7/31/2025 Aggregate $7,500,000 G: Excess Liability AEC011173110 7/31/2024-7/31/2025 Aggregate $15,000,000 H: Excess Liability XSL345214K01 7/31/2024-7/31/2025 Aggregate $10,000,000 I: Excess Liability EXC5772941 7/31/2024-7/31/2025 Aggregate $10,000,000 D: Excess Liability 78187246 7/31/2024-7/31/2025 Aggregate $25,000,000 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DAiL� ... 0 - 2 Hours 2 - 3 Hours S FP. 3 - 5 Hours 4.00 5 - 8 Hours- 8 - 24 Hours 8'00 tie' 10.00 LOST TICKET ImI THLY� c �� T.-�•.�1 STANDARD $55 1 MONTH PAR idING PREEviillM I $90 I MONTH RESERVED RESIDENTIAL $40 I MONTH PART TIME - $35 / MONTH. OPERATED BY: IZ Main and Wayne Parking Garage PARKIRS DAILY RATES it 2 k ' l Yours 1 FREE I �� . 0�/I/ DAILY RATES 0 - 2 Hours $FREE 2 - 3 Hours 4.00 3 - 5 Hours 6.00 5 - 8 Hours 8.00 8 - 24 Hours 10.00 LOST TICKET = $10.00