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Fax Server f 4/6/2017 9:37:38 AM PAGE 2/002 Fax Server I ��. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYYI 4i6/2017 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 endorsemen s . PRDDUCER The Horton Group 340 Columbia Place South Bend IN 46601 CONTACT NAIVE: Thomas R. Cassady, Jr. PHONE 574-334-5500 FAA574-334-5600 E-MAIL INSURERS AFFORDING COVERAGE NAIC to INSURER A: M edloal Protective 11843 INSURED BEACHEA-02 iNsuRERB:Amerisure Mutual Insurance Co, 23396 INSURERC: Beacon Health System, Inc. Memorial Hospital of South Bend, Inc. 615 N. Michigan Street INSURERD: South Bend IN 46601 tNSURERE: €NSURER F : r^IIMMAr_r=o rcoTlerrAY= nutneeco• 7R9R9R119 RRVf.R1nM MIIMRr=R- 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. TN —SR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EPF MMlODNYYYI POLICY £XP (MWDD)YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY H002223 12/1/2016 12/112017 EACH OCCURRENCE $1,000,000 CLAIMS -MADE 0 OCCUR PREM SES Ea occu rneMg $50 000 MED FXP (Any one person) $6,000 PERSONAL&ADV$NJURY $1,000,000 GENL AGGREGATE LIM IT APPLES PER: GENERAL AGGREGATE $3,000,000 PROI7UGTS-COMPIOPAGG $3,000,000 X POLICY ❑ 5EGT ❑ LOC $ OTHER: B AUTOMOBILE LIABILITY CA13212592102 8/13/2016 8/13/2017 (C a a Iu dn8 I G MIT $1 000,000 ODDLYINJURY(Perperson) $ALL ANY AUTO OWNED SCHEDULED AUTOS BODILY IWURY(Per accident) $ PROF[]ZTY PRMAGE Per acddent $ H Rt77 AUTOS NON-MNED X AUTOS Ix A X UMBRELLA LIAB X OCCUR E002223 - 12/1/2016 12/112017 EACH OCCURRENCE $25,000,000 AGGREGATE $25,000,000 EXCESSLIAS CLAIMS -MADE REp IX 1RF.TFNTIDNS25,000 $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY YIN ANY PROPRIETORPARTNERIE)ECUTNE ❑ OFFICERIMEMBER EXCLUr ... STATUTE ER E.L EACH ACCIDENT $ (MandamryInNH) E.LDISUASE- EAEMPLOYE $ E.L 01SEASE • POLIGY LIM Ir $ If yes, describe under QESCRIPT#ON C>= OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) Annual Parking Garage License: Centennial, Bartlett and Navarre Garages 4CK I lrR.H I C r7U LUCK �.Fa�ra.cLr-r+ I IWIM City or South Bend 227 W. Jerferson Blvd, Suite 140G South South Bend IN 46601 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHOMZED REPRESENTATIVE Q;� 191313-2014 ACQKD CORPOKA l ION. AN rights reserves. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD