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Certificate of Coverage Da to: 4124:/21017 <br />Cer•liricale linider <br />]'his Certificate is issued as a matter of itrfor•tnatfon only ,and <br />Tito Diocese of Hor't Wayne -South Bend, luc. <br />confers uo rights upon tiie holder- of this certificate. This cerfiflcate <br />Chilii(:ory Office <br />does not atnenti, extend or alter the coverage afforded below. <br />P 0 Box 390 <br />Cnnipany Affording Coverage <br />For( Wayne, I N 46801 <br />THE CATHOLIC MU'l'{]AI., RELIEF <br />SOCIETY OFAMERICA <br />10843 OLD MILL RD <br />Covered Location <br />St. Joseph Grade School <br />OMAHA, NE 68154 <br />216 North Hill <br />South Berid, IN 46617 <br />Coverages <br />This is to certify that file coverages listed below have been issued to the eertificate holder' Danced above for the certificate <br />indicaled, notivilhstanding illy re(iuirctnent, term or conditfoil of any contract or other document with respect to ��°bleb frets <br />certificate may be issued or may pertalo, the <br />coverage afforded described Ital•cilt is subject to all the tennis, exclusions and <br />c(rnditious of such coverage. Limits Shown <br />may have been redileed by paid claims. <br />Type of Coverage <br />C'crtifientc rlunrber <br />Coverage Effective <br />Date <br />Coverage Expiration <br />Date <br />Limits <br />Property <br />Real & Personal Property <br />D, General Linen€ty <br />Encir Occurrence <br />300,000 <br />General Aggregate <br />2,000,000 <br />Occurrence <br />Products-ComplOP Agg <br />8679 <br />I{}I112(}16 <br />10/112017 <br />Personal & AflS' Injury <br />Li stead( <br />Fire Damage (An)' one five) <br />\led Exp (Any one person) <br />Excess Liabitily <br />8679 <br />1011/20I6 <br />10/1I2017 <br />Fach Occurrence <br />Annual Aggregrale <br />1,000,000 <br />Other <br />Ench Occurrence <br />Claims Made_ <br />Annual Aggregrate <br />LimitlCoverage <br />l)rscriptiun of OperatipnslLocntionsfL'clriclrslSpeclal Items ((he following language supersedes any nther language in this endorsement or the Cer(lticate In <br />conflict rvilh this language) <br />Coverage only extends foe' claims arising out of St. Joseph Orade School's field day in which St. Louis Street will be closed from Colfax <br />to LaSalle oil May 31, 2017. <br />Holder of Cerillicate <br />Cnncc€ration <br />Additional Protected Person(s) <br />Should any of the above described coverages be cancelled <br />before file expiration (late flrereaf, tine issuing ecnnpany will <br />endeavor to mail 30 days written notice to the holder' of <br />City of South Bend, IN <br />certificate uniued to the left, but failure to mall such notice shall <br />227 West Jefferson Blvd <br />impose no obligation or liability of any Idnd upon the conipnny, <br />South Bend, IN 46601 <br />its agents or representatives. <br />Authorized Representative <br />0067003068 <br />