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AC"R" CERT`IFICA TE LIABILITY IN U NCE <br />�� <br />ATE <br />D/23/ )DDlY7 <br />723/201 <br />THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED 13Y THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, Certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Amity Insurance Agency, Inc. <br />500 Victory Rd. <br />Marina Bay <br />North Quincy MA 02171 <br />CONTACT Frank Griffin <br />NAME: <br />PHONE (617) 471-122U FAfc No: (617)479-5137 <br />A➢oRlEss:fgxaffxnQamxtyins.com <br />INSURERS AFFORDING COVERAGE <br />NAIL # <br />INSURERA:Lexin ton Insurance Com an <br />INSURED - <br />LAZ Parking Midwest, LLC <br />33 West Monroe Street <br />Suite 270 <br />Chicago IL. 60603 <br />INSURER B:Liberty Mutual Fire Insurance <br />INSURERC:Federal insurance Com an <br />INSURER D:Liberty Insurance Corporation <br />INSURERE:American Guarantee & Liability <br />INSURERFIThe Ohio Casualty Company <br />COVERAGES CERTIFICATE NUMBER:17-18 REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BF ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADUL <br />INSR <br />SUER <br />WVO <br />POLICY NUMBER <br />POLICY EFF <br />MMIDD)YYYY <br />POLICY EXP <br />MMI➢D)YYYY <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 11000,000 <br />X COMMERCIAL GENERAL LIA131LITY <br />DAMAGE TO <br />PREMISES (ES a occu ence) <br />$ 11000,000 <br />MED EXP (Any one person) <br />$ EXCLUDED <br />A <br />7 CLAIMS -MADE WOCCUR <br />013135971 <br />/31/2017 <br />/31/2018 <br />PERSONAL & ADV INJURY <br />$ 11000,000 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GENT AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS -COMP/OP AGG <br />$ 2,000,000 <br />$ <br />POLICY PRO X LOC <br />AUTOMOBILE LIABILITY <br />E� aaadenDtSINGLE LIMIT <br />$ 11 000100 0 <br />BODILY INJURY (Per parson) <br />$ <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />X HIRED AUTOS X AUTOS NON-OWNED <br />S2611260451017 <br />/31/2017 <br />/31/2018 <br />BODILY INJURY (Per accident) <br />$ <br />Perr a cidentPOrDAMAGE <br />$ <br />* <br />UMBRELLA LIAR <br />X <br />OCCUR <br />SEE ATTACHED <br />EACH OCCURRENCE <br />$ 100,000,000 <br />* <br />AGGREGATE <br />$ 100, 000, 000 <br />EXCESS LIAR <br />CLAIMS-MADELIST <br />OF EXCESS POLICIES <br />/31/2017 <br />/31/2018 <br />DED RETENTION $ <br />$ <br />D <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNERIEXECUTIVE � <br />OFFICERIMEMBEREXCLUDED? <br />(Mandatory In NH} <br />NIA <br />A561D260451027 <br />/31/2017 <br />J31/2018 <br />� WC STATU- OTH- <br />ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYE <br />$ 11000,000 <br />E.L. DISEASE - POLICY LIMIT <br />$ 11000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS belav <br />A <br />GARAGEKEEPERS LIABILITY <br />013135971 <br />/31/2017 <br />/31/2010 <br />$1,0DO,000LIMIT <br />C <br />CRIME/EMPLOYEE DISHONESTY <br />82224802 <br />/31/2017 <br />/31/2018 <br />$1.000,000LIMIT <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space is required) <br />If agreed upon in a written contract or agreement, City of South Bend is included as an additional <br />insured for general liability per CGL Form #LX9466, but only with respect to the operations of the named <br />insured. <br />Re: 100903 - Eddy Street Commons at Notre Dame <br />UL:K I H-16A I r PIULUrK 4HIVl.rGL.LN 1 IUIV <br />City of South Bend <br />Attn: Michelle Adams <br />227 W. Jefferson. Boulevard <br />Suite 1400 S <br />South Bend, IN 46601 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE. EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />Griffin/FG ��-.� <br />ACORD 25 (2010105) <br />I NS025 (201005).01 <br />(01988-2010 ACORD CORPORATION: All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />