Opening of Proposals - 2018 Lawn Maintenance and Mentorship Program - Greater Impact Lawn Care

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TRANS-3 OP 1D: CH '``64. R� CERTIFICATE OF LIABILITY INSURANCE DATE(MU3/0812018/201YY) 8 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 poilcy(les) must be endorsed. If SUBROGATION 16 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 R.S. Miller &Sons, Inc. P.O. Box 229 109 W. Plymouth Street Bremen, IN 46506 CONTACT NAME: Ben NehIS PHONE x (A/C, No Ext :574-546-3341 A/C No): 574-546-2687 E-MAIL ADDRESS: ENSURERS AFFORDING COVERAGE NAIC # Berl Nehis INSURERA:Pekin Insurance Company 24228 INSURED Transformation Industries, LLC dba Greater Impact Lawncare Kory Lantz INSURER B : INSURER C : INSURERD: 616 CUSHING ST South Bend, IN 46616 INSURER U : INSURER F : COVERAGES CERTIFICATE NUMBER: RPVIQlnm MIInnR11=. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE kNSURED 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 LTA TYPE OF INSURANCE INSD IWVD POLICY NUMBER P U10Y EFF MM/DDIYYYY POLICY EXP MM/DDIYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MAIDEN OCCUR CLO199239 04/17/2018 04/17/2019 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 1DD,00 MED EXP (Any one person) $ 5,D0 PERSONAL & ADV INJURY $ 1,000,00 GEN'LAGGREGATE PIPOLICY❑ LIMIT APPLIES PER: PRO• ❑LOGPRODUCTS JECT OTHER: GENERAL AGGREGATE $ 2,000,00 - COMPIOP AGG $ Included $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED rxSCHEDULED AUTOS AUTOS AUTOSNON-OWNED AUTOSPeraccldent)$ 0OP702340 04/17/2018 04/17/2019 COMBINED SliVGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ 11000,00 BODILY INJURY (Per accident) 3 1,000,00HIRED PROPER Y DAMAGE 1,000,00 $ A UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE N/A WC8010342 04/17/2010 04/17/2019 EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICERIMEMBER EXCLUDED? ECUTIVE YIN (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below X STATUTE I ERTH _ $ E.L. EACI3ACCIDENT $ 500100 E.L. DISEASE - EA EMPLOYE $ 600,00 ELL._DISEASE - POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS / LOCATIONS IVEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) SOUTHBE City of South Bend Parks Dept. 321 E. Walter St, South Bend, IN 46614 TION 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 Ben Nehls 91988-2014 ACORD CORPORATION. All rights reserved. ACORD 26 (2014/01) The ACORD name and logo are registered marks of ACORD