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Acak`o CERTIFICATE OF LIABILITY INSURANCE <br />DAI'E(MM10D1YYVY) <br />03113/2018 <br />THIS CERTIFICATE IS 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 BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed, <br />[ If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />t: this certificate does not confer rights to the certificate holder in lieu of such endorsemenl(s). <br />PRODUCER <br />NAME: Michelle Harrell <br />Randy Leflaert Agency Inc <br />=410 Lincoln Way W <br />PHONE f�c Nu): (574)674-9582 <br />AD RESS: <br />tNSURER(S) AFFORDING COVERAGE <br />NAIC# <br />INSURER A: Illinois Casualty Company <br />_ <br />000000 <br />2,Osceola IN 46561 <br />INSURED <br />INSURER L3 <br />INSURERC: <br />Vegetable Buddies Inc <br />INSURER n : <br />PO Box 1202 <br />INSURER E: <br />{ <br />INSURERF: <br />South Bend IN 46624 <br />±.'OVFs;RAGFS CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS ES 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 BE 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 />ILTR <br />LTR <br />TYPEOFINSURANCE <br />L <br />POLICY NUMBER <br />MM.JDDYYYY <br />MNVDD1YYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LtABIL(TY <br />CLAIMS -MADE 1XI OCCUR <br />Y <br />N <br />SP38698 <br />04/28/2018 <br />04/28/2019 <br />EACH OCCURRENCE <br />$ 1000000 <br />DAMAGE <br />PREMISES aoccurrence <br />$ 100000 <br />MED EXP (Anyone Person) <br />$ 20t1O <br />71 <br />GENT <br />X <br />PERSONAL & ADV INJURY <br />$ 1000000 <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY ❑ JPERb 171 LOG <br />OTHER- <br />GENERAL AGGREGATE <br />$ 2000000 <br />PRODUCTS -COMPIOPAUG <br />$ 2000000 <br />$ <br />E <br />AUFOMOBILE LIABILITY <br />ANYAUTO <br />OWNED F I SCHEDULED <br />AUTOS ONLY AUTOS <br />H[REU NOWOMED <br />AUTOS ONk.Y Id AUTOS ONLY <br />COMBINED SIN LE LIM <br />@a accident <br />$ <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTYD AGE <br />Peraccidenl <br />$ <br />A <br />x <br />UMBRELLA LIAR <br />EXCESS LIAR <br />Id <br />OCCUR <br />CLAIMS -MADE <br />Y <br />N <br />UL15936 <br />04/25/2018 <br />04/26/2019 <br />EACH OCCURRENCE <br />$ 1000000 <br />AGGREGATE <br />$ 1000000 <br />DIED I I RETENTION 10000 <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOY FIRS' YIN S' LIABILITY <br />ANY PROPRiFT0RIPART14ERlFXECUTIVE <br />OFFIC! RrMEMBER EXCLUDED <br />(Mandatary in NH) <br />Iryes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N/A <br />N <br />WC16896 <br />04/25/2018 <br />04/25/2019 <br />STATUTE ER <br />EL. EACH ACCIDENT <br />$ 100000 <br />- - — <br />E.E. DISEASE -EA EMPLOYEE <br />$ 100000 <br />E1- DISEASE - POLICY LIMIT <br />$ 500000 <br />A <br />Liquor Liability <br />FY <br />flN <br />LL101147 <br />04/25/2018 <br />04/25/2019 <br />Each Common Cause <br />1000000 <br />-DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may he attached if more space is required) <br />CERTIFICATE HOL <br />City of South Bend <br />227 W Jefferson Blvd <br />ACORD 25 (2016/03) <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 />AUTHORtIrD REPRESENTATIVE <br />® 1988-2015 ACORD CORPORATION. All rights reserved, <br />TheACORD name and logo are registered marks of ACORD <br />