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Sidewalk Cafe - Aloft South Bend
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Sidewalk Cafe - Aloft South Bend
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Last modified
4/3/2025 1:39:44 PM
Creation date
4/26/2018 2:45:28 PM
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Board of Public Works
Document Type
Permit Applications
Document Date
4/24/2018
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f_liantii- R1san <br />AZULHOS <br />ACORD.. CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DDNYYY) <br />9/18/2017 <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(les) 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 />ON] Risk Partners <br />CONTACT NAME: Connie J. Messer <br />C574 <br />ai, No 866-893-4638N-3- <br />E-MAIL ADDRESS: connie.messer@onirisk.com <br />1111 Chestnut Hills Parkway <br />INSURER(S) AFFORDING COVERAGE <br />NAIC# <br />Fort Wayne, IN 46814 <br />INSURER A: Zurich Insurance Company Limite <br />INSURED <br />Azul Hospitality -Indianapolis, LLC <br />Azul Hospitality -Services, LLC <br />B00 W. Ivy St. Suite D <br />San Diego, CA 92101 <br />INSURER B : The Continental Insurance Compa <br />35289 <br />INSURER C <br />INSURER D <br />INSURER E <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED 13Y THE POLICIES DESCRIBED HEREIN IS SU13JEaCT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTpR <br />TYPE OF INSURANCE <br />NSR <br />WV❑ <br />POLICY NUMBER <br />MNWDNEYYY <br />MMO/LDI�/YYYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />X <br />CP0106375700 <br />9/15/2017 <br />09/15/201 <br />EAAqC��Hqq��OCCURRENCE <br />$1 000000 <br />CLAIMS -MADE OCCUR <br />PREMISES Eaoccurrenca <br />$1 OOO OOO <br />MED EXP (Any one person) <br />$10 000 <br />PERSONAL & ADV INJURY <br />$1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$2000,000 <br />PRO- <br />X POLICY ❑ JECT [:] LOG <br />PRODUCTS-COMPIOPAGG <br />$2,000,000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILE LIABILITY <br />CP0106375700 <br />9/15/2017 <br />09/15/201 <br />°&8lctlEeDSNGLELIMIT <br />1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />BODILY INJURY (Per accident) <br />$ <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />HIREDAUTOSXNON-OWNED AUTOS <br />IX <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />$ <br />B <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />6050530380 <br />9/15/2017 <br />09/15/2016 <br />EACH OCCURRENCE <br />$50000 000 <br />AGGREGATE <br />$5000O 0O0 <br />EXCESS LIAB <br />CIAIMS•MADE <br />DED I X1 RETENTION00000 <br />$ <br />WORKERS COMPENSATION <br />PER OTH- <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOfl/PARTNER/EXECUTIVE Y / N <br />OFFICERIMEMBEREXCLUDED? ❑ <br />(Mandatory In NH) <br />N/A <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />Ryon describe under <br />DESCRIPTION OF OPERATIONS below <br />A <br />Garagekeepers <br />CP0106375700 <br />9/15/2017 <br />09/15/201 <br />Limit: $250,000 <br />Camp Ded: $1,000 <br />Call Ded: $1,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) <br />Marriott International, Inc. and its affiliates & subsidiaries are loss payee for personal property in the <br />amount of $5,000,000 with $2,500 deductible, and additional insured to the general liability with respect <br />to property and general liability for property located at, 211 W. Washington Street, South Bend, IN <br />46601 <br />Loc# 1 - 211 W. Washington Street; South Bend, IN <br />Building # 1 Hotel <br />Marriott International, Inc. and SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />its affiliates & subsidiaries ACCORDANCE WITH THE POLICY PROVISIONS. <br />c/0 Cert Focus PO Box 140528 <br />Kansas City, MO 64114 AUTHORIZEDREPRESENTATIVE <br />01988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014101) 1 of 1 The ACORD name and logo are registered marks of ACORD <br />#S11453801M1145296 C M ESS <br />
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