Opening of Quotations - Leighton Parking Garage Entrance Repair Proj NO 118-038 - HRP Construction Inc

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AC R" CERTIFICATE OF LIABILITY INSURANCE DaT� €MMroDm vvy 8/28/2017 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 policy(ies) must be,endorsed. If SUBROGATION IS 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 CONTACT Ellie Lloyd PHONE (800) 814-2122 FAX No. (800)836-2122 Gibson Insurance Agency, Inc. E-MAIL ellay d@ a_bsonins.com -ADDRESS: 130 S Hain St, Ste 400 INSURER€SI AFFORDING_ COVERAGE NAI-# PO BOX 11177 INSURER A:Amerisure Mut. Ins Co 23396 South Bend IN 46601-0177 INSURED INSURER B : I INSURER C : _ HRP Construction Inc. INSURERD: 5777 Cleveland Rd INSURERE: PO Box 266 INSURER ,South South Bend IN 46624-0266 COVERAGES CERTIFICATE NUMBER:9-1-17/18 Liability REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED 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. _ ILTRVv_- LTR TYP OF INSURANCE ADDL SUER POLICY NUMBER MMfDIDYEFF IYYYY MMf�DYfYY Y LIMITS i X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE_ 1 , 000 , 000 $ _ A i CLAIMS -MADE OCCUR PREMISES (Fa occurrence) S 1,000,000 X MED EXP (Any one person) $ 10,000 XCU CPP20316441202 9/1/2017 9/1/2018 X Contractual Lia it ty-,-„__ PERSONAL BADVINJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GEN'L POLICY PRO- � JEC D LOC PRODUCTS - COMPIOP AGG 5 2 , 000 , 000 $ OTHER: AUTOMOBILE LIABILITY _ COMBINED SINGLE LIMIT Ea accident $ 1,000,000 _ BODILY INJURY {Per person) $ A X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS ('A20316451202 9/1/2017 9/1/2018 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident ._._.... $ NON -OWNED X HIRED AUTOS X AUTOS $ X UMBRELLA LtAB X OCCUR EACH OCCURRENCE S 10 000 000 AGGREGATE S 10 0_00-,--,.,0,00- A EXCESS LIAB CLAIMS -MADE DED X RETENTIONS 0 $ I CU20316431102 9/1/2017 9/1/2038 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOPWARTNERIEXECUT#VE ��Y-- --I N;;I X PER OTH- STATUTE ER„ E.L. EACH ACCIDENT S Z 000 000 A OFFICERIMEMBER EXCLUDED? L'J (Mandatory in NH) NIA wc20316421102 9/1/2017 9/1/2018 E.L. DISEASE - EA EMPLOYE $ 1 000 000 if yes, describe under DESCRIPTION OF OPERATIONS below States of IN 6 ML E.L. OISEASE - POLICY LIMIT $ J. 000 000 I � DESCRIPTION OF OPERATIONS I LOCATIONS r VEHICLES (ACORD 104, Additional Remarks Schedule, may be attached if more space is required) . (574)235-9171 City of South Bend Board of Public Works 227 West Jefferson, 13th Floor South Bend, TN 46601 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 Ins Agency/ELLIE �` (9 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD NS025 rmte0o)