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A4CR" CERTIFICATE OF LIABILITY INSURANCE DATE(MMfDDlYYYY) 0511712018 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 have ADDITIONAL INSURED provisions or 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 Susan Thompson NAME: Laven Insurance Agency Inc. A1�NNo Ext : {574) 291 5510 arc No : {574) 291-8505 EMAIL suet@laveninsurance.com ADDRESS: P. O. Box 2379 INSURERS) AFFORDING COVERAGE NAIC N INSURERA: Liberty Mutual SOUTH BEND IN 46680 INSURED INSURER B : INSURER C : Sunnyside Presbyterian Church Corp. INSURER D : 115 N. Frances Street INSURER E : INSURER F : South Bend IN 46617 COVERAGES CERTIFICATE NUMBER: 18-19 Master REVISION NUMBER: THIS IS TO CERTIFYTHATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. IOLICY TIR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDNYYY EXP € €MIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE x OCCUR BKS58277002 01/01/2018 01/01/2019 EACH OCCURRENCE $ 1,000,000 DA T R o PR MISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL& ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPOES PFR: JECT %� POLICY ❑ PRO LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMPIOPAGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED HNON-OWNED AUTOS ONLY AUTOS ONLY BAS58277002 01/01/2018 01/01/2019 COMBINEDSINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ A X UMBRELLA LIAB EXCESS LIAR ITILAIMS CCUR -MADE US058277002 01/01/2018 01101l2019 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED I X1 RETENTION $ 0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA XWS58277002 01/01/2018 01l01l2019 SPER X1 TATUTE 6RH E.L. EACH ACCIDENT 500,000 $ E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is required) r:FRTIFlr`ATF I-InI r11-P CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of South BendlPubIic Works ACCORDANCE WITH THE POLICY PROVISIONS. 227 W. Jefferson Blvd. AUTHORIZED REPRESENTATIVE South Bend IN 46601{ @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD