Non Res Block Party - Unity Gardens Inc

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co�zc� 1 ® ,aCERTIFICATE OF LIABILITY INSURANCE ��. DATE (MMIDWYYYY) 05/30/2018 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 Aldridge Insurance 1323 North Ironwood CONTACT Nora Grimm NAME: __-...... --- 1 PHONEFAX nloa: 5742328232 ...__ _....... ADDRES& INSURER{S1 AFFORDING COVERAGE, NAIC # INSURER A : Surplus Insurance Brokers 000000 South Bendm IN 46615 _ _ INSURED _ INSURER B :. Erie Insurance Exchange - 26271 - C : Unity Gardens Inc. _INSURER INSURER D: P O Box 10022 INSURER E: INSURER F: South Bend IN 46680 C:C)VFRAGFS CERTIFICATE NUMBER: 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICYEFF MMIDDIYYYY POLICY EXP MMlDDNYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1000000 CLAIMS -MADE OCCUR X DAMAGE TO RENTED PREMISES,,, Ea occurrence $ 100000 WED EXP (Any one person) $ 5000 - - PERSONAL a ADV INJURY $ 1000000 ' A N N CS02223417-06 05/30/2017 05/30/2018 _ AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2000000 I GEN'L I POLICY ElPRO 1-1 LOC JECT PRODUCTS - COMPIOP AGG $ 2000000 -� $ OTHER: ' AUTOMOBILE LfAGILITY COMBINED SINGLE LIMIT $ 1000000 - -- -. -- ANY AUTO BODILY INJURY (Per person) $ BODILY INJURY IPer accident) $ OWNED SCHEDULED X, AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY r N N Q02-1531021 02/15/2018 02/15/2019 PROPERTYDAMAGE er Paccident -- _- $ x UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4000000 AGGREGATE $ 4000000 A EXCESS LIAR CLAIMS -MADE N N CXS0010847 05/30/2018 05/30/2019 € DED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? n (Mandatory in NH) N f A N 087-0103598 03/01/2018 03/01/2019 I PER STATUTE �RH IATQT' E.L. EACH ACCIDENT - $ 500000 E.L. DISEASE - EA EMPLOYE - -- $ 500000 E-L- DISEASE - POLICY LIMIT $ 500000 yescer_-- Ifes, dribe und ID ESCRIPTION OF OPERATIONS below I DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Addiliatal Remarks Schedule, may be attached if more space is required) .....I CERTI City of South Bend ATTN: Marcia Qualid 731 S. Lafayette Blvd 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 South Bend Fax; (574)235-9171 ACORD 25 (2016103) ail: ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD