Procession - Fraternal Order of Police #36 - Fallen Officer Scholarship Ride

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A� �® CERTIFICATE OF LIABILITY INSURANCE DATE (MM10IYYYY) 06,13,201E 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 Chuck Kennedy NAME: STAR Insurance - Huntington Office AHCNN Ext . (260) 356-3313 Arc No : (260) 356-3764 E-MAIL angela.altzroth@stafflnancial.com ADDRESS: sta�nancial.com 400 Frontage Rd INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Scottsdale Insurance Company Huntington IN 40750 INSURED INSURER S : INSURER C : Fraternal Order Of Police, South Bend Lodge 36 INSURER D : PO Box 299 INSURER E : INSURER F : South Bend IN 46624 COVERAGES CERTIFICATE NUMBER: 2018 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 I 4WD POLICY NUMBER POLICY EFF MMfDDIYYYY POLICY EXP MMIDDfYYYY LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP {Any one person) $ 5,000 PERSONAL & ADV INJURY S 1,000,000 A CPS2766873 011071201E 01/0712019 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE g 2,000,000 POUCY ❑ PRO- JEGT LAC PRODUCTS -COMPIOPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $AUTOS HIRED NON -OWNED ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEO I RETENTION $ $ 1 1 WORKERS COMPENSATION AND EMPLOYERS' LIAABILITY Y 1 N PER OTH- STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? NIA E.L.EACHACCIDENT $ (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT S DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) For the Fallen Offers Ride being held August 11, 2018 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of South Bend ACCORDANCE WITH THE POLICY PROVISIONS. 227 W Jefferson St AUTHORIZED REPRESENTATIVE South Bend IN 46601 O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 26 (2018103) The ACORD name and logo are registered marks of ACORD