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08-16—' 18 07:29 FROW <br />5742396407 T-453 P0004/0007 F-675 <br />-4�'+ F" CERTIFICATE OF LIABILITY INSURANCE <br />°A,r7 1411201Y1YYY' <br />2a�a <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIAMATiVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED OY THE POLICIES <br />OF -LOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTAN71% If the cortiftoato holder Is an ADDITIONAL. INSURED, the policy(tes) must have ADDITIONAL INSURED provisions or be endorsed. <br />if SUOROGATION is WAIVED, subject to the terms and conditions of the polloy, corbIn policies may require an endorsement. A statement on <br />this celtifloato does not confer H ftts to the certificate holder In lieu of such endorsemen sL <br />PRODUCER <br />Waldorf Risk Solutions, LLC <br />Sox Hu <br />Huntingtonon NY 11i�#3 <br />CONOT <br />NAIVE <br />PtloNe 831�29 95a0 Fax , 831-424,1690 <br />ADDR info wrs192A.com <br />INSURERS) AFFORDING COWRAGE <br />NAIC# <br />INIVRERA: Corlain Underwriters at Llo ds London-AA1122000 <br />INSURED CHUWRL <br />Church World Service [no, <br />Business Manager <br />28606 Phillips St, PO Box WS <br />INSURER e: <br />IN IIRERC:' <br />IIIsuReno <br />INSURER r:: <br />Elkhart IN 46615 <br />INSURER F: <br />r�nv��Acesx (IFRTIFIP_ATF I+ l lURFR- oI eI61CIAre RrIVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NWED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWTHSTANDING ANY APQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W)TH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE. POLICIES Ot_SCRISED HERON IS SUBJECT 'TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. <br />ILT <br />TV <br />D <br />POLICYNUMEER <br />MPMLH:Y@FF <br />IPQIlUYEIIP <br />UMM <br />A <br />X <br />COMMpRa1ALGl K"11-LIAIKITY <br />CLAIMS -MADE ELF OCCUR <br />Y <br />tam7Yt <br />4W2018 <br />A17t2MO <br />EACHOCCURREENNCE <br />V1,000,006_ <br />PREMISES Eaenra.MtAncd <br />$ <br />MEO EXP AA4rw raon <br />$ <br />$ <br />PERSONAL& ADV INJURY <br />GI;N'LAGGREGATE LIMITAPPLIESPER; <br />X POLICY ❑ dCr LOC <br />OTHER: <br />GENERALAGGREGATE <br />$20w.000 <br />PRODUCTS - COMPIOP AGG <br />$ <br />$ <br />AUTOMOBILELIA91UTY <br />A14YAUTO <br />AWN S '5 10 ULEO <br />AUTOS ONLY AUTOS <br />HIRED NON.OWNI;D <br />AUT080NLY wros ONLY <br />�oM �dep181N LELIMEF <br />$ <br />BODILY INJURY (Per porsen) <br />$ <br />ROPILY INJURY (Per &oadsnl) <br />s <br />PR PERTY AMAG <br />Par d n <br />$ <br />3 <br />UMURELLAiJAIi <br />r!XCE88LIAB <br />OCCUR <br />CLAIMS -MADE <br />EACHOCCURRENCF <br />$ <br />AGGrOiGATE <br />� <br />S <br />DEO r7E'rE14'fI0N8 <br />$ <br />W ORK£RS COMPENSATION <br />AND EMPLOYERS' LIADIUYY <br />AWPROPPJPTORIPARTNER![XECUTIVE YIN <br />OFFICERRdW8FRE=LUI)E07 <br />IMandatarylnNH) <br />If ea dewrle911114" <br />'31PTION OPOPERATIONShelow <br />NIA <br />TH- <br />STATIiT ER <br />E.L. EACH ACVI)EOT <br />_ <br />$ <br />G.LDISEASE -EA FMPLOYEE <br />$ <br />E.I, L115EA$E-POLICY11MIT <br />$ <br />oWfl!"(ON OI= OPRIZATION5) LOCATIONS J VEHICLES (ACORD 101, Addltrolfal ReMkIrM Scheclule, may be atlaclMd Irmora space Is mgUlrsd) <br />Coverage osrtifed above extends to inol€Ide the Certificate Holder as Additional Insured but only with respect to liability arising out of the CROP Walk. <br />RE: @Crop Walk St Joseph County, Event Data_ 913012018, Event Type, CROP Plunger Walk. <br />SOUTH BEND <br />227W Jefferson <br />South Bond IN 46601 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THSREOF, NOTICE WILL BE ;DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED RSPAESENTATtVE <br />U' MW <br />01908.2015 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD <br />