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ACCWU CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)05/14/2019
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsements .
<br />PRODUCER CONTACT Steve McNeil
<br />N�kII
<br />Aldridge Insurance T
<br />PHONE
<br />, FAX
<br />No):,
<br />5742328232
<br />1323 North Ironwood E-MAIL
<br />INSURERISI AFFORDING COVERAGE NAIC #
<br />South Bend IN 46615
<br />,
<br />INSURER A : Erie Insurance Exchange
<br />,,,,....................
<br />26271
<br />INSURED
<br />INSURER B :
<br />„_... _ _ _ .A,,,,,,,,,,,, ,
<br />,,...... ...
<br />JCD Holdings, Inc. & Woochi Japanese Fusion & Bar, Inc.
<br />INSURER c ;
<br />123 W Washington St
<br />RD:
<br />INSURER
<br />INSURER E
<br />South Bend IN 46601
<br />1 INSURER
<br />COVERAGES CERTIFICATE NUMBER:
<br />REVISION NUMBER':.
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION
<br />OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE
<br />BEEN REDUCED BY PAID CLAIMS.
<br />INSRJ..... ......LTR TYPE OF INSURANCE .......-iAf,T'01.75itli•7Fi� ... POLICY NUMBER
<br />IN
<br />v1fVD
<br />POLICYEFF POLICYXP I LIMITS ....
<br />4
<br />COMMERCIAL GENERALLIABILITY
<br />EACH OCCURRENCE
<br />$ 1000000
<br />-
<br />CLAIMS -MADE /�OCCURl1MA.
<br />E:�cS I'LNTCCI
<br />ERL�'I�E.� t�'�;t rn�wTR�rumpJ
<br />.
<br />$_ 1000000
<br />�
<br />MED EXP (Any one person)
<br />$ 5000
<br />A
<br />N
<br />N
<br />Q97-1154951
<br />11/02/2018 11/02/2019 PERSONAL 8 ADV INJURY
<br />s 1000000
<br />hI
<br />GFN
<br />A. AAaGRIEGATIE LIMIT APPLIES PER
<br />GENERAL AGGREGATE
<br />$ 2000000
<br />%'Cyll.ICY I �JECT PRO- ❑ LOG
<br />PRODUCTS COMPIOPAGG
<br />$ 2000000 ,
<br />¢rI•IER:
<br />Contents Llabili
<br />$ 141,500
<br />AUTOMOBILE LIABILITY
<br />COMBINED SINGLE I MIST
<br />fC--1,a9;<' dapJI
<br />$
<br />I ANY AUTO
<br />BODILY INJURY (Per person)
<br />$
<br />1 ALL OWNED • SCHEDULED
<br />tAUTOS
<br />,e M
<br />BODILY INJURY (Per accident)
<br />$
<br />-AUTOS
<br />� NON -OWNED
<br />PROPER"rY DAMAGE,
<br />$
<br />_ HIRED AUTOS AUTOS
<br />(P,erspoovn$)„
<br />UMBRELLA LIAR OCCUR
<br />EACH OCCURRENCE
<br />$
<br />EXCESS LIAB CLAIMS MADE
<br />AGGREGATE
<br />.. ...
<br />$
<br />DED RETENTION$
<br />1 $
<br />WORKERS COMPENSATION
<br />X FIR
<br />YIN
<br />AND EMPLOYERS' LIABILITY NERI ECUTIVE YN� N IA N Q94-0900651
<br />ME
<br />A OFFICER/MEMBER
<br />STATUTE
<br />EL EAGHUT
<br />ACCIDENT $ 100,000
<br />10/09/2018 10/09/2019 -
<br />REXCLUDED?
<br />yes dR
<br />EL DISEASE - EA EMPLOYEE$ 500,000
<br />under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L DISEASE -POLICY LIMIT 1 $ 100,000
<br />I
<br />-
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule,
<br />may be attached if more space is required)
<br />123 W Washington St South Bend, IN 46601
<br />119 N Michigan St, South Bend, IN 46601
<br />L:tK I IFIL:A I t MULUtK
<br />CITY OF SOUTH BEND
<br />227 W JEFFERSON BLVD
<br />South Bend IN 46601
<br />EmallI .k mifinvuck(nlcni ithin— in nnv
<br />GANGtLLA
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED RII::'F11REISI1:E.IN"[A71TI"YI::'.
<br />0)1988-2014 ACORD CORPORATION- All rinhts reserved_
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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