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Client#: 61560 AZULHOS ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE01 /(MM/°°"YYn 08/2020 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 certifi-------pr y(y )� ----- cate' holder is an ADDITIONAL INSURED, the olio 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Connie J. Messer ONI Risk Partners PHONIE FAX _ tArc, No, En 574-314----- (Arc No)'866-893-4638 100 East Wayne Street, Ste 315 E-MAIL ,AODRE"t connie.mosser@onirisk.com South Bend, IN 46601 . INSURERS) AFFORDING COVERAGE � NAIC # COVERAGES 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 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„ TRR TYPE OF INSURANCE INS L SUSR yyly/iD POLICY NUMBER ...,... OD Y EFL) (MVNda}OIYIYYMII�Y PbiEXP G JYY1 Y)q .,. ......... LIMITS ,,,,. A X COMMERCIAL X CP0106375702 09I15/2019 09/15/202 XCLIABILITY LAIMS-MADEGENERAL OCCUR 'PREMSE- RENTED nce) ., ,$1�00----- OO MED EXP (Any one person) $1 O 000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY J COT X I LOC PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER11111111111 $ A_... .. AU TOMOBILELIABILITY CP0106375702 m........ 09/15/2019 -.- O9/15/2O2 COMBINED ISINGLE LIMIT $1,000 OO ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident ( ) _ .,.... $ HIRED NON -OWNED X X dT 7PBRTb iAMA� L $ AUTOS ONLY AUTOS ONLY IW arrarrplw91-Fg) ---- ........ .,.... �,� $ B �( RELLA LIAB X OCCUR ®„ 6050530380 9/15/2019 5 09/15/202 .., EACH OCCURRENCE $5O OOO OOO EXCESS LIAB CLAIMS MADE AGGREGATE $50,000,000 DIED'1 PPE NTIiON " 1 OOOO .YIN ®ee„e �„ $ OTH- �STpT AND EMPLOYERS�LIABILITY lT , , F m ,fi ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? q N / A EL EACH ACCIDENT $ (Mandatory in NH) E.L DISEASE EA EMPLOYEE $ If yes, describe under ,,-----_.. _ DESCRIPTION OF OPERATIONS below E.L DISEASE POLICY LIMIT $ A Ligour Liability CP0106375702 9/15/2019 09/15/202 $1Mil Occ/2 Mil Agg DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) The City of South Bend is additional insured to the general liability policy when required when required by signed written contract dated prior to any loss or knowledge thereof. Loc# 1 - 111 N. Main Street; South Bend, IN Building # 1 Hotel %,r-m i iri,_m I e City of South Bend SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 227 W. Jefferson Blvd Ste. 1316 ACCORDANCE WITH THE POLICY PROVISIONS. South Bend, IN 46601 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD 440-3-Incn7elaeo')n0n" rlseocc