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AC"ROB CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br />2/5/2020
<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 have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such end'orsement(s).
<br />PRODUCER CO`NT EpireaN I'enSOn
<br />Yau'oom Laurance Services, Inc NAMEt�/c.NvM.ast, n .
<br />.rr .,
<br />6900 Code a Blvd PHONE 888-24CV 8803
<br />Ne). 877-835 I3,
<br />Ste 1000i E-MAIL -
<br />ADDRE a, AMServi enter�uarro headgrg.�aam
<br />Overland Park KS 66211 � _", - _
<br />,INSURER(' AFFORDING AGE NAIC# I ,.DING COMJ�fl�.. ,... .. ,..... , ,a.,.._.... _ ..,..
<br />_........ .... �,_� .. ,® INSURER„A Zurich American Insurance Conn ,an 16535
<br />INSURED . .... ...
<br />MC1RSINtw,-tit ,._ .can Guarantee ....,,� . , me .. _...
<br />Korson Inc INSURER B American rantee and Llabllil+y Insurance 26247
<br />dba ASAP Towing INSURERec Carolina Casualty Insurance Compa iy 10510
<br />1906 S Olive Street INsuReR o ..
<br />South Bend IN 46613�-
<br />INSURER E
<br />INSURER. F
<br />COVERAGES CERTIFICATE NUMBER: 818699447 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 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 BEEN REDUCED BY PAID CLAIMS.
<br />RNSR I111— �AoDu.i"3G��i'�k�` _ _..
<br />LTR TYPE OF INSURANCEINSD 21/12/O 020
<br />PJLtlCYNUNBBER,.......... POLICYEXP f
<br />Y..�. N1M/ODPYYYY LIMITS
<br />A COMMERCIAL GENERAL LIABILITY tCP01640181-03 2/12/2021 51 000.0I31;� 1 EACH OCCURRENCE
<br />X ? J L1I�s.MA� L IO V'�'i`NTED
<br />(CLAIMS -MADE OCCUR f rRQ MISC"'S ( cc Lurre aty,r) S300,00011111
<br />M .,, r
<br />I tl 000
<br />,,PERSONAL ADV INJURY
<br />S 1 0,004000
<br />IaEN d„. AGGREGATE LIMI'HoT APPLIES PER: GENERAL AGGREGATE
<br />AGG S2,000,000
<br />00 000
<br />POLICY E JECT LOG I
<br />I OTHER: S
<br />B AUTOMOBILE LIABILITY CP01640181-03 2112/202U 2/12/2021 CO aY I d/aryl SINGLE LJMIT S 1,000,000
<br />y I rIMI3INFI0"
<br />Y ANY AUTO . INJURY
<br />._........ ,..m...
<br />! AUTOS ONLY AUTOS B BODILY INJURY (Per person)
<br />HIRED NON -OWNED P-
<br />AU705 ONLY AUTOS ONLY JJJ BODILY INJURY (Per accident),
<br />.w. `.....__,. (0„'YILR1"'M`D�rkV1ACPf S
<br />)( �i SCHEDULED i r
<br />� � Plqu syaeidenl �,... _...
<br />OWNED i
<br />S
<br />`UMBRELLA LIAB k ..l OCCUR
<br />�a r I EACHOCCURRENCE
<br />EXCESS LIAB CLAIMS MADE AGGREGATE,
<br />,... �.,.. VIED —� RETENTIONS s
<br />C WORKERS COMPENSATION 1 Bi 9/8/202D X
<br />ll
<br />AND EMPLOYERS'LIABILITY , E,„�STAVUl A
<br />Y/N NUWC0149018 9/8/2019 .,m
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE L EACH AC (DENT $ 500 000
<br />OFFICER/MEMBER EXCLUDED: IN/A �a„.
<br />(Mandatory in NH) "` E,L DISEASE - EA EMPLOYE $500 000
<br />If yes, describe under � ,. __ , ."I'll,
<br />DESCRIPTION OF OPERATIONS LrAlo w � I I E3. 01SEA,SE - PO ICCY L..IMIT $500,000
<br />B Garagekeepers CPO1640181-03 2/12/2020 2/12/2021 Limit See Desc of Ops
<br />DESCRIPTION OF OPERATIONS P LOCATIONS 0 VEJ41CLES (ACOND 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Garagekeepers Includes On -Hook Coverage
<br />Covered (Locations and Garagekeepers Limits at each Policy Location:
<br />1906 S Olive St South Bend IN / Limit $120,000
<br />55303 Mayflower Rd South Bend IN / Limit $100,000
<br />CERTIFICATE HOLDER CANCELLATION
<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 />City of South Bend Dept, of Community Investment
<br />227 W. Jefferson Blvd Suite 1400 S
<br />South Bend IN 46601 AUTHORIZED REPRESENTATIVE
<br />©1988-2015 ACORD CORPORATION, All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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