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CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MMIDDIYYYY) <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 endorse, <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 endorsements . <br />PRODUCER I Mq!Acl Matt Klalwaall <br />John Scott Insurance <br />106 Commercial St. <br />Dowagiac, MI 49047 <br />269-782-21 <br />206339-8224 <br />NAIC # <br />INSURED INSURER B ------ <br />Purple Porch CO-OP <br />_______ � . ....eeeeeeee�.. <br />. <br />Kristy Robinson INSURER C:. <br />123 N Hill St <br />South Bend, IN 46617-2717 INsuFwz: <br />INSURER. F : <br />COVERAGES CERTIFICATE NUMBER. 00014185-192482 <br />REVISION NUMBER: <br />8 <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 <br />THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED <br />HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY <br />PAID CLAIMS. <br />"NSR TYPE OF INSURANCE AFL BR POLICY NUMBER.. ......POLICY EFF <br />LTR <br />POLICY EXP . ......... ......... .. „...,.. <br />LIMITS <br />.... ------ <br />A VCOMMERCIAL GENERAL LIABILITY CPP6312152 02/1112020 <br />02/11/2021 EACH OCCURRENCE <br />$ 1, 0011 0 011 00 <br />CLAIMS -MADE I OCCUR <br />tlrlaiA4aL'h"l�Rt"IwrY1mG� <br />-° <br />5,000 <br />.. <br />PERSONAL 8 ADV INJURY <br />.. <br />$..........1r00Qr000-.. <br />E LIMIT APPLIES PER: <br />�nENL AGGREGATE <br />GENERAL AGGREGATE <br />$ 2,000„,000 <br />PRO -I LOC <br />POLICY JECTPRO- 1 <br />u <br />PRODUCTS <br />PRODUCTSCOMPIOP AGG <br />S 2mOl)..Qa0.Q0.. <br />OTHER. <br />$ <br />AUTOMOBILE LIABILITY <br />GO MMNEO i NGLFciim . <br />q��q_sa•,deank <br />$ <br />JANY AUTO <br />------ <br />BODILY INJURY (Par person) <br />......... ............................... <br />$ <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY Per acddent) <br />$ <br />HIRED NON -OWNED <br />PR%,1,5•lY DAMACaE <br />AUTOS ONLY AUTOS ONLY <br />1Pe1 xncRlnlb _ <br />$ <br />UMBRELLA LIAR OCCUR <br />EACH OCCURRENCE <br />$ <br />EXCESS LIAB CLAIMS -MADE <br />AGGREGATE <br />$ <br />-- .- ------- <br />DED , RETENTION $ <br />$ <br />A WORKERS EMS' WC 6312152 0211112020.... <br />rH <br />02111/2021 PEA7Vr, R. <br />1 000 000 <br />I <br />LIABILITY YIN <br />.......,. ,•• <br />_._! ..._... <br />ANY <br />$ 1,000,000 <br />OFFICE /MEMBH)PARTUDED?ECUTIVE <br />OFFICER/MEMBER EXCLUDED? � N / A <br />�,L,EACHACCIDENT <br />' ' '� <br />L.DISEASE -EAEMPLOYE <br />$ 1,000,000 <br />yy <br />If DESCRIP ION OF OPERATIONS below <br />E L. DISEASE - POLICY LIMIT <br />$ 1,000000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace Is required) <br />The certificate holder is listed as an additional insured <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />The City of South Bend ACCORDANCE WITH THE POLICY PROVISIONS. <br />South Bend, IN 46601 <br />AUTHORIZED REPRESENTATIVE <br />MDK <br />©1988-2016 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD <br />Printed by MDK on July 06, 2020 at 02:19PM <br />