Sidewalk Cafe - Fiddler's Hearth (2)

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�a DATE (MM/2020 Y) A ---I CERTIFICATE OF LIABILITY INSURANCE 03111/2020 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 certificate holder is an ADDITIONAL INSURED, the policy(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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER Laven Insurance Agency, Inc. P. O. Box 2379 SOUTH BEND IN 46680 CONTACT Susan Thompson NAME: PHONE., .Cxt . (574) 291-5510 FAX No : (574) 291-8505 EDMAIL s: suet@Iayenlnsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Frankenmuth Mutual Ins. Co. 13986 INSURED Fiddler's Hearth, Inc., DBA: Fiddler's Hearth 127 N Main Street South Bend IN 46601 INSURER B : INSURER C : INSURER D : INSURER E : _ I INSURER F rnvGlzer_I=c CFRTIFICATF NIHMRFR, IU-ZU Master 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 CONTRACT OR 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, INSR LTR I TYPE OF INSURANCE N WVD POLICY NUMBER POLICY EFF MM/DDIYVYYI POLICY EXP MM/DDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR PREMISES Ea o rrence $ 500,000 IVIED EXP (Any oneperson) $ 5,000 A Y 6605292 09/18/2019 09/18/2020 PERSONAL &ADV INJURY $ 1,000,000 GENVAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 POLICY ❑ PRO• ❑ LOC JECT Employment Pract Liab $ 100,000 OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea amide t $ 1,000,000 BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY 6605291 09/18/2019 09/18/2020 BODILY INJURY (Per accident) $ P OPERTY DAMAGE Par accidanl $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE 6605292 09/18/2019 09/18/2020 AGGREGATE $ 5,000,000 X DED RETENTION $ 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED?FNI (Mandatory in NH) NIA 6605290 09/18/2019 09/1 BI2020 X STATUTE Fg-51 IT ER E. L. EACH ACCIDENT $ SOO,000 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 500,000 $ A L iquor Liability 6605292 09118/2019 09/10I2020 Occurrence Limit $1,000,000 Aggregate Limit $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Location: 127 N. Main Street, South Bend, IN 46601 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of South Bend ACCORDANCE WITH THE POLICY PROVISIONS. 125 S. Lafayette Blvd. AUTHORIZED REPRESENTATIVE Suite 100 South Bend IN 46601� @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD