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A� RE0 CERTIFICATE OF LIP THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYANE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTE BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the poll If SUBROGATION IS WAIVED, subject to the terms and conditions of the pI this certificate does not confer rights to the certificate holder in lieu of suc PRODUCER Laven Insurance Agency, Inc. P. O. Box 2379 SOUTH BEND IN 46680 INSURED Fiddler's Hearth, Inc. dba Fiddler's Hearth 127 N. Main Street South Bend IN 46601 BILITY INSURANCE DATE(MMIDD/YYYY) 09/16/2022 CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS ND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES ONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED :y(les) must have ADDITIONAL INSURED provisions or be endorsed. Ilicy, certain policies may require an endorsement. A statement on h endorsament(s). NAME: Susan Thompson PHONE (574)291-5510 F (574)291-8505 A!C No: L -ADDRESS: suet@laveninsurance.com INSURER($) AFFORDING COVERAGE NAIC # INSURERA: Frankenmuth Mutual Ins. Co. 13986 INSURER B INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 22.23 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NOR JR TYPE OF INSURANCE INSD AVVO POLICY NUMBER MMFDD� MMIDD/YYPOLICY YY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR A COVERAGES CERTIFICATE NUMBER: 22.23 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NOR JR TYPE OF INSURANCE INSD AVVO POLICY NUMBER MMFDD� MMIDD/YYPOLICY YY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR A Y 6605292 09/18/2022 09/18/2023 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY E a El LOC OTHER: AUTOMOBILE LIABILITY ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS 6605291 09/18I2022 09/18/2023 HIRED NON -OWNED AUTOS ONLYQ AUTOS ONLY x UMBRELLALIAB OCCUR A EXCESS LIAR CLAIMS -MADE 6605290 09/18/2022 09/18/2023 DEp X RETENTION $ 10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N A ANY PROPRIETOPJPARTNERIEXECUTIVE ornCERIMEMBERExCLUDE5 N N/A 6605290 09/18/2022 09/18/2023 (Mandatory In NH) If yes, describe under Liquor Liability A 6605292 09/18/2022 09/18/2023 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Location: 127 N. Main Street, South Bend, IN 46601 ABOVE FOR THE POLICY PERIOD WITH RESPECT TO WHICH THIS SUBJECT TO ALL THE TERMS, LIMITS EACH OCCURRENCE $ 1,000,000 PREMISES Es occurrence & 500,000 MED EXP IAmy one rson S 5,000 PERSONAL&ADVtNJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMPIOPAGG $ 2,000,000 Employment Pract Liab $ 100,000 COMBINED SINGLE LIMIT $ 1,000,000 Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per aeddenl EACH OCCURRENCE 5 3,0D0,000 AGGREGATE S 3,000,000 S PER OTH- STATUTE ER E.L. EACHACCIDENT $ 900.000 E.L. DISEASE - EA EMPLOYEE S 500,000 E.L_ DISEASE - POLICY LIMIT S 500,000 Occurrence Limit $1,000,000 Aggregate Limit $2,000,000 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 BIVd. Suite 100 AUTHORIZED REPRESENTATIVE 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 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 BIVd. Suite 100 AUTHORIZED REPRESENTATIVE 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