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Shared Mobility Program <br />ERMIT RENEWAL CHECKL <br />Please submit signed and completed documents to the City of South Bend at: <br />Via flail: License Administrator <br />City of South Bend, Indiana <br />7 West Jefferson <br />1316 oun ` it Building <br />South Send, Indiana 46601 <br />Via Email{ ikain@southbondin.gov <br />Please complete and provide the f llo l n g <br />1, Shared Mobility device operator renewaT form (enclosed) <br />`License and permit bond form fenosad) <br />3. A check payable to lhe.Gity gf South Bend for the License fee <br />44. Gertificate of commercial general liability insurance issued to the applicant <br />Must name the license applicant as the 'Insured' <br />Must show the City as Additional I nsured' on the certificate. <br />If an endorsement is needed, use ISO CG2036 or equivalent <br />Must include 30 days written cancellation notice <br />* Required minimum Coverage: <br />1,000, 000 per occurrence $100.000 for damage to rented premises <br />,000 for medical expenses $500,000 for personal and advertising injury <br />1,00 ,000 products/complete operations $1,000,000 auto liability <br />, 00,000 general aggregate limit S5,000,000 excess/ti mbrella f iabii i <br />Note: <br />License w11 expsre on December 31 of U7e year of issuan (Uranse norx-transferable) <br />Renewal app I Ito cn s must be s ubm rued within 30 days <br />Department of PuNic Woeks <br />2023 Smry d Mobility N wce Opem ror er;s s Appkcodon <br />