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.4cvR►r3� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br />�~•` 9/13/2023
<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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />Brown & Brown of MA, LLC
<br />500 Victory Rd.
<br />Marina Bay
<br />North Quincy MA 02171
<br />CONTACT NAME' Frank Griffin
<br />PHONE FX (617)471-1220 no: (617)479-5147
<br />E-MAILADnRF 9; frank. griffin@bbrown.com
<br />INSURER 3 AFFORDING COVERAGE
<br />NAIC 9
<br />INSURER A: LibeKty Mutual Fire Insurance
<br />:23035
<br />INSURED
<br />Laz Parking Chicago, LLC
<br />33 West Monroe Street
<br />Suite 2010
<br />Chicago IL 60603
<br />INSURERB:LM Insurance Corporation
<br />:33600
<br />INSURFRC:Berkkey Insurance Company
<br />:32 60 3
<br />INSURERD:HDI g2ecialty Insurance Company
<br />:16131
<br />INSURERE: Federal Insurance Company
<br />20281
<br />wsuRERF:Everest National Insurance Company
<br />10120
<br />GUVLRAGE5 (:LRIIFIGAIL NUMBE11:2J-24 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAYBE 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 />IINSR
<br />lJDIYYYY
<br />TYPE OF INSURANCE
<br />.ADDL
<br />8 BR
<br />POLICY NUMBER
<br />EFF
<br />MMIDD YYYY
<br />1
<br />MM/6POLICY
<br />LIMITS
<br />GENERAL LIAMUTY
<br />EACH OCCURRENCE
<br />$ 11000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />PREMISEAMAGETORENTED
<br />S Ca=Wronce
<br />$ 1,000,000
<br />A
<br />CLAIMS -MADE Fx� OCCUR
<br />1EB2621260451033
<br />7/31/2023
<br />7/31/2024
<br />MED EXP (Any one person)
<br />$ EXCLUDED
<br />PERSONAL &ADVINJURY
<br />$ 1,000,000
<br />X Contractual Liability
<br />GENERALAGGREGATE
<br />$ 2,000,000
<br />GEN'L AGGREGATE
<br />LIMIT APPLIES PER:
<br />PRODUCTS -COMP/OPAGG
<br />$ 2,000,000
<br />POLICY X
<br />PRO• X LOC
<br />$
<br />AUTOMOBILE
<br />LIABILITY
<br />COMB[NtD SINGLE LIMIT
<br />acodfing
<br />5, 00,000
<br />BODILY INJURY (Per person)
<br />$
<br />A
<br />ANYAUTO
<br />BODILY INJURY (Per accident)
<br />$
<br />ALL OWNED SCHEDULED
<br />ikS2611260451013
<br />7/31/2023
<br />7/31/2024
<br />Ix
<br />AUTOS AUTOS
<br />aerOPER
<br />$
<br />N
<br />ANONGOWNED
<br />HIRED AUTOS
<br />ac tlenDAMAGE
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />SEE ATTACKED LIST OF
<br />EACH OCCURRENCE
<br />$ 100, 000, 000
<br />XEXCESS
<br />AGGREGATE
<br />$ 100, 000, 000
<br />LIAB
<br />CLAIMS -MADE
<br />'POLICIES
<br />7/31/2023
<br />7/31/2024
<br />DED RETENTION $
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />X WC ATU- CTH-
<br />AND EMPLOYERS' LIABILITY Y / N
<br />E.L. EACH ACCIDENT
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />$ 1,000,000
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory In NH) �
<br />N /A
<br />iA561D260951053
<br />7/31/2023
<br />.1/31/2024
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 11000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 11000,000
<br />A
<br />GARAGEREEPERS LIABILITY
<br />LS2611260451013
<br />7/31/2023
<br />7/31/2024
<br />$1,000,000 LIMIT
<br />C
<br />CRIME/EMPLOYEE DISHONESTY
<br />ICCR4500289226
<br />7/31/2023
<br />7/31/2024
<br />15,000,000 LIMIT
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
<br />If agreed upon in a written contract or agreement, The City of South Bend is included as an additional
<br />insured for general liability, auto liability and umbrella, but only with respect to the operations of
<br />the named insured.
<br />Re: 720121 - South Bend Leighton, 109 W Jefferson Blvd, South Bend, Indiana, 46601 - Parking Spaces 500
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of South Bend, Indiana
<br />Attn: Executive Director Venues Parks &
<br />Arts
<br />301 S. St. Louis Blvd
<br />South Bend, IN 46617
<br />1
<br />Ar-nRr) 25 (2n1n1rls)
<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 />AUTHORIZED REPRESENTATIVE
<br />Fallon Carey/FACARE
<br />Ce19QAR-9nin Af nPrI ('f1RPnR1LTIAW All rinh4e rarar nrl
<br />INS025 (201005).Ol The ACORD name and logo are registered marks of ACORD
<br />
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