|
ACCWE)� � CERTIFICATE OF LIA
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AN
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTE
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certifioate holder is an ADDITIONAL INSURED, the poll
<br />the terms and conditions of the policy, certain policies may require an end
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />Brown 6 Brown of MA, LLC
<br />500 Victory Rd.
<br />Marina Bay
<br />North Quincy MA 02171
<br />INSURED
<br />Laz Parking Midwest, LLC
<br />33 West Monroe Street
<br />Suite 2010
<br />Chicago IL 60603
<br />COVERAGES
<br />polio
<br />D
<br />BI L I TY INSURANCE DATE (MMIDD/YYYY)
<br />1/3/2024
<br />CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />ND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />orsement. A statement on this certificate does not confer rights to the
<br />c "MFrank Griffin
<br />NAME:
<br />PHONE (617)471-1220 /UAX C No: (617)479-5147
<br />ADDRESS: frank. griffin@bbrown.com
<br />INSURERS AFFORDING COVERAGE NAIC 9
<br />INsuRERA: Liberty Mutual Fire Insurance 23035
<br />INSURERB:LM Insurance Corporation :33600
<br />INSURERC: Berkley Insurance CompanyCoMpany 32603
<br />INSURER D: HDI Specialt-Z Insurance ComDany 131
<br />INSURERE ' federal Insurance Company '20281
<br />INSURERF:Everest National Insurance Com an :10120
<br />CERTIFICATE NUMBER: 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 PERIOE
<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 />L SUBR POLICY EFF POLICY EXP
<br />LTR TYPE OF INSURANCE IIN POLICY NUMBER MMIDD jMMID0IYYYY1
<br />GENERAL LIABILITY
<br />X COMMERCIALGENERALLIABILITY
<br />A CLAIMS -MADE a OCCUR 2611260451033 1/31/2029 !/31/2024
<br />x Contractual Liability
<br />GEN'LAGGREGATE LIMITAPPLIES PER:
<br />POLICY X PRO. X LOC
<br />AUTOMOBILE LIABILITY
<br />A X ANYAUTO
<br />ALL OWNED SCHEDULED 2611260451013 /31/2023 7/31/2024
<br />AUTOS AUTOS
<br />X HIREDAUTOS X AUTOSWNED
<br />X UMBRELLA LIAB X OCCUR EL ATTACHED LIST OF
<br />X. EXCESS LIAB CLAIMS -MADE OLICIES 7/31/2023 1/31/2024
<br />DED RETENTION S
<br />B WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y I N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? N❑ NIA
<br />(Mandatory In NH) GID260451053 /31/2023 /31/2024
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />A GARAGEKEEPERS LIABILITY s2611260451013 1/31/2023 /31/2024
<br />C CRIME/EMPLOYEE DISHONESTY CR4500269226 /31/2023 r/31/2024
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
<br />If agreed upon in a written contract or agreement, City of South Bend, Indiana is included as an
<br />additional insured with a waiver of subrogation in their favor for general liability, but only with
<br />respect to the operations of the named insured.
<br />M22121: 109 W Jefferson Blvd, South Bend, IN 46601
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />LIMITS
<br />EACH OCCURRENCE S 1,000,000
<br />DAMAGE to R NTEp
<br />PREMISESen e 5 1,000,000
<br />MED EXP (Any one son S EXCLUDED
<br />PERSONAL & ADV INJURY S 1,000,000
<br />GENERAL AGGREGATE S 2,000,000
<br />PRODUCTS •COMNOPAGG S 2,000,000
<br />COMBINED SINGLE LIMIT
<br />5,0000000
<br />BODILY INJURY (Per person) $
<br />BODILY INJURY (Per accident) $
<br />PROPERTY DAMAGE $
<br />EACH OCCURRENCE S 100,000,000
<br />AGGREGATE S 100,000,000
<br />5
<br />X WC STATU• OTH-
<br />TOW WITS E
<br />E.L. EACH ACCIDENT S 1,000,000
<br />EL DISEASE - EA EMPLOYEE $ 11000,000
<br />E.L DISEASE -POLICY LIMIT 5 1,000,000
<br />$1,000,000 LIMIT
<br />$5.000,000 LIMIT
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of South Bend, Indiana ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Attn: Executive Director Venues
<br />Parks & Arts AUTHORIZED REPRESENTATIVE
<br />301 S. St. Louis Blvd
<br />South Bend, IN 46617 - -�
<br />:Fallon Carey/FACARE
<br />I
<br />ACORD 26 (2010106) ©1988-2010 ACORD CORPORATION. All rights reserved.
<br />INS025 (201005).01 The ACORD name and logo are registered marks of ACORD
<br />CERTIFICATE NUMBER: 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 PERIOE
<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 />L SUBR POLICY EFF POLICY EXP
<br />LTR TYPE OF INSURANCE IIN POLICY NUMBER MMIDD jMMID0IYYYY1
<br />GENERAL LIABILITY
<br />X COMMERCIALGENERALLIABILITY
<br />A CLAIMS -MADE a OCCUR 2611260451033 1/31/2029 !/31/2024
<br />x Contractual Liability
<br />GEN'LAGGREGATE LIMITAPPLIES PER:
<br />POLICY X PRO. X LOC
<br />AUTOMOBILE LIABILITY
<br />A X ANYAUTO
<br />ALL OWNED SCHEDULED 2611260451013 /31/2023 7/31/2024
<br />AUTOS AUTOS
<br />X HIREDAUTOS X AUTOSWNED
<br />X UMBRELLA LIAB X OCCUR EL ATTACHED LIST OF
<br />X. EXCESS LIAB CLAIMS -MADE OLICIES 7/31/2023 1/31/2024
<br />DED RETENTION S
<br />B WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y I N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? N❑ NIA
<br />(Mandatory In NH) GID260451053 /31/2023 /31/2024
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />A GARAGEKEEPERS LIABILITY s2611260451013 1/31/2023 /31/2024
<br />C CRIME/EMPLOYEE DISHONESTY CR4500269226 /31/2023 r/31/2024
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
<br />If agreed upon in a written contract or agreement, City of South Bend, Indiana is included as an
<br />additional insured with a waiver of subrogation in their favor for general liability, but only with
<br />respect to the operations of the named insured.
<br />M22121: 109 W Jefferson Blvd, South Bend, IN 46601
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />LIMITS
<br />EACH OCCURRENCE S 1,000,000
<br />DAMAGE to R NTEp
<br />PREMISESen e 5 1,000,000
<br />MED EXP (Any one son S EXCLUDED
<br />PERSONAL & ADV INJURY S 1,000,000
<br />GENERAL AGGREGATE S 2,000,000
<br />PRODUCTS •COMNOPAGG S 2,000,000
<br />COMBINED SINGLE LIMIT
<br />5,0000000
<br />BODILY INJURY (Per person) $
<br />BODILY INJURY (Per accident) $
<br />PROPERTY DAMAGE $
<br />EACH OCCURRENCE S 100,000,000
<br />AGGREGATE S 100,000,000
<br />5
<br />X WC STATU• OTH-
<br />TOW WITS E
<br />E.L. EACH ACCIDENT S 1,000,000
<br />EL DISEASE - EA EMPLOYEE $ 11000,000
<br />E.L DISEASE -POLICY LIMIT 5 1,000,000
<br />$1,000,000 LIMIT
<br />$5.000,000 LIMIT
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of South Bend, Indiana ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Attn: Executive Director Venues
<br />Parks & Arts AUTHORIZED REPRESENTATIVE
<br />301 S. St. Louis Blvd
<br />South Bend, IN 46617 - -�
<br />:Fallon Carey/FACARE
<br />I
<br />ACORD 26 (2010106) ©1988-2010 ACORD CORPORATION. All rights reserved.
<br />INS025 (201005).01 The ACORD name and logo are registered marks of ACORD
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
<br />If agreed upon in a written contract or agreement, City of South Bend, Indiana is included as an
<br />additional insured with a waiver of subrogation in their favor for general liability, but only with
<br />respect to the operations of the named insured.
<br />M22121: 109 W Jefferson Blvd, South Bend, IN 46601
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />LIMITS
<br />EACH OCCURRENCE S 1,000,000
<br />DAMAGE to R NTEp
<br />PREMISESen e 5 1,000,000
<br />MED EXP (Any one son S EXCLUDED
<br />PERSONAL & ADV INJURY S 1,000,000
<br />GENERAL AGGREGATE S 2,000,000
<br />PRODUCTS •COMNOPAGG S 2,000,000
<br />COMBINED SINGLE LIMIT
<br />5,0000000
<br />BODILY INJURY (Per person) $
<br />BODILY INJURY (Per accident) $
<br />PROPERTY DAMAGE $
<br />EACH OCCURRENCE S 100,000,000
<br />AGGREGATE S 100,000,000
<br />5
<br />X WC STATU• OTH-
<br />TOW WITS E
<br />E.L. EACH ACCIDENT S 1,000,000
<br />EL DISEASE - EA EMPLOYEE $ 11000,000
<br />E.L DISEASE -POLICY LIMIT 5 1,000,000
<br />$1,000,000 LIMIT
<br />$5.000,000 LIMIT
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of South Bend, Indiana ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Attn: Executive Director Venues
<br />Parks & Arts AUTHORIZED REPRESENTATIVE
<br />301 S. St. Louis Blvd
<br />South Bend, IN 46617 - -�
<br />:Fallon Carey/FACARE
<br />I
<br />ACORD 26 (2010106) ©1988-2010 ACORD CORPORATION. All rights reserved.
<br />INS025 (201005).01 The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of South Bend, Indiana ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Attn: Executive Director Venues
<br />Parks & Arts AUTHORIZED REPRESENTATIVE
<br />301 S. St. Louis Blvd
<br />South Bend, IN 46617 - -�
<br />:Fallon Carey/FACARE
<br />I
<br />ACORD 26 (2010106) ©1988-2010 ACORD CORPORATION. All rights reserved.
<br />INS025 (201005).01 The ACORD name and logo are registered marks of ACORD
<br />
|