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ACC CERTIFICATE OF LIABILITY INSURANCE 2;2;2024
<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(ies) 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 NAME; Frank Griffin
<br />FAX
<br />Brown & Brown of MA, LLC HOONE Ext: (617)471-1220 AFC. No: 1s171479-514"/
<br />500 Victory Rd. ADDRESS frank. griffin@bbrown.com
<br />Marina Bay INSURER(S) AFFORDING COVERAGE NAIC N
<br />North Quincy MA 02171 INSURER A: Liberty Mutual Fire Insurance 23035
<br />INSURED INSURERB:LM Insurance Corporation 33600
<br />Laz Parking Midwest, LLC INSURER c: BerkleyInsurance Company '32603
<br />33 West Monroe Street INSURERD:HDI Specialty Insurance Company 16131
<br />Suite 2010 INSURER E: Federal Insurance Company 20281
<br />Chicago IL 60603 INSURER F: Everest National Insurance Com an 10120
<br />r_nVFRAr;FS r:FRTIFICATF 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 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 />INS;
<br />LTR .
<br />TYPE OF INSURANCE
<br />ADOL
<br />U
<br />POLICYNUMBER
<br />iMOiDIGY£FF
<br />EXP
<br />MI1WDY
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />AMA N
<br />PREMI E Ea occurrence
<br />$ 1,000,000
<br />MED EXP (Any one Derson)
<br />$ EXCLUDED
<br />A
<br />CLAIMS -MADE ® OCCUR
<br />:B2611260451033
<br />7/31/2023
<br />.7/31/2024
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />X Contractual Liability
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />GEN'LAGGREGATE LIMITAPPLIES PER:
<br />PRODUCTS - COMP/OP AGG
<br />$ 2 , 000 , 000
<br />POLrCY X PRC- Fx-1 LOC
<br />S
<br />AUTOMOBILE LIABILITY
<br />COMBINED 51 NGLE LIMIT
<br />En acz�iddnkl
<br />S 5,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />AALL
<br />ANYAUTO
<br />OWNED SCHEDULED
<br />NON -OWNED
<br />HIREDAUTOS X AUTOS
<br />Ix
<br />'kS2611260451013
<br />7/31/2023
<br />7/31/2024AUTOSAUTOSBODILY
<br />INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per den
<br />$
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />LIST OF
<br />EACH OCCURRENCE
<br />$ 100,000,000
<br />NX
<br />X
<br />AGGREGATE
<br />$ 100,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />[EEATTACHED
<br />OLI CIES
<br />/31/2023
<br />7/31/2024
<br />DED RETENTION $
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE �
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />N /A
<br />4A561D260451053
<br />7/31/2023
<br />7/31/2024
<br />X WC STATUS OTH-
<br />R R
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />A GARAGEKEEPERS LIABILITY
<br />1.S2611260451013
<br />7/31/2023
<br />7/31/2024
<br />$1,000,000 LIMIT
<br />C CRIME/EMPLOYEE DISHONESTY
<br />3CCR4500289226
<br />7/31/2023
<br />7/31/2024
<br />$5,000,000 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, City of South Bend, Indiana is included as an
<br />additional insured for general liability, but only with respect to the operations of the named insured.
<br />L22102: Commerce Center Matthews 1 - 401 E Colfax Ave South Bend, IN 46617. Parking Spaces 300
<br />CERTIFICATE HOLDER GANGELLAIJUN
<br />City of South Bend, Indiana
<br />Attn: Executive Director Venues
<br />Parks & Arts
<br />301 S. St. Louis Blvd
<br />South Bend, IN 46617
<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 V
<br />ACORD 25 (2010/05) (D1yt3tf--lU1U AUUI{U L:UKVUKAI IUIN. All rlgnLs reserveo.
<br />INS025 (201005) 01 The ACORD name and logo are registered marks of ACORD
<br />
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