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Home My WebLink AboutBlue to Gold LLCACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 04/18/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THI: CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIE: BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE{ REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(ies) must have ADDITIONAL INSURED provisions or be endorsed If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement or this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER CONTACT EVAN TAMASHIRO NAME: Statefarm STATE FARM ULYANNA CHUNG'S AGENCY PHONE 7028980038 FAX 7028980039 (A/C No): • 4730 W BLUE DIAMOND RD STE 125 E-MAIL EVAN.TAMASHIRO.VADR6S@STATEFARM.COM �' INSURE $ AFFORDING COVERAGE NAIC M LAS VEGAS, NV 89139 INSURERA : State Farm Fire and Casualty Company 25143 INSURED INSURER B ' INSURER C : BLUE TO GOLD LLC 1818 W FRANCIS AVE #101 INSURER D : SPOKANE, WA 99205 INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER101 INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI: CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR an POLICY NUMBER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS MADE ®OCCUR PREMI E TO REs NTED enoa S 300,000 MED EXP (Any one person) S 5,000 PERSONAL & ADV INJURY s 1,000,000 A Y 98-CB-J654-4 04/20/2024 04/20/2025 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 2,000,000 POLICY u PRO- JECT LOC i PRODUCTS - COMPIOP AGG $ 2,000,000 OTHER. BUSN PROP $ 92,700 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accida 1 S BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON-OVVNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident) S $ UMBRELLA U AB L I OCCUR EACH OCCURRENCE S AGGREGATE S EXCESS LIAB CLAIMS -MADE DED I I RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? El N 1 A PER OTH- TATUTE ER E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYE $ (Mandatory In NMI H yea describe under DESCRIPTION OF OPERATIONS bebw E.L. DISEASE -POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addltlonal Remarks Schedu[e, may ba aKaehad If mom space Is required) DEDUCTIBLES APPLIED: 1000 ALL PER OTHER DED MAY APPLY CITY OF CALDWELL PO BOX 1179 CALDWELL, ID 83606 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED Ih ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REEPPR-ESEEN-TwATIVE CND V 7%'4" ®1988-2015 ACORD CORPORATION. All rights reservec ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 1001486 132849.12 03-16-2(