HomeMy WebLinkAboutCustom Residential PlumbingA� pCERTIFICATE OF LIABILITY INSURANCE
DATE6/DD24
7/16/2024®
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in IIeU of aLich endorsement(s).
PRODUCER
WNIAtol NAME: ANNA SCOTT
PHONE (20B) 466-8944 F� N0. 42001465-0539
Ballenger Insurance
P 0 BOX 450
E-MAIL
ADDRESS: ANNAQAaT.?.x rJGERINSVRANCE . Cab1
INSURERS AFFORDING COVERAGE
NAIC /
INSURERA:Auto—Owners Insurance Company
NAMPA ID 83653
INSURED
INSURERS:
INSURERC:
CUSTOM RESIDENTIAL PLUMBING
INSURERD:
11854 WILLIS RD
INSURER E :
INSURERF:
MIDDLETON ID 83644-5206
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 PERIOD
INDICATED, NOTWITHSTANDINGANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENTV61TH RESPECT TO WHICH THIS
CERTIFICATE MAYBE 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 I
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
--1
CLAIMS -MADE 1z OCCUR
DAMAGE TO
PREMISES eocccrrence
S 300,000
MED EXP (Any one person)
$ 10,000
PERSONAL S ADV INJURY
$ 1,000,000
57303517
07/15/2022
07/15/2025
GEN'LAGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE
$ 2,000,000
%t POLICY ❑ JEa LOC
PRODUCTS -COMPIOPAGG
$ 2,000,000
5
OTHER:
A
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
nl)1,
s 000, 000
BODILY INJURY (Per person)
$
X ANYAUTO
51-303-517-00
07/15/2022
07/15/2025
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident)
S
PROPERTY DAMAGE
Per accident
S
NON -OWNED
HIREDAUTOS AUTOS
s
UMBRELLALIAB
OCCUR
EACH OCCURRENCE
S
AGGREGATE
S
EXCESS L1AB
CLAIMS -MADE
DED RETENTION
$
WORKERS COMPENSATION
B-
AND EMPLOYERS' LIABILITY Y I N
ANY PROPRIETORIPARTNERIEXECUTIVE
E.L. EACH ACCIDENT
$
OFFICERIMEMBER EXCLUDED? ❑
NIA
E.L. DISEASE- EA EMPLOYEE
S
(Mandatory In NH)
If yes. describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
S
A
5103 AVIATION WAY #605
57303517
07/15/2023
07/15/2025
BUILDING COVERAGE $147,300
CALDWELL, ID 83605
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space Is required)
5103 AVIATION WAY #605 F?ECf.111"ojiy
CALDIMLLL b-TY PLERK,
AUG n7e.
CERTIFICATE HOLDER CANCELLATION
LAUSTIN@CITYOFCALDWELL.ORG
CITY OF CALDWELL
PO BOX 1179
CALDWELL, ID 93605
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
SCOtt/ANNA
{ Z.A-
@ 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014101)
INS025 (2o1401)
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