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Home My WebLink AboutGreg HerzogA� o® CERTIFICATE OF LIABILITY INSURANCE (MMIDDNYYY) 74/24/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE BOLDER. 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 lieu of such endorsement(s). PRODUCER NAME C BARKUS VAN T Western Community Ins Co PHONE 208�898_8848 FAX 208-232-3608 (AIC_NO_l! ): SAK No}: PO Box 4848 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # Pocatello, 10 83205-4848 INSURER A Western Community Ins Ca 39519 INSURED II II 118111811 11 1111111 11 INSURER B 11111111111119111111lisp Is 11 HERZOG GREGG INSURER C . HERZOG DEBRA INSURERD. INSURER E: PO BOX 1483bb9 STAR ID INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:AF0670 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED- NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS 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 TYPE OF INSURANCE AODL SUBR POLICY NUMBER MWDDDrYICY EYYY MMODpY�Y LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 PREMISES (Ea occurrence) S 100,000 %( COMMERC AL GENERAL LIABILITY CLAIMS•VAIIE X OCCUR MED EXP (Any one person) S 10,000 A N N 8R304501 5/ 19/24 5/ 19/25 PERSONAL s ADV INJURY s 1,000,000 GENERAL AGGREGATE S 2 ! OOO, OOO GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS. COMP/OP AGG S INCLUDED X I POLICY PRO• LOC S AUTOMOBILE LIABILITY COMBINED Ed accident SINGLE LIMIT $ BODILY INJURY (Per person) 5 ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) S PROPERTY DAMAGE S Per accident NON -OWNED HIRED AUTOS AUTOS S UMBRELLALIAO OCCUR EACH OCCURRENCE S AGGREGATE $ EXCESS LIAR CLAIMS•MADE DED RETENTIONS S WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE E L EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? ❑ N I A (Mandatory in NH) E L DISEASE - EA EMPLOYEE S II yes, describe under DESCRIPTION OF OPERATIONS below E L DISEASE •POLICY LIMIT S air,} DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (Attach ACORD 101. Additional Remarks Schedule, if more space Is regylreU I 4103 Aviation Way Caldwell, ID Row J J 1f N 0 t3 20211 III 11111111111111111111 � 11111111 I 1111111111111111111 CM OF CALDWELL 48140E LINDEN ST CALDWELL ID 83605 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR ZED REPRESEN7A-IVE L ACORD 25 (2010105) C 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD