HomeMy WebLinkAboutKristen BrewerA`� vim® CERTIFICATE OF PROPERTY INSURANCE oao312a24ADn
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.
PRODUCER CONTACT Doug Stokes
Doug Stokes
StafeFarm 760 Blue Lakes Blvd N #1
I!
NAME.
uc No EMI: 208.734.7765 FAX
IAICNDI: 208.733.2625
ArknREss, doug@doug-stokes.com
Twin Falls ID 83301-4000 INSURER(S) AFFORDING COVERAGE NA1C 0
INSURED INSURER A: State Farm Mutual Automobile Insurance Company 25178
Kristen Brewer INSURER a :
3300 W Grand Rapids Dr INSURERC:
INSURER D
Meridian ID 83646.5615 INSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 1
LOCATION OF PREMISESI DESCRIPTION OF PROPERTY (Attach ACORD 401, Addltlsnal Remarks Schedule, I<more space Is required)
THIS IS TO CER71FY 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
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMA)DNYYY)
POLICY EXPIRATION
DATE (MMIDDIYYYY)
COVERED PROPERTY
LIMITS
A
PROPERTY
CAUSES OF LOSS
DEDUCTIBLES
HO - 12-BL-V389.6
03/14/2024
03/14/2025
BUILDING
PERSONAL PROPERTY
BUSINESS INCOME
EXTRA EXPENSE
RENTAL VALUE
BLANKET BUILDING
BLANKET PERS PROP
BLANKET BLDG & PP
Liability
$
$
BASIC
BUILDING
s
BROAD
S
CONTENTS
X
SPECIAL
s
EARTHQUAKE
$
WIND
s
FLOOD
X
s
S 100,000.00
$
INLAND MARINE
OF LOSS
NAMED PERILS
TYPE OF POLICY
$
CAUSES
$
POLICY NUMBER
$
s
CRIME
TYPE OF POLICY
S
$
$
BOILER i MACHINERY/
EQUIPMENT BREAKDOWN
s
S
A
PERS LIAB UMBRELLA
12-B"908-0
03/19/2024
03/19/2025
$ 1,000,000.00
M
$
SPECIAL CONDITIONS I OTHER COVERAGES (ACORD 101, Addidanal Remarks Schedule, may be aMached if man apace Is raquind)
5515 Aviation Way #1016
Caldwell ID 83605
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Caldwell Airport THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Caldwell ACCORDANCE WITH THE POLICY PROVISIONS.
4818 E Linden Road AUTHORIZED REPRESENTATIVE
Caldwell ID 83605-8036 Completed by an authorized State Farm representative. If signature
Is required, please contact agent.
01996-2016 ACORD CORPORATION. All rights reserved.
ACORD 24 (2016103) The ACORD name and logo are registered marks of ACORD
1004360 142986.5 04-24-2020