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HomeMy WebLinkAboutRobert BurnettA/�o p 1 0 SS�� It CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 04/2512024 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 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 on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Josh Lowry Northwest Insurance Brokers PHONE (208) 322-8300 (208) 376-5444 A/C No. Eat): Al No): ADDRESS: josh@northwestbrokers.com 1860 N. Lakes Place INSURER(S) AFFORDING COVERAGE NAIC 0 Meridian ID 83646 INSURE A: The Travelers Indemnity Company 25658 INSURED INSURER B : Robert Brian Burnett INSURER C : 513 DISHMAN PL INSURER 0: INSURER E; CALDWELL ID 83605-6230 INSURER F ; COVERAGES CERTIFICATE NUMBER: CL2342502580 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. 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. LTR TYPE OF INSURANCE INSD WVO POLICY NUMBER MMIDDIYYYY) (MMIDDIYYYYJ LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s 1,000.000 CLAIMS•MADE ® OCCUR PREMISES Ea occurrence $ 300,000 M-D EXP (Anyone person) S Excluded PERSONAL BADVINJURY s Excluded A 630-5T275520-24 05/11/2024 05f'.tr'2025 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000.000 x POLICY El jEa El LOC PRODUCTS-COMPIOPAGG $ Excluded $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANYAUTO OWNED SCHEDULED AUTOSONLY AUTOS BODILY INJURY (Par accident; $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident S S UMBRELLA L(AB HCLAIMS-MADE OCCUR EACH OCCURRENCE S AGGREGATE $ EXCESS LIAB DED RETENTIONS S WORKERS COMPENSATION AND EMPLOYERS! LIABILITY YIN PER OTH STATUTE ER E L EACH ACCIDENT S ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? N f A EL DISEASE - EA EMPU YEE S {Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIM T S A Commercial Property Ded: $2,500 Wind-Hail/$1,000 All Other 630-5T275520-24 05/1112024 05111/2025 Building Limit Business Persona Prop $1.000 000 $5.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required) RE: 513 DISHMAN PL, Caldwell, ID 83605 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Caldwell ACCORDANCE WITH THE POLICY PROVISIONS. 4814 E Linden Street AUTHORIZED REPRESENTATIVE Caldwell ID 83605 (} ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD