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HomeMy WebLinkAboutAM Signal LLC (2)I N, 1 A \\1 oY Y\ 1�1LX A`� o® —'[E CERTIFICATE OF LIABILITY NSURANCEr v (MMI DIYYY DAr419/2024Y) 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(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 endorsements). PRODUCER Arthur J. Gallagher Risk Management Services, LLC 6967 South River Gate Dr. Suite 200 CONTACT NAME: Aubrie Kemp PHONE 801-924-140t} FAX 0 No (AC. EMAIL ADDRESS. certreclueststMaig.corn Salt Lake City UT 84047 INSURER 3 AFFORDING COVERAGE NAIC N INSURER A: Federal Insurance Company 20281 INSURED INTESAF-06 AM Siggouth LLC 8100 Sauthpark Way, Unit A-10 INSURER B : WCF National Insurance Company 40517 INSURER C : BCS Insurance Company 38245 INSURER D : Scottsdale Insurance Company 41297 Littleton CO 80120 INSURER E . INSURER F COVERAGES CERTIFICATE NUMBER: 1751287004 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER OD 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 S 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 POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMJOOfYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y 36064224 2128/2024 2/28/2025 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR Ea occurrence $ 1,000,000 -PREMISES MEO EXP (Any one person) $ 10,000 PERSONAL R ADV INJURY $ 1.000,000 GEN'L GENERAL AGGREGATE $ 2,000,000 AGGREGATE LIMIT APPLIES PER: X PRO - POLICY JECTPRO ❑ LOG PRODUCTS - COMPIOP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY 73619969 2/2812024 2/28/2025 COMEaBINdEDentSINGLE LIMIT a:aa $1.000,000 X 800 i Y INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PER DAMAGE Per accident $ A X UMBRELLA LIAR X OCCUR 7619-24-00 2/28/2024 2/28/2025 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 EXCESS LIAB CLAIMS -MADE DED I I RETENTIONS $ g WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN 405085E 8/13/2023 8/13/2024 X STATUTE ERH E.L. EACH ACCIDENT $1,000,000 ANYPROPRIETOWPARTNERfEXEGUTIVE ❑ OFFICERJMEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $1,000.000 (Mandatory in NH) If yes. describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S 1,000,000 A C D Business Personal Property Cyber Liability Excess Cyber 36064224 RPS-P-50259892M EKS3517331 2/28/2024 3/14/2024 3/14/2024 2/28/2025 3/14/2025 3/14/2025 Prop Limit P-P Deduchlbe CyberTotel Limit $15,000 $5,000 $5.000 000 DESCRIPTION OF OPERATIONS! LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ECEIVFr) 8Y City of Caldwell is named as additional insured with respects to the general liability as per the policy form. (7 wWRL r;;y CI ERIi APR 0 J 2024 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Caldwell PO BOX 1179 AUTHORIZED REPRESENTATIVE Caldwell ID 83606 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD