HomeMy WebLinkAboutCC Group Holdings LLCACORU CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDIYYYY)
03/19/2024
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(iss) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and cgnditions 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
r
Western Community Insurance Company
NAMNT
E•CT Jared Hall
PHONE 208-425-2280 FAX No ; 208 425-2281
ADD E S: jhall@idfbins.com
ADOnE ldfbins.com
Jared Hail
INSURERS AFFORDING COVERAGE
NAIC 0
Hillcresl Ave
INSURER A; Western Community Insurance Company
39519
American Falls ID 83211
INSURED
INSURER B :
INSURER C :
CC GROUP HOLDINGS LLC
INSURER D :
BRIAN COOPER
INSURER E :
863 W QUARTER DR
INSURER F :
EAGLE ID 83616
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. 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
TYPEOFINSURANCE
ADOL
SUBR
Ima
POLICYNUMBER
POLICY EFF
MMIODrfYYYI
POLICY EXP
(MMIDDIYYYYI
LIMBS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
S 1,000,000
CLAIMS -MADE FXI OCCUR
PREMISES Ea occurrence
S 100,000
MED EXP (Any one person►
$ 10,000
PERSONAL & ADV INJURY
S 2,000,000
A
N
N
8V744501
03/18/2024
03/18/2025
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
X POLICY JECT LOC
PRODUCTS -COMPIOP AGO
$ NOT INCLUDE
S
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea acddant
S
BODILY INJURY (Per person)
S
ANY AUTO
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per acadent)
$
PROPERTY DAMAGE
Per accident
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
UMBRELLALIAB
OCCUR
EACH OCCURRENCE
S
HCLAIMS-MADE
AGGREGATE
S
A
EXCESS LIAB
DED I I RETENTIONS
S
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$
A
OF CERIMEMBEREXC UD D7ECUTIVE ❑
NIA
E.L. DISEASE - EA EMPLOYEE
$
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
I
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101, Additional Remarks Schedule, may be attached if more apace Is required)
5103 AVIATION WAY #831
CALDWELL, ID 83605
HANGER $450,000
FURNISHINGSITOOLS $100,000
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
AUTHORIZED REPRESENTATIVE
621 E CLEVELAND
CALDWELL ID 83605
01988-2015 ACORD CORPORATION. All rights reserved.
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