HomeMy WebLinkAboutIgnacio MezaMEZAI00001 KBARN
`a'R� CERTIFICATE OF LIABILITY INSURANCE DA EIMM M YY'
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(les) 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 riohts to the certificate holder In lieu of such endorsement(s).
PRODUCER
Acrlsure Northwest Partners Insurance Services, LLC
1940140th Ave W, Suite 440
Lynnwood, WA 9803E
INSURED
Ignacio Maza
3103 Arcandian Drive
Caldwell, ID 83605
RECEIVED e
CALDWELL CITY CLE
FEB 14 2025
IArPHONC, r o, BM. (208) 229FAX
-1357 , Noy:(208) 459�417
was: kabarnes@acrisure.com
INSURERS} AFFORDING COVERAGE NAIC NI
INSURER A. Philadelphia Indemnity Insurance Company 18058
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISION NUM13ER:
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.
IlSR TYPE OF INSURANCE �ADOL;SUSR POLICY NUMBER POLICY EFF POLICY EXP
UK"
A
X co111iiERCiAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMSMADE X OCCUR x
I
EV159271 $11112025 5/13/2025
PREMISESDAMAGE To , D�,,,,,,,,o,)
; 300,000
MED EXP (Any Des perm
$ 0
1,000,000
PERSONAL &ADVINJURY
$
GENT AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
S 3,000,000
I
X POLICY LOC
OTHER:
PRODUCTS - COMPIOP AGO
¢ 3,000,000
AUTOMOBILE LIABILITY
( COMBINED SINGLE LIMIT
;
ANY AUTO
BODILY INJURY (Per paean)_
:
AUTOS ONLY SOS
BODILY INJURY Weerr soeid")
$
AUTOS ONCY
B�
l� Plp
3
AUTOS ONLY
UMBRELLA LIAB OCCUR
EACH OCCURRENCE
$
EXCE88 LIAR CLAIMS -MADE
AGGREGATE
j
DED I RETENTIONS
E
WKERS LSAT I I
AND EMPLOYERS LAIBILITY
STATUTE ER
Y ! N
ANY PROPFUETRRIP NEE CUTIVE
E.L. EACH ACCIDENTEXCLU
;
ED?NIA
Ilan MNAH
E.L. DISEASE - EA EMPLOYEE _
Iyss, dseeriAa under
DESCRIPTI OF OPERATIONS Allow
E.L. DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addrdonai Remarks Schedule, may be attached If more spew Is required)
evidence of Insurance for Mother's Day event 5-11-25
City of Caldwell
6181rving 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.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016103) 01988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD