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Home My WebLink AboutJeanne RossRLACOI DATE(MMIDDmYY) � CERTIFICATE OF LIABILITY INSURANCE 5/03/2024 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 pollcy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the temm 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 Western Community Ins Co PO Box 4848 Pocatello, ID 83205-4848 NCAO NTACT CARON KEEI=AN PHONE 208-618-208 MC . 208-232-3608 EMAIL DRESS: INSURERS AFFORDING COVERAGE NAIC1r INSURER A'. Western Community Ins Co 39519 INSURED �Illlllllllllllllllllllelllllsslsel�ll lllllllil�lllll ROSS JEANNE PO BOX 142 MIDDLETON ID 83644 INSURERS: INSURER C : INSURERD: INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:AF0670 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 TYPE OF INSURANCE ADDL SUB wvD POLICY NUMBER INMI ICY EFF PO C Y LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 5XI OCCUR N N 8V770501 5/03/24 5/03/25 EACH OCCURRENCE s 1 000 000 PREMISES tag occurrence $ 1 00 000 MED EXP (Any oneperson) $ 51000 PERSONAL& ADV INJURY S 1,000,000 s 2.000.000 GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER, X I POLICY 7 PRO- LOC PRODUCTS • COMPIOP AGG $ INCLUDED $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS ANON -GOWNED HIRED AUTOS AUTOS COMBINED IN LIMIT Ea accident S BODILY INJURY (Per person) S BODILY INJURY (Per accident) S PROPERTY DAMAGE Per accident $ S UMBRELLA LIAR HOCCUR EXCESS LIAR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE S DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPMETORIPARTNERIEX£CLITIVE ❑ OFFICERIMEMSER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC STATU- OTH- E.L. EACH ACCIDENT % E.L. DISEASE • EA EMPLOYEE S E.L. DISEASE • POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addttlenal Remarks Schedule. If more space Is requited) Hangar 5515 Aviation Way #922' *3 II=1:Lel4114za City of Caldwell Caldwell Airport 4814 E Linden St Caldwell 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 ID 83605 � .� 40 'oj ACORD 25 (2010105) W TV55-ZUIU AL:UKU L:L.JhLFUKA I lUrt. Au ngms reserves. The ACORD name and logo are registered marls of ACORD