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ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY)
3/7/2024
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(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 nLQ`i
ii nAF.I,L I„ f i-Ltni
C CT
The Hartwell Corporation
PO Box 400
Caldwell, ID 83608 Y
PONE _FA)
kC Na Ext : (208 459-1678 Arc No :(208) 454-1114
jinksr.thc@thehartwelicorp.com
INS RER S AFFORDING COVERAGE
NAIC N
INSURER A: Ohio Security Ins CO
24082
INSURED
INSURER B :
INSURER C :
Nathan Pickens
INSURER D :
2112 Arlington Avenue
Caldwell, ID 83605
INSURER E
INSURER F:
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
TYPE OF INSURANCE
AOOL
SUER
POLICY NUMBER
POLICY EFF
POLICY EXPLTR
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE F_x] OCCUR
BKS63027258
3/31/2024
3/31/2025
EACH OCCURRENCE
S 1,000,000
DAMAGE TSESO RfE,ENTED
1,000,000
MED EXP (Any one more
15,000
PERSONAL & ADV INJURY
1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICYEl JECT LOC
OTHER:
GENERALAG RE TE
2,000,000
PRODUCTS - COMPIOP AGG
2,000,000
s
AUTOMOBILE LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
AUTOS ONLY AUrO� ONLY
COMBINED SINGLE LIMIT
$
BODILY INJURY Per
S
BOODILY INJURY Per accident
BODILY
S
PaOr PacEclRdent AMAGE
s
UMBRELLA LIAB
EXCESS LIAR
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
AGGREGATE
DED I RETENTIONS
WORKERS COMPENSATION
ANDEMPLOYERS'UABIUTY YIN
ANY CPROPRIIETBOERRIPARTNER/EXECUTIVE
{MFandetory in NHj EXCLUDED?
If es, describe under
DESCRIPTION OF OPERATIONS below
N 1 A
OTH-
ELITE
E.L. EA H A IDENT
E.L. DI E- EAEMPL YE
E.L. DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Sch*dul*, may be attached If more space is required)
In regards to -
4321 Aviation Way #290
Caldwell, ID 83605
City of Caldwell
4814 E Linden Street
Caldwell, ID 83606
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