HomeMy WebLinkAboutPacific Horizon LLCClient#: 8742
PACIFICHOR
ACORD. CERTIFICATE OF LIABILITY INSURANCE
DATE (MMlDD1Ysro3MIDDNYYY)
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 any rights to the certificate holder in lieu of such endorsement($).
PRODUCER
Moreton & Company - Idaho
P.O. Box 191030
CONTACT NAME: Teresa Peterson Roberts
PHONE 208 321-9300 2
a ERl : p1C, No : 0$-321-0101
E-MAIL
ADDRESS: tpeterson@moreton.com
Boise, ID 83719
208 321-9300
INSURER(II) AFFORDING COVERAGE
NAIC p
INSURER A: Employers Mutual Casualty Co.
21415
INSURED
Pacific Horizon LLC
INSURER B
Fred Oliver c/o 2120 Lanark St.
INSURER C
Meridian, ID 83642
INSURER D :
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 CONTRACTOR 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
TYPE OF INSURANCE
ADDL
INSR
SUER
WVD
POLICY NUMBER
POLICY EFF
MMIDD
POLICY EXP
MM1DD
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
6X3364124
6101r2024
06/01/2025
EEACH�OECCTURRENCE
$1 000000
CLAIMS -MADE — OCCUR
PREMISES EaEocccuErrence
000,000
x
MED EXP (Any one person)
s5,000
PD Ded: 250
PERSONAL & ADV INJURY
$1 000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
s 2,000,000
POLICY ECTT LOC
PRODUCTS -COMPIOPAGG
$2,000,000
$
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea adent
BODILY INJURY (Per person)
$
ANY AUTO
OWNED F SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per aaadenl
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
$
UMBRELLA LIAR
EACH OCCURRENCE
S
HOCCUR
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED I I RETENTION $
$
WORKERS COMPENSATION
PER OTH-
TA LITE EIR
AND EMPLOYERS' LIABILITY Y I N
OFFICERIPROMEM ER EXCLUDED ECUTIVE 7
I
N 1 A
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
(Mandatory In NH)
It yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
A
Property
6X3364124
6101r2024
06/011202
1,990,000 Buildings
90% Coinsurance
100,000 BPP
$500 Deductible
100.000 Business.lnco e
DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) BALD CLKRK
Property at 519,521 & 605 Dishman, Caldwell, ID.
Caldwell Airport Manager City of
Caldwell
4814 Linden
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
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2096103) 1 of 1
#S 1959910IM 1959907
The ACORD name and logo are registered marks of ACORD
TERPE