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Home My WebLink AboutPsycological DimensionsDATE (MWDDfYYYY) ,4coRv® CERTIFICATE 4F LIABILITY INSURANCE 06111I2024 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 certflcate holder in lieu of such endorsements . PRODUCER CONTACT NAME: American Family Insurance - Business Insurance American Family Insurance - Business Insurance PHONE FAX PO Box 5316 (AIC, No, Exq: 866-908-0626 (A/C, No): Binghamton, NY 13902 EMAIL ADDRESS: service@amfambusinessinsurance.com INSURERS) AFFORDING COVERAGE NAIC p INSURER A: Midvale Indemnity Company 27138 INSURED INSURER B : INSURER C : PSYCHOLOGICAL DIMENSIONS INSURER D : 6696 S DAYTON ST STE 2300 1 INSURER E : GREENWOOD VLG CO 80111 INSURER F : COVERAGES CERTIFICATE NUMBER: 339410161225156105554270611 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 TYPE OF INSURANCE ADDL INSR SUER WVD pOl)GY NUMBER POLICY EFF MWDDIYYYY POLICY EXP MWDOlYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000 A CLAIMS -MADE X❑ OCCUR Y N BPPI017402 01/0112024 01/0112025 DAMAGE TO RENTED PREMISES Ea occurrence $50,000 MED EXP (Any one person) $5.000 PERSONAL & ACV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 X POLICY ❑ JECT PRO- LOC PRODUCTS - COMP/OP AGG $4,000,000 OTHER: AUTOMOBILE LIABILITY 0,A{.o'JIELL (, IY 6. COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) ANY AUTO OWNED SCHEDULED L I /'� BODILY INJURY AUTOS ONLY AUTOS Per accident PROPERTY DAMAGE HIRED NON -OWNED AUTOS ONLY AUTOS ONLY (Per accident) MBRELLALIAB UR EACH OCCURRENCE AGGREGATE XCESS LIAB LoMMS-MADE DED RETENTIONS WORKERS COMPENSATION PER I OTH I AND EMPLOYERS' LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNERIEXECU -TlVe0rF1CeRrMeM5FREXtUU0ED? NIA E.L. EACH ACCIDENT (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT PROFESSIONAL LIABILITY OCCURRENCE AGGREGATE DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attaehed if more apace is required) Physicians and Surgeons Office CERTIFICATE HOLDER CANCELLATION CITY OF CALDWELL PO BOX 1179 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) The ACORD name and logo are registered marks of ACORD