HomeMy WebLinkAboutBrad JeppesonCERTIFICATE OF LIABILITY INSURANCE DATEIMWODIYY"
_ 11/16/2021
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(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 ri hts to the Certificate holder in lieu of such endorsements .
PRODUCER c cr Dakota Stallions
PHONE 208-365-5382 FAQ o. 208-365-2465
Dakota Stallions ED I , dstallions@ldfbins.Gom
1312 S Washington Ave, Ste D INSURERS AFF RAINA COVERAGE NAIC 9
Emmett 1D 83$17 INSURED INSURER A . Westem Community Insurance Company 39519
BRAD JEPPESEN
INSURERO:
PO BOX 1371
INSURER E
CALDWELL ID 83606 INSURERF:
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
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
TERMS,
_IQTRINSR TYPE OF INSURANCE I ADOL R POLICY NUMBER MOLICY EF MNOtop
LIMITS
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE 191 OCCUR
EACHOOCURRENCE ; 1,000,000
A
E S S Ea caurre ; 100,000
A
MED EXP (Anyone person) ; 5,000
N N $M543601 02/06/2024 02lO6I2025
PERSONAL &ADV INJURY ; 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY ❑ 0 LOC
GENERALAGGREGATE ; 2.000,000
JECTPRC.
PRODUCTS -COMPIOPAGO ; INCLUDED
OTHER:
S
AUTOMOBILE LIABILITY
EDSINGLELIMT ;
ANY AUTO
a danll
BODILY INJURY (Par paman) ;
A OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per acddent) S
HIRED NON -OWNED
AUTOS ONLY AUTOSONLY
PR 'ER OAMA E S
P r I
i
UMBRELLALIAB
OCCUR
OCCURRENCE
S
AGGREGATE
;
A
EXCESS LIAR
CLAIMS -MADE
}EACH
{
OED RETENTIONS
S
WORKERS COMPENSAT10N
PER OTH
AND EMPLOYERS' LIABILITY YIN
j1TUTE ER
E.L. EACH ACCIDENT
S
A
ANYPROPRIETOWPARTNERIEXEC4TIVE
OFFICERIMEMBEREXCLUDED?
NIA
(Mandatory In NH)
If yyeea, des. -Abe under
E.L. DISEASE, - EA EMPLOYEE
S
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS/ LOCATIONS IVEHICLES (ACORD 101, AddItIonal Remarks Schedule, maybe attoohoil 11 more space Is raqwkeai - it.
RAI
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
CITY OF CALDWELL
4814 E LINDEN STREET
CALDWELL ID 63605
U 1a05-4U10 AUUKD CURPURATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD