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�� CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDIYYYYj
0312812024
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 condltlons 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
NOINT,' CT keefan Caron
PHONE 208-618-2085 FAXfAfc, 2O&-375-2180
INC. Me. Rufl!Keefan
Caron
E4WL
DRE S:
INSURERS AFFORDING COVERAGE
NAIL tl
1250 S Allante Ave
INSURERA: Western Community Insurance Company
39519
Boise ID 83709
INSURED
INSURER B :
INSURER C :
INSURER D :
Gary Isaacs
INSURER E :
6226 W Braveheart St
INSURER F :
Eagle ID 83616
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
LTR
TYPE OF INSURANCE
ADOL
SUBR
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ED OCCUR
N
N
BV313601
03112r2024
03/12r2025
EACHOCCURRENCE
$ 1,000,000
PREMISES Ma occurrence
$ 100,000
MEP EXP (Any oneperson)
$ 5,000
PERSONALSADVINJURY
S 1,000.000
GENL AGGREGATE LIMIT APPLIES PER:
POLICY ❑ PRO-
JECT � LOC
OTHER:
GENERAL AGGREGATE
$ 2.000,000
PRODUCTS - COMPIOP AGG
s 2,000.000
$
A
AUTOMOBILE LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
COIa61 QED SINGLE LIMIT
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per aoddent)
$
PROPERTY DAMAGE
Per ecdtleot
$
$
A
UMBRELLALIAa
EXCESS LIAR
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
S
DED I I RETENTION
S
WORKERS COMPENSATION
AND EMPLOYERS' LIABILRY YIN
ANYPROPRIETORIPARTNERIEXECUTIVE ❑
OFFICERIMEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS belaw
NIA
PER OTH-
STAT R
E.L. EACH ACCIDENT
S
E.L. DISEASE - EA EMPLOYE
S
E.L. DISEASE - POLICY LIMIT
S
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If mane space Is required)
5515 Aviation Way #922
CERTIFICATE HOLDER CANrFI I ATICIN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Caldwell Airport
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Caldwell
AUTHORIZED REPRESENTATIVE
4814 E. Linden
Caldwell ID 83605
-
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ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD