HomeMy WebLinkAboutHerbert & Hai LongworthA OR ® CERTIFICATE OF LIABILITY INSURANCE DAT6/2112D/YYYY)
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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(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 rights to the certificate holder In lieu of such endorsements .
rONTACT KeefanCaron
PRDDUCER AME:HONE s 208-618-2085 Nat; 208-375 2180
Keefan Caron
1250 S Allante Ave
Boise
INSURED
ID 83709 I INSURERA. Western Community Insurance
39519
Herbert And Hai Longworth INSURER D :
5615 Meadow Ct INSURER E
Nampa ID 83687 INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
THIS IS TO CERTIFY THAT
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
INDICATED. NOTWITHSTANDING
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 ADDL BURR POLICY NUMBER POLICY EFF POLICY EXP
LIMITS
X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $ 1,00,000
CLAIMS -MADE a OCCUR
PREMISE Ea occurrence S 100,000
MED EXP (Any oneperson) S 5.000
A N N SDD42501 05/04/2024 135A)4/2025
PERSONAL & ADV INJURY S 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE S 2.000,OD0
X POLICY 0 jECT DLOC
PRODUCTS -COMPIOPAGO S 2.000,000
a
OTHER:
SINGLE LIMIT $
AUTOMOBILeUAaILrTY
(E08aINED
ANY AUTO
BODILY INJURY (Per person) $
A OWNED SCHEDULED
BODILY INJURY (Per sccldenl) S
AUTOS ONLY AUTOS
HIRED NON-OWNEO
PROPERTY DAMAGE S
AUTOS ONLY PAUTOS ONLY
jPer accident
i S
UMBRELLALIAe
OCCUR
EACH OCCURRENCE
$
AGGREGATE
S
A
EXCESS LIAS
CLAIMS -MADE
DED I I RETENTION
S
wORKERSCOMPENSATION
ISVARTUTEERH
AND EMPLOYERS' LIABILITY
Y❑
ANYPROPRIETORIPARTNERIEXECUTNE
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
OFFICERIMEMBEREXCLUDED?
(Mandslory In NH)
NIA
E.L. DISEASE -POLICY LIMIT
$
It yes, describe under
DESCRIPTION OF OPERATIONSbelow
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD tilt, Additional Remarks Schedule, may be attached if more space is required) IiFCFiVr0 BY
I . , rY CLERK;
5515 Aviation Way Hangar 202 & 212
AUG I ? 20M
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 Road
Caldwell ID 83605
W I%PUB-LD10 At:UKLJ L:UKYUKA r lU111. An rignts reserveo.
ACORD 25 (2046/03) The ACORD name and logo are registered marks of ACORD