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A� o CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDD/YYYY)
05108/2024
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 certificate holder In lieu of such endorsements .
PRODUCER
Keefan Caron
1250 S Allante Ave
Boise ID 83709
cGNTACT Keefan Caron
NAME•
PHONE208-618-2085 JA No, 208-375-2180
EaYIAIREL kcaron@idfbins.com
ADD
INSURERS AFFORDING COVERAGE
NAIC i
INSURER A: Western Community Insurance Company
39519
INSURED
Lucky Dog Land Company LLC
4003 Preston Ave
Caldwell ID 83605
INSURERS;
INSURER C :
INSURER D :
INSURER E :
INSURER F :
I'AV GO AA=0 PenTICICaTC IM111URFr?- 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.
ILT R
TYPE OF INSURANCE
ADDL
SUER
POLICY NUMBER
POLICY EFF
MMIDDrfYYn
POLICY EXP
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE N OCCUR
N
N
BV532201
03/17/2024
03/17/2025
EACH OCCURRENCE
S 1,000,000
PREMISES Ea ocwrrenoe
E 100,000
MED EXP An one icon
$ 5,000
PERSONAL&ADVINJURY
$ 1,000,000
�G/EN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO- LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS -COMPIOPAGG
S INCLUDED
$
A
AUTOMOBILE LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
COMBINED SINGLE LIMIT
Ea .DI
S
BODILY INJURY (Per person)
S
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Pe ea�dent
$ _
S
A
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
Id
AGGREGATE
$
DIED I I RETENTION
$
WORKERS COMPENSATIONTP
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETORIPARTNERIEXECUTIVE ❑
OFFICERIMEMBEREXCLUDED7
(Mandatory in NH)
n yes. dewdw wider
DESCRIPTION OF OPERATIONS below
NIA
STATUTE ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
S
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional RemerM Schedule, may be altachad N more space Is required)
Hangar#272
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City Of Caldwell
ACCORDANCE WITH THE POLICY PROVISIONS.
Caldwell Airport
AUTHORIZED REPRESENTATIVE
4814 E Linden St
Caldwell ID 83605
(D1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD