HomeMy WebLinkAboutTabor Construction IncACOR7 0 CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDomrY)
09/13/2022
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
CONTACT
NAME: Jason Gardner
Jason Gardner
PNONE 208-401-0132 FVC No,: 208-401-0137
EMAIL
ADDRESS:
525 S Middleton Rd, STE 100
INSURERS AFFORDING COVERAGE
NAIC t
INSURER A: Western Community Insurance Company
39519
Middleton ID 83644
INSURED
INSURERS:
INSURERC:
Tabor Construction Inc
INSURER D :
28277 Country Ln
INSURER E :
INSURER F
Caldwell ID 83607
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
TYPE OF INSURANCE
ADDL
UBR
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMBS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE I X OCCUR
PREMISES Ea occurrence
$ 100,000
MED EXP (Any one person)
S 5,000
_
PERSONAL d ADV INJURY
S 1,000,000
A
_
N
N
8N607801
02115Q024
02115/2025
GEWL
GENERAL AGGREGATE
$ 2,000,000
AGGREGAT E LIMIT APPLIES PER-.
X
POLICY 1 JECT LDC
PRODUCTS - GOMPfOP AGG
$ no coverage
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
(Ea accident
$
BODILY INJURY (Per pecan)
S
ANY AUTO
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
$
X
UMBRELLALIAB
X
OCCUR
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$
A
EXCESS LIAe
CLAIMS -MADE
N
N
UN607802
02115/2024
02/15/2025
DED I X I RETENTION 10,000
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
OFFCEOPRIETOERPARTNE EXECUTIVE ❑
N!A
PER OTH-
STATUTE I I ER
E.LFACHACCIDENT
$
(Mandatory In NH)
E.L. DISEASE -EA EMPLOYEE
S
If es, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached If more space Is required)
In regard to locations:
501 Dauntless PI, Caldwell ID
505 Dauntless PI, Caldwell ID
509 Dauntless PI, Caldwell ID
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.
4814 E Linden St
AUTHORIZED REPRESENTATIVE 9�a� �L
Caldwell ID 83605
?74!f
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