HomeMy WebLinkAboutTimberlake Construction LLC,�� vrxv" CERTIFICATE OF LIABILITY INSURANCE OATEIMM/DO
12/0B1202323
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 COVE RAOE 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 It the certificate holder is an ADDITIONAL INSURED, the polic-Ails) must have ADDITIONAL INSURED provisions Or be endorsed. If
SUBROGATION IS WAIVED, subject to the terns 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 endorsement(s).
PRODUCER
FEDERATED MUTUA. NSURANCE COMPANY
HOME OFFICE: P.O BOX 328
O
NAAME CT CLIENT CONTACT CENTER
PHONE FAX
JAM. No. Bail: WO-333-4949 IA/C, Nal: 507-4464664
ADOREss:CLIENTCONTACTCENTER FEDINS.COM
CMIATONNA, MN 55060
INSUNERS AFFORDING COVERAGE
NAIC Y
INsumam A:FEDERATED MUTUAL INSURANCE COMPANY
13935
INSURED 189-9667
INSURER 0:
TIMBERLAKE CONSTRUCT'ON LLC
PO BOX 274
INSURER C:
INSURER D:
WILDER, ID 63676-0274
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 49 REVISION NUMBER: 0
THIS ;S 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 CR 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.
INSA TYPE OF INSURANCE i 3 POLICY NUMBER PO r ii POLICY XP
LIMITS
X COMMERCIAL OEkERAL LIAIULITY
EACH OCCURRENCE
$1,DDO,000
' CLAIMS -MADE OCCUR
E TO ENFED PAEWSES
$100,000
MED EXP IA-y era parson)
EXCLUDED
A
N N
9941585
01/01/2024 OlMlt2M
j
PLRSOHALA ADVINJURr
$1.0w.000
ummo
OENL AGGREGATE LIMIT APPLIES PEA :
PRODUCTS 6 OOMPlOP AGO
$2.000,000
I6
X POLICY CF LOC
I
OTHER
AUTOMOBILE LIABILITY
COMBINEEDOSINOLE LIMIT
iBBODILY
s1,000,000
X ANYA„TO
INJURY War PermoN
A cw1EDAIITOSapILY1-- N SCTH&u FD N N 9841585
HIRE AVTOS ONLY AUTOS
(ANEW OONLY
.AUTOS I
01/01/2024
011' 'IFM e001LY INJURY IPar Accld.no
�lVr 00
i PROPE DAMAGE
X
UkIBREL_ALIAB XOCCUR
EACH OCCURRENCE
V.000000
A
EXCESS LIAB CLAIMS -MADE i N N I 1850487
01/01/2024
614112025
AGGREGATE
32,000,0DO
I
:DED I �RETENTICG
WORKERS COMPENSATN)N
AND EMPLOYERS' LIABILITY VIAI
ANY PROPRI£TOR/PARTNERI E><ECUT14rE
A, �OFFICEFUMEMBER EXCLUDEDT NIA N
(Mandatory In NN)
18107S2 01/0112024 011G1 5
t
X PER STATUTE THER
E.L EACH ACCIDENT
=1.000,000
E.L DISEASE EA EMPLOYEE
$1 000.000
-11 Yes. describe under
DESCRIPTION OF OPERATIONS b.1—
E.L OISEASt - POLICY LIMIT
i1 D01,000
I
DESCRIPTION OF OPERATION$ r LOCATIONS I VEHICLES IACONO 101. AAdSonal A.marks Sthed.I.. may be aNaehed -1 Iaere span -s r"airedl
CERTIFICATE HOLDER CANCELLATION
189.965-7
CITY OF CALDWELL
PO BOX 1179
CALDWELL, 10 83606•'.1.79
49 0 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPAESENTAT VE r f1I fl �
O 1988•2015 ACORD CORPORATION AN rights reserved.
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