HomeMy WebLinkAboutCanyon County Pickleball ClubACORO® CERTIFICATE OF LIABILITY INSURANCE
DATE(MMfDDIYYYV)
0610612024
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 endorsement(s).
PRODUCER
NAME T Jeff Cevenger
Mustard Seel! Financial 8 Ins.
PHONE (208) $77-5577 A (208) 939-1780
AtC No ERt : AIC No
501 S Main St
ADDRESS: ,ef @?rnseedflnancial.Com
INSURER(S) AFFORDING COVERAGE
NAIC 0
Meridian ID M42
INSURERA: Ohio Security insurance Company
24082
INSURED
INSURER B .
Canyon County Pickleball Club
INSURER C :
19283 Goldfn�h Way
INSURER D-
INSURER E:
Caldwell ID 83605
INSURER F :
COVERAGES CERTIFICATE NUMBER: CL2443035612 RpVISIrtm mlMptFR-
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTAND NG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN I$ SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIOW. OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PALD CLAIMS.
INSR
LTR
TYPE OF INSURANCE
AVUL
INSD
5UUM
WVO
POLICY NUMBER
POLICY EFF
MMIDDIYYYY
POLICY EXP
MMXIDIYYYY
LIMITS
COMMERCIAL GENERAL LIABILITY
CLA.ML-MADE Fx—] OCC. R
EACH OCCURRENCE
$ 1,000,000
PREMISES Ea occurrence
$ 1,000,000
MED EXP (Any one person)
$ 15,000
PERSONAL &ADV INJURY
$ 1,000,000
A
Y
BKS65911870
C512I2024
05112/2025
GEN'LAGGREGATE LIMITAPPLIES PER:
X RO-
POLICY ❑ JECT Lac
GENERALAGGREGATE
$ 2,000,000
PRODUCTS -COMPIOPAGG
$ 2,000,000
OTHER:
GL Non Owned Auto
$
AUTOMOBILE LIABILITY
SOMBM1ED SINGLE LIMIT
Ea accident
$
BODILY INJURY (Per person)
$
ANYAUTO
OWNED SCHEDULED
AUTOSONLY AUTOS
BODILY1 INJURY (Per accident
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
(per..
$
5
UMBRELLA LIAR
OCCUR
Id
EACH OCCURRENCE
5
AGGREGATE
$
EXCESS LIAR
CLAIMS -MADE
DED I I RETENTION 5
s
WORKERS COMPENSATION
PER OTH.
AND EMPLOYERS' LIABILITY YIN
STATUTE ER
E L EACH ACCIDENT
S
ANY PROPRIETORIPARTNERIEXECUTIVE ❑
OFFICERIMEMBER EXCLUDED?
NIA
E L DISEASE - EA EMPLOYEE
$
(Mandatory In NH)
11 yes. describe under
E L DISEASE - POLICY LIMIT
S
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required)
Certificate Holder is included as Additional Insured as respects to General Liability
Cty of Caldwell Parks & Rec
P.O. Box 1179
Caldwell
ID 83606
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 REPRESENTATIVE
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD