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HomeMy WebLinkAboutIdaho Vintage Motorcycle ClubA`� EP CERTIFICATE OF LIABILITY INSURANCE °A�+%22i2oa�+ 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 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 Western Community Ins CO CONTACT NAME: BAXTER KERRY M PHONE tag_ aa_ a A FAX No): 208-232-360e PO i3ox 4848 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAICB Pocatello, ID 83205-4848 INSURER A : Western Community Ins CO 39519 INSURED 1 f ��u�rri��n��lrel�n�l�nr�r�lrl�ln��rr�r�nrl�r�� IDAHO VINTAGE MOTORCYCLE INSURER B : INSURERC: INSURER0: CLUB INCORPORATED INSURERE: 11 1R1 I D HIREgLES DR 3 9 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: AF0670 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. ILTR NSR I TYPE OF INSURANCE IU L LAM SUER POLICY NUMBER POLICY MMIDDIYYYY MMfDn�Y LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 51OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: RO LOC X POLIGY PECT Y N 8c9674ol 5/17/24 5/17/25 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5.000 PERSONAL RADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ INCLUDED $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT a aociden $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ ;� O��i a DAMAGE $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ 4 AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ (Mandatory in NH) II yes, describe under DESCRIPTION OF OPERATIONS below N I A WC STATU- I OTH- TORY LIMITS ER E-L EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L DISEASE - POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RECERmO BY 0401v%fl L l;i (Y rl =H)( OR CERTIFICATE HOLDER CANCELI_ATInN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN t I�Il�rrt��tl��ll��ltla��alral��err���rar��r�er�r�ll� CITY Of CALDWELL ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE PO BOX 1179 CALDWELL ID $3606 ACORD 25 (2010105) ©1988-2010 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD