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A`ORU CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIODIYYYY)
a5/08/2024
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(les) 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 1
coila Keefan Caron
NAME•
FPHONE 208-61B-2085 AjrXC No 208-375-2180
C,l
_AaE�Okcaron@idfbins.com
INSURERS AFFORDING COVERAGE
NAiC f
INSURERA: Western Community Insurance Company
39519
INSURED
Robert Denton
5615 Meadow Ct
Nampa ID 83687
INSURER B :
INSURER C .
INSURER D :
INSURER E.-
1 INSURER F :
rnvFQAr_Fc rFRTII=IrATF NIIMRFR- 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
SUER
POLICY NUMBER
POLICY EFF
POLICY EXPLTR
LIMITS
A
X
COMMERCIAL GENERALLIABILITY
CLAIMS -MADE FROCCUR
N
N
8DO42501
05/04/2024
05/04/2025
EACH OCCURRENCE
S 1,000,000
DAMAGE TO
PREMISES Ea �rrenoe
$ 100,000
MED EXP (Any onePerson)
S 5,0D0
PERSONAL S ADV INJURY
S 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY ❑ JECT LOC
OTHER:
GENERAL AGGREGATE
$ 2.000.000
PRODUCTS -COMPIOPAGG
S INCLUDED
E
A
AUTOMOBILE LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
i
COMBINED SINGLE LIMIT
Ea a ddenti
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTYOAMAGE
Per accici
$
S
A
UMBRELLALIAB
EXCESSLIAB
OCCUR
HCLAIMS-MADE
EACH OCCURRENCE
S
AGGREGATE
S
DIED I I RETENTION S
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETOWPARTNERIEXECUTWE
OFFICERIMEMBER EXCLUDED?
(Mandatary In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
I PR
STATUTE ER
E.L. EACH ACCIDENT
f
E.L. DISEASE - EA EMPLOYEE
S
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mom space is required)
Hangars 244,291,293 & 294 @ 4321 Aviation Way
I=
City of Caldwell
Caldwell Airport
4814 E Linden St
Caldwell
U)E:kI:ilI.'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 REPRESENTATIVE
01986-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD