HomeMy WebLinkAboutRuben AsumendiV1 ) ��
UBILFAR-01 EMARTI
14`C1111R EP, CERTIFICATE OF LIABILITY INSURANCE
DAT414/2 DIYYYY,
14/2024
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 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 endorsements .
PRODUCER
ACT
Deal Insurance
917 2nd Street South
HTN E:, ; {2D8) 4fi6-24fi5 FC A X' No ;{2013) 4fi6-2471
Mkss,thc@thehartwelicorp.com
Nampa, ID 83657
INSURER(S) AFFORDING COVERAGE
NAIC A
INSURERA-Granite .State Insurance Co
INSURED
INSURER B
INSURER C :
Ruben Asumendi
INSURER D:
23032 Highway 20126
Parma, ID 83660
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER-- REVICInN 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
XL
POLICY EXPLTR
1NM29a=
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE 0 OCCUR
X
02-LX-089476940-1
3/22/2024
3i22I2025
EACH OCCURRENCE
S 1,000,000
DAMAGE TO RSESE,ENTED
PR.Moccurrencel
MED EXP (Any oneperson)
PERSONAL 8 ADV INJURY
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY Eljra- LOC
OTHER:
GENERAL AGGREGATE
2,000,000
PRODUCTS-COMP/OP AGG
$
AUTOMOBILE LIABILITY
ANY AUTO
OWNED SCHEDULED
AURTEO�S ONLY AUUT�OpSyyN n
AUTOS ONLY AUTOS ONLY
COMBINED (Ea a dent,SINGLE LIMIT
$
BODILY INJURY Per
BODILY INJURY Per accident
S
PPeOarlent AMAGE
S
S
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
DED I I RETENTIONS
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y I N
ANY PRO RIIETOEREJIPARTNERRI ECUTIVE ❑
�ulandYatory En NH)
If Yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
PER OTH-
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
S
E.L DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101. Addhional Remake Schedule, may be attached If more space Is required)
Insurance coverage for the hangar at 517 Dauntless Place, Caldwell, ID 83605
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Treasure Valley Executive Airport
4814 E Linden
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Caldwell, ID 93605
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016103) 01988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD