HomeMy WebLinkAboutSteven GrahamA QRD CERTIFICATE OF LIABILITY INSURANCE DATE
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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 INSURERS), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(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 confel rf itfti'ttiINWcertificats holder in lieu of such endorsement a .
PRODUCER - CONTACT Keefan Caron
Keefan Caron
1250 S Allante Ave
Boise
INSURED
PHONE
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ADDRESE'
INSURE S AFFORDING COVERAGE NAICN
ID 83709 INSURER A: western Community Insurance Company 39519
INSURER S.
INSURER C :
Steve Graham INSURER 0,
1719 E Spruce St INSURER E:
Caldwell ID 83605 INSURER F :
C-nVFRA11.Fl4 PFRTICIf ATC NI IURCO- OCUICIeW srr Iuocn.
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
LTR
TYPE OF INSURANCE
AADL
SUaR
POLICY NUMBER
POLICY EFF
POLICY EXP
fMf4VDDMYYI
LIMIT$
A
X
COMMERCIAL GENERAL LIABILITY
z/
CLAIMS-MADE I^ I OCCUR
N
N
83963603
02/07/2024
02/07/2025
EACHOCCURRENCE
DAI�iAr;E roRENYE"D-
PREMISEB{Eaggairrem)
MED EXP (Any oneparson)
S 1.000,000
S 100,000
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L
X
AGGREGATE LIMIT APPLIES PER:
POLICY JET Loc
OTHER:
GENERALAGGREGATE
$ 2.000.000
PRODUCTS -COMPIOPAGO
S INCLUDED
S
A
AUTOMOBILE LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
COMBINED SINGLE LIMIT
acadent
S
S
BODILY INJURY (Per person)
BODILY INJURY (Par accident)
$
PROPERTY DAMAGE
Per a.Q'
$
S
A
UMBR£LLALIAS
EXCESS LIAR
OCCUR
CLAIMS -MADE
EACHOCCURRENCE
$
AGGREGATE
S
DED I I RETENTION
S
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETORIPARTNERtEXECUTIVE
OFFICEWMEMBEREXCLUDED7 El
(Mandatory In NH)
If yes desa@e under
DESCRIPTION OF OPERATIONS below
N I A
PER OTH-
STATUTE I I ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
S
$
E.L. DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS r LOCATIONS t VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It mwe specs is requ red)
5515 Aviation Way #1027
CERTIFICATE HOLDER CANCI=I I ATInN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Caldwell Airport
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Caldwell
AUTHORIZED REPRESENTATIVE
4814 E. Linden Road
Caldwell ID 83605
64
{/ W 19a8-2015 ACORD CORPORATION. All Fights reserved.
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