Loading...
HomeMy WebLinkAboutPavement Specialists of IdahoPAVESPE-01 ESHULTZ OATE1/202YYYY) 811l2024 CERTIFICATE OF LIABILITY INSURANCE 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 endorsements . PRODUCER C NTACT Boise Office Marsh McLennan Agency LLC 960 Broadway Avenue Suite 500 Boise, ID $3706 PHONE FAX AlC, No, ERt : (208) 424.2900 (AIC. No :(877) 512-2753 INSURERS AFFORDING COVERAGE NAIC M INSURER A: Em l0 ers Mutual Casual Company 21415 INSURED INSURER B : WCF National Insurance Company 40517 INSURER C : Pavement Specialties of Idaho, Inc. INSURER D : 4850 Henry St. Boise, ID 83709-5643 INSURER E INSURER F nnVFRACSFA rFRTIFICATF MIIMRFR- RFVICIrk1J Ml IIURGR- 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 AODL SUBR POLICY NUMBER POLICY EFF POLICY EXPrYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FA] OCCUR X 6DI7715 3115/2024 3/15/2025 EACH OCCURRENCE 10000,000 DAMAGE TO RENTED PREMISES (Ea occurLeacal— 500,000 $ MSD EXP (Any one personl $ 10,000 PERSONAL ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY IXI za- LOC OTHER: GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMPIOP AGG 3,000,000 EMPLOYEE BENEFI 31000,000 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOSONLY AUTOS yy p AUTOS ONLY X AUTO ON Y X 6E17715 311512024 3115/2025 COMBINED SINGLE LIMIT $ 1,000,000 X BODILY INJURY Per arson $ INJURY Per accident) X pBODILY PeOaccident AGE A X UMBRELLA LIAO EXCESS LIAR X OCCUR CLAIMS -MADE 6.117715 311512024 311512025 EACH OCCURRENCE $ 5,000,000 AGGREGATE 5,000,000 DIED RETENTION$ 0 B WORKERS ND EMPLOYERS' LIABILITYCOMPENSATION ANYPROPRIETORWARTNERIEXECUTIVE YIN QFFICER/'M t EXCLUDED? andatory in NHj I yes, describe under DESCRIPTION OF OPERATIONS below N I A 3500297 11112024 11112025 X PER OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)ZEC E)V t1.1 Project: LID 24-1, and LID 24-2 CFlLDWELLC4TY CLERK Additional Insured where required by contract per attached forms SEp 3 0 2024 City of Caldwell PO Box 1179 Caldwell, ID 83605 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 HO ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD