HomeMy WebLinkAboutTerra-West ConstructionAC<> & CERTIFICATE OF LIABILITY INSURANCE
DAT0S/MO24
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 he endorsed. It
SUBROGATION IS WAIVED, subject t0 the terms and conditions of the policy, certain policies may require an erNlorsement. A statement an this
certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
FEDERATED MUTUAL INSURANCE COMPANY
HOME OFFICE: P.O. BOX 328
NAME; CLIENT CONTACT CENTER
PHONE FAX
!A/C. No, Ex* 888-333-4949 fAlC, Itol: 507-4454664
ADDRESs:CLIENTCONTACTCENTER FEDINS.COM
OWATONNA, MN 55060
INSURERS AFFORDING COVERAGE
NAIC p
INSURER A:FEDERATED MUTUAL INSURANCE COMPANY
_ 139_35
INSURED 199-258-5
INSURER B:
INSURER C:
TERRA -WEST, INC.
9990 W STATE ST
BOISE, ID 83714.3613
INSURER D.
INSURER E!
INSURER F,
COVERAGES CERTIFICATE NUMBER: 64 REVISION NUMBER; 0
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE: INSURED NAMED ABOVE FOR THE POLICY PER OD INDICATED
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W TH RESPECT TO WHICH TH S CERTIFICATE MAY BE
ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CORO TIONS OF
SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TYPE OF UJSURANCE
ADDLPOLICY
F
02/2M024
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OOCCUR
Y
N
984178-D
DR.25+2'.25
EACH OCCURRENCE
$1,000,000
AMAOE TOrm ELATED PREMISES
$100,000
MED EXP lAnr am person)
S5,DD0
CENL
tHFA:
AGGREGAIT—E —LILMIT APPLIES PER:
LICY I k1ECT �LOC
PERSONAL d ADV INJURY
$1,000 000
2
GENERAL AGORE
PRODUCTS ItCOMPIOPAGO
$2,000,000
A
AUTOMOBILE LIABILITY
X ANYAUTO
OWNED AUTOS ONLY AURQULED
HIRED AUTOS ONLY NON -OWNED AUTOS ONLY
N
N
9841789
02120/2024
C2128/2025
�Id1
Ea.. den SINOLE LIMIT
$1,000,000
BODILY INJURY JPer Parsanl
BODILY INJURY (Par Accldeno
ROPER DAMAGE
A
X
UMBRL.L-A LIAR
EXCESSLIAB
OCCUR
MCLAIMS -MADE
N
N
9$4'790
02/26/2024
02/28/2025
EACH OCCURRENCE
$2,000,000
AGGREGATE
$2.000,000
DED I RETENTION
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTHERI EXECUTIVE
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH I
11 yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
N
1811843
02/28I2O24
02=12025
X PER STATUTE OTHER
E.L. EACH ACCIDENT
$1,000,000
E .L DISEASE EA EMPLOYEE
g1,000,000
C.I. DISEASE • POLICY OMIT
$1,0130,000
DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES WORD 101. Additional Remarks Schedule. may be aeaehed It mere space If required)
THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY.
4tKI11•ICA1t NVLLILK n' n;�wov"l iff ww G,rv,1
199-258-5 -,L hr, 64 O
CITY OF CALDWELL SHOULb ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
621 CLEVELAND BLVD�` n f� ���� BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
CALDWELL, ID 83605-4052 1 J ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE Altvf `
0 1SM-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2018f03) The ACORD name and logo are registered marks of ACORD