HomeMy WebLinkAboutYour Buildings ImageA� �® CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDlYYYY,
o21o9r2a24
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 INSURERIS), 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 endorsement(s).
PRODUCER
CONTACT Amy Van Ry
NAME:
Ballenger Insurance
P O BOX 450
PHONED (208) 466-89" FAX
No; (208) 465 0539
E-MAI L AMY@BALLENGERI NSU RANCE COM
ADDRESS:
INSURE S AFFORDING COVERAGE
NAIC N
INSURERA: ACUrty
NAMPA ID 83653
INSURED
INSURER B: AMTRUST NORTH AMERICA. INC
DOUG SHEPHERD, DBA. YOUR BUILDINGS IMAGE
INSURERC:
22177 MARKET RD
INSURER D :
INSURER E :
PARMA ID 83660
INSURER F :
COVERAGES CERTIFICATE NUMBER: CL234503577 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE 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
POLICY NUMBER
MMIODIYYYYY
POLICY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ® OCCUR
EACH OCCURRENCE
s 1 000.000
PREMISES Ea occurrence
$ 100 000
MED EXP (Any oneperson)
s 5 000
PERSONAL 8 ADV INJURY
S
A
Y
ZQ3286
02116/2024
02/16/2025
GEN'LAGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE
S 2000.000
X POLICY jRa El LOC
PRODUCTS - COMPtOPAGG
S 2000.000
S
OTHER
AUTOMOBILE LIABILITY
COMBINED SINGLE LIM T
Ea accident
s 1000.000
BODILY INJURY 1Perperson:
S
ANYAUTO
A
OVMED SCHEDULED
AUTOS ONLY AUTOS
ZQ3286
02116/2024
02/1612025
BODILY INJURY Wer a:; -dent}
S
X HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAC-E
Per accident
s
S
UMBRELLA LIAB
HCLAIMS-MADE
OCCUR
EACH OC,.URRENI" E
S
RIEXCESS
AGGREGATE
$
LIAB
DED I I RETENTION S
s
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y 1 N
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICERJMEMBEREXCLUDED?
(Mandatory In NH)
NIA
WWC3643$$7
03H612023
03116I2D24
PER I I oTH.
STATUTE I ER
ElEACHACCIDENr
$ 500 000
El DISEASE � EA EMPWYEE
s 500 000
It yes, describe under
DESCRIPTION OF OPERATIONS below
E-L DISEASE POL ;:Y I IMIT
S Sao 000
WORKERS COMP
EACHACCIDENT
$500.000
B
WWC3643887 (RENEWAL)
03/16/2024
03/16/2025
EACH EMPLOYEE
$500.000
POLICY LIMIT _
$500.000
DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space Is required) GALOWELL Ci IY CL_s
F EB .1 (1 2024
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
CITY OF CALDWELL
ACCORDANCE WITH THE POLICY PROVISIONS.
PO BOX 1179
AUTHORIZED REPRESENTATIVES
CALDWELL ID 83606
I / m, vhn
01988-2015 ACORD CORPORATION. All rights reserved.
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