HomeMy WebLinkAbout5K Services LLC.d►coRrO® CERTIFICATE OF LIABILITY INSURANCE
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DATE(MMIDDNYYY)
05/02/2024
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(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 LEANN PULLMAN
NAME:
LEANN PULLMAN AGENCY
PNONE 208-505-6363 FAXNo ; 208 505 4757
ADDRESS, Ipullman@idfbins.com
INSURERS AFFORDING COVERAGE
NA1C #
3050 12TH AVE RD
INSURERA: Western Community Insurance Company
39519
NAMPA ID 83686
INSURED
INSURER B :
INSURER C :
5 K SERVICES LLC
INSURER D :
% BRET KIMMEL
INSURER E :
607 FAIRHAVEN
INSURER F :
MIDDLETON ID 83644
COVERAGES CERTIFICATE NUMBER: 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 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.
I�TR
TYPE OF INSURANCE
ADPL
SUBR
POLICY NUMBER
EFF
MMI�DIYYYY
MCY
MI POLICY
LIMITS
A
X
COMMERCIALGENERALLIABILITY
CLAIMS -MADE L"] OCCUR
Y
I
Y
8V966601
05/01/2024
ftOUM5
EACH OCCURRENCE
$ 2,000,000
PREMISES Me -occurrence)
$ 100,000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
G£N'LAGGREGATE LIMIT APPLIES PER.
POLICY F
X ] PROT- LOC
OTHER
GENERAL AGGREGATE
S 2,000,000
PRODUCTS-COMPIOPAGG
$ INCLUDED
S
A
AUTOMOBILE LIABILITY
ANY AUTO
OWNED SCHEOULEO
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
COMBINED SINGLE LIMIT
Ea accident)
S
BODILY INJURY (Per person)
S
BODILY INJURY (Per accident)
$
PROPERTYDAMAGE
Per accident
5
S
A
UMBRELLALIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
S
AGGREGATE
S
DEO I I RETENTIONS
S
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETOPJPARTNERIEXA OF ICERIMEM EEXCLUDED? ECUTIVE ❑
(Mandatory in NH)
I1 yes, descr bo under
DESCRIPTION OF OPERATIONS below
NIA
PER OTH-
STATUTE I I ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
S
E.L. DISEASE - POLICY LIMIT
5
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
Refer to IDCG 236 (03107) Exclusion of Coverage for Structures Built Outside of Designated Areas Endorsement
It KULUtK
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.
AUTHORIZED REPRESENTATIVE
PO BOX 1179
CALDWELL ID 83606 ,L.44m4p /110U&M441
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ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD