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CERTIFICATE OF LIABILITY INSURANCE
DATEIMWDDfYYYY)
F02107i2024
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 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 rf hts to the ce flcate.h Ider in lieu of such endorsement(s).
PRODUCER
BOISE RIVER INSURANCE LLC
41 S BALTIC AVE STE 100 APR 0 3 2021
Meridian, ID 83642
NAME T PAULA LOGUE
PHONE (208)949-2222 uC No : (208)949-2223
EMAIL PAULAL BOISERIVERINSURANCE.COM
INSURERS AFFORDING COVERAGE
NAIC N
INSURER A: AUTO OWNERS INSURANCE CO
32700
INSURED
Linda V Gardner
DALLAS N MAAG
18380 HARVESTER AVE
NAMPA, ID 83687-5100
INSURER B :
INSURER C :
INSURER D :
INSURERE:
INSURER F :
COVERAGES CERTIFICATE NUMBER: 00026067-164058 REVISION NUMBER: 5
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 I
LTR
TYPE OF INSURANCE
ADDL
BR
POLICY NUMBER
POLICY EFF
MWDDIYYYY
POLICY EXP
MMIDDIYYYY
LIMITS
A
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE DOCCUR
57718287
02/1312024
0211312025
EACH OCCURRENCE
S 11000,000
DAMAGE TO RENTEIT-
PREMISES Ea occurrence
S 300,000
MED EXP (Any oneperson)
S 5 000
PERSONAL & ADV INJURY
S 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY JECT LOC
OTHER:
GENERAL AGGREGATE
S 2,000,000
PRODUCTS-COMPlOPAGG
E 1000,000
$
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
COMBINED SINGLE LIMIT
Ea accident
$
BODILY INJURY IPer person)
S
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per aor�dent
S
S
UMBRELLA LIAR
EXCESS LIAO
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
Ll
AGGREGATE
$
DE❑ I I RETENTIONS
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIE70RIPARTNERIEXECUTIVE ❑
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH)
If pes, describe under
DESCRIPTION OF OPERATIONS below
NIA
P R TH-
STATUTE ER
E,L EACH ACCIDENT
$
E,L DISEASE - EA EMPLOYE
$
E,L DISEASE - POLICY LIMIT
E
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
#284 - $37,700 $1,000 deductible
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 REPRESENTATIVEq
- c (PK
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD Printed by PKL on 02/07/2024 at 02:13PM