HomeMy WebLinkAboutMark Elliott & Kum Sun Son'-%qL- %_.4FM CERTIFICATE OF LIABILITY INSURANCE DATE(MMlpplYYyy)
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: It the Certificate holder Is an ADDITIONAL INSURED, the pollcy(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
INSURED
TOM PEMBERTON
10020 FAIRVIEW AVE STE 202
BOISE. ID 83704
ELLIOT MARK & KUM SUN SON
1369 W STAFFORD DR
EAGLE, ID 83616 6710
TOM PEMBERTON
208-323-7914
INSURER A: State Farm Fire
INSURER B :
D-
E :
NAIC 0
25143
INSURER F:
OVERAGES 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 POucY 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.
R TYPE OF INSURANCE IN WVD POLICY NUMBER MWD MMIDD
LIMIT$
COMMERCIAL GENERAL LIABILITY
EACFIOCCURRENCE S
CLAIMS -MADE OCCUR '1AMAGETORFNTFn
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY 0 PERO-
JCT [__1 LOC
X I OTHER; OFF PREMISES
AUTOMOBILE LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
UMBRELLA LIAe I I OCCUR
EXCESS LIAR H rt ewe
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE Y1 N
OFFICERIMEMBER EXCLUDED? ❑ N!
(Mandatory In NH)
It yes, descnbe Ugder
12-BN-5590-8 103110/2025 101'10r2026
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS -COMPIOPAGO §
PERSONAL LIABILITY §
CO BI ED IN LE
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BODILY INJURY (Per person) g
BODILY INJURY (Per acddent) §
EACH OCCURRENCE
AGGREGATE
§
F L EACH ACCIDENT
E L DISEASE SA EMPLOYE
E. L. DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, me be Attached It more
OFF PREMISES COVERAGE FOR. 4407 AVIATION WAY #346 y� la requlrM)
APR 0 2 2025
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE F-XPIRA71ON DATE THEREOF,
CALDWELL AIRPORT ACCORDANCE WITH THE POLICY PROVISIONS.E WILL BE DELIVERED IN
4814 E LINDEN
AUTHOR RESEN '
CALDWELL, ID 83605
ACORD 25 2016103 �J 01998'-`16'ft3�'WRIS CO RATION, All rights reserved.
i i The ACORD name and logo are registered marks of ACORD
100t486 132.849 14 04.137022