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Home My WebLink AboutBradley BallenAC R ® CERTIFICATE OF AIRCRAFT INSURANCE DATE (MMIDDIYYYY) 07/1512024 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 endorsements . PRODUCER CONTACT NAME: Avemcw Insurance Company Avemco Insurance Company PHONE: 800-638-8440 FAx: 800-863-3338 8490 Progress Drive, Suite 200 Frederick, MD 21701 (A/C, No, E.t): (A/C, No): E-MMLADDRESS: avem ave.00m PRODUCER CUSTOMER ID No. INSURED Bradley Gallen INSURER(5) AFFORDING COVERAGE % NAIC No. INSURER A: AVEMCO INSURANCE COMPANY 100% 10367 16215 Quail Rd INSURER B : Sky Valley, CA 92241 INSURERC: INSURER 0: INSURER E : Pamela Ballen INSURER F 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 HERIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. WLJLIL7 IMFCJWML 11[JN IJGIIMI"M wIlmni u. POLICY TYPE LINE OF BUSINESS SUSCODE INDUSTRIAL X PLEASURE d COMMERCIAL X AIRPLANE HELICOPTER MIXED FLEET EXCESS QUOTA AID BUB LJ SHARE NO"WNED LIABILITY HULL d LIABILITY HULL ONLY ONLY X AIRCRAFT INFORMATION I I ACORD 333. Aircraft Schedule attached YEAR 1947 MAKE STINSON MODEL 108-2 SERIAL NUMBER REGISTRATION NUMBER N9338K TERRITORY: AIRCRAFT COVERAGES INSURER LETTER — POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE ADDITIONAL INSURED (Y I N) A 100118770017 07/2212024 0712212025 Y COVERAGE w OPTION5 LIMIT APPLIES TO LIMIT $ AIRCRAFT HULL _ I Risk Grouts L Flight round Not In Motion $ round Not In Flight X JncludiriPD&Ganqom AGREED VALUE AIRCRAFT LIABILITY $ 1,000.000 EA OCC $ 1� xcludinglPaSSergers X INCLUDING CREW $ EA PASS $ MEDICAL PAYMENTS EXCLUDING CREW EA PER $ COVERAGE _ — CODE IDESCRIPTION OPTIONS LIMIT APPLIES TO LIMIT ION WAIVED (Y IN) Y APPLIES TO _ Ded. - Not in moil Ded. — In motion EA PER AGGR EA PASS APPLIES TO $ $ iY CI -F _ $ $ $ $+ 2 7x $ $ ! _ $ $ DESCRIPTION OF OPFRATiONS 1 RrUARWI.R fAf'ORh 9n9 AAARI... I R—A— s, ko.a.,m ..,s.. ks .64—h-A Is EE ATTACHED ENDORSEMENT 127301 CERTIFICATE HOLDER CANCELLATION Caldwell Airport SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Caldwell EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 4814 E Linden SE ACCORDANCE WITH THE POLICY PROVISIONS, Premises: 5515 Aviation Lot #923 & #924 Caldwell, ID 83605 REPRESENTATIVE 7RLMO ARCI L VERONIE W LUUV, LU10 AL;UKU [4UKr'UKA I IUN. All KIgnm reserved. ACORD 21 (2016103) The ACORD name and logo are registered marks of ACORD