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HomeMy WebLinkAboutExtreme Concrete ConstructionCERTIFICATE OF LIABILITY INSURANCE DATE (MMfDDA7M 5/29/2025 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 Arthur J. Gallagher Risk Management Services, LLC PO Box 429 Eagle ID 83616 INSURED Extreme Concrete Construction, Inc 12740 La Mirada Lane Melba ID 83641 Liliana Cruz Leon rtr 801-924-1400 FAX {AIC, Noj: INSURER A: Auto -Owners Insurance Company 18988 l f INSURERS: Idaho Slate Insurance Fund 36129 1 COVERAGES CERTIFICATE NUMBER:357810084 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. {LTA TYPE OF INSURANCE ADDL SUER POLICY NUMBER MWDDYNYYY MMO POLICY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR y 57775623 702024 7/2/2025 EACH OCCURRENCE $ 1.000.000 DAMAGE T�R�NT D PREMISES Ea occurrence $ 300,D00 MED EXP (Any one person) S 10,000 PERSONAL S ADV INJURY $ 1.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [fl jE4 M LOC GENERAL AGGREGATE $ 2.000.000 PRODUCTS -COMPIOPAGG $ 2.000,000 $ OTHER A AUTOMOBILE LIABILITY 5077562304 7/2/2024 7/2/2025 EO BINEDISINGLE LIMIT $ 1,0OO,ODO BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS IX Per accident) BODILY INJURY ( ) $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY X PROPERTY DAMAGE Per accident) S S A X UMBRELLALIAB X OCCUR 5077562301 702024 7/2/2025 EACH OCCURRENCE S1,000,000 AGGREGATE S 1,000,000 EXCESS L1AS CLAIMS -MADE DIED I X I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y!N 636934 711l2024 7/1/2025 X STA TUTE I I ERH E.L. EACH ACCIDENT — S 2,000,000 ANYPROPRIETOPJPARTNERfEXECUTIVE OFFICERIMEMSER EXCLUDED? N ! A E.L. DISEASE - EA EMPLOYEE S 2,000,000 (Mandatory In NH) II yes, describe under E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS 1 LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space is requiredl E C E IV E D BY RE: ROW1196 City of Caldwell is listed as additional Insured on the General Liability policy as required by written contract.CALDWELL CITY CLERK MAY 3 0 2025 CERTIFICATE HOLDER CANCELLATION City of Caldwell PO Box 1179 Caldwell ID 83606 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZER 9 IVUU-205 ACUKU CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD