HomeMy WebLinkAboutFernando SaenzACCO oCERTIFICATE OF LIABILITY INSURANCE
DATE 2512IHYYYY}
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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 INSURERM, AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If 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
NAME T Carrie
PHONE 208-947-9777 1(Fa.Nfl:
Carrie Purcell
Ao RL . Carrie@insure-id.com
INSURER 8 AFFORDING COVERAGE
NAIC 0
1693 S Spring Valley Ln Ste 200
INSURER A: Fireman's Fund Insurance Company
21873
Meridian ID 83642
INSURED
INSURERB: Axis Insurance Company
�1273
Fernando Saenz
INSURERC:
INSURER D :
316 5th Street
Wilder, ID 83676
INSURER E:
INSURER F :
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.
INSR
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY D EFF
MMLK;Y EXP
LIMITS
A
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE IZI OCCUR
Host Liquor Liability
✓
UST022072240
NAEP129785
7/27/2025
8/25/2025
EACH OCCURRENCE
$ 11000,000
PREMISES
$ 50.000
MEDICAL EXPENSE
$ 11000
PERSONAL & ADV INJURY
$ 1.000.000
GEWL
AGGREGATE LIMIT APPLIES PER:
POLICY JECT 7 LOC
OTHER:
GENERAL AGGREGATE
$ 2.000,000
PRODUCTS - COMPIOP AGG
$ 1.000,000
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
COMBINED SINGLE LIMIT
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
S
$
UMBRELLA LIAR
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DED I I RETENTION$
$
WORKERS COMPENSATION
AND EMPLOYERS' LUIBILrrY YIN
ANYPROPRIETORIPARTNERIEXECUTIVE El
OFFICERIMEMBEREXCLUDED7
(Mandatory in NH)
If yes, desanbe under
DESCRIPTION OF OPERATIONS below
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required)
Additional Insured: Additional Insured; City of Caldwell
Event; Sunday Family Market
CERTIFICATE HOLDER CANCELLATION
City of Caldwell
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 1179
Caldwell, ID 83605
AUTHORIZED REPRESENTATIVE
Joseph Guerrero ( �•
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD