HomeMy WebLinkAboutMain Street Mile CityofRexburg_CertificateOfInsurance_853146 (2).pdfCERTIFICATE OF INSURANCE Issue Date:
Agent for Public Entity: 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 policy below. This certificate of insurance does not constitute
a contract between the issuing insurer, agent and the certificate holder.
ICRMP Member: PROGRAM AFFORDING COVERAGE:
Idaho Counties Risk Management Program, Underwriters
This certifies coverages listed below are issued to the above insuring pool participant for the time 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. Policy Number Effective Date Expiration Date Property Deductible (Except flood/quake)
Section # Type of Insurance –Coverage Form Limits
V PROPERTY INSURANCE
--Occurrence
1. Buildings, Structures and Property
2. Automobile/Mobile Equipment Physical Damage
General Aggregate
As Reported in Schedule of Values
up to $100,000,000 per occurrence.
$200,000,000
VI MACHINERY BREAKDOWN
--Occurrence
1.Property Damage
2. Expediting Expenses
3. Business Income and Extra Expense
4. Spoilage Damage
5. Service Interruption
6. Newly Acquired Premises
7. Ordinance or Law
8. Errors and Omissions
Each Occurrence
Each Occurrence
Each Occurrence
Each Occurrence
Each Occurrence
Each Occurrence
Each Occurrence
Each Occurrence
General Aggregate
Varies Per Item
$2,500,000
$1,000,000
$1,000,000
$2,500,000
$5,000,000
$5,000,000
$10,000,000
$100,000,000
VII CRIME INSURANCE
(PUBLIC OFFICIALS'
SURETY-IN-LIEU)
1. Employee Dishonesty
2. Loss Inside Premises
3. Loss Outside Premises
Each Occurrence $500,000
For Claims Pursuant Title 6,Ch.9, ID Code Other Covered Liability Claims
VIII AUTOMOBILE LIABILITY
--Occurrence
1. Automobile Liability
2. Automobile Medical Payments
3. Uninsured/Underinsured Motorists
Each Accident
Each Person
Each Accident
Each Person
Each Accident
IX GENERAL LIABILITY
--Occurrence
1. General Liability Each
Occurrence
$500,000
X LAW ENFORCEMENT LIABILITY--Occurrence 1. Law Enforcement Liability Each
Occurrence
$500,000
XI ERRORS/OMISSIONS--
Claims Made 1. Errors & Omissions Each Claim $500,000
XII EMPLOYEE BENEFITS--
Claims Made 1. Employee Benefits Liability Each Claim $500,000
XIII EMPLOYMENT
PRACTICES- Claims Made
1. Employment Practices Liability Each Claim $500,000
XIV SEXUAL MOLESTATION-
Claims Made
1. Sexual Molestation Liability Each Claim $500,000
Description of Operations/Locations/Vehicles/Restrictions/Special Items or Notes:
Certificate Holder: Cancellation: Should any of the above described policies be cancelled before the expiration
date thereof, notice will be delivered in accordance with the policy provisions.
Authorized Representative: Sandy Moser
City of Rexburg
$2,500
Archibald Insurance Center, Inc.
Rexburg, ID 83440
$100,000$100,000
$3,000,000
$3,000,000
$3,000,000
$3,000,000
10/1/2016
$100,000$100,000
10/1/2020
Rexburg, ID 83440P.O. Box 280
$300,000$300,000
For above described item, coverage both for property damage & liability arising from Insured. If Certholder is named as party to
lawsuit solely due to relationship with Insured & not as result of its own conduct, we will accept tender of defense, until liability
determination. Certholder as Loss Payee as their interest may appear.
Idaho Department of Transportation
$500,000
Teton Dam Marathon - use of highway
39A02158100119
$3,000,000
Gary Archibald
$5,000
$5,000$5,000
Boise, ID 8370711293311 West State Street
135 W Main
1/7/2020
$3,000,000