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HomeMy WebLinkAboutCERTIFICATE OF LIABILITY INSURANCE - 07-00029 - 3-D Fire ProtectFrom: Colleen Rowan At: The Hartwell Corporation FaAD: To: Brooke Date: 1/31/2007 03:24 PM Page: 2 of 3 CSR CR �4CORD., CERTIFICATE 4F LIABILITY INSURANCE 3DFIR-1 DATE (MMIDDM Y) 1 01/31/07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Hartwell Corporation PO Box 51019 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Idaho Falls ID 83405-1019 Phone:208-522-5656 Fax:208-524-5721 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A Advantage Work Comp INSURERS Travelers Casualty s sur*ty Co 39357 INSURER of America 3-D Fire Protection Inc INSURER PO Box 50845 Idaho Falls ID 83405-0845 INSURER E COVERAGES 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS lNbK LTR NS TYPE OF INSURANCE POLICY NUMBER DATE (MMIDD" DATE (MMIDDIYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1, 0 0 0, 0 0 0 B X COMMERCIAL GENERAL LIABILITY C0539C21A06TIA 08/18/06 08/18/07 PREMISES(Eaoccurence) $ 100,000 CLAIMS MADE FX] OCCUR MED EXP (Any one person) $ 5 , 0 0 0 PERSONAL 8 ADV INJURY $ 1, 0 0 0, 0 0 0 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2 , 0 0 0 i 0 0 0 POLICY X JEC LOC B AUTOMOBILE LIABILITY X ANY AUTO 8105393C21A06TIL 08/18/06 08/18/07 COMBINED SINGLE LIMIT {Ea accident) $ 1000000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY. AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ $ DEDUCTIBLE RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE 2271484 10/01/06 10/01/07 X TORY LIMITS I IMTER"7' EL. EACH ACCIDENT $ 500000 E L DISEASE - EA EMPLOYEE $ 500000 OFFICER/MEMBER EXCLUDEDI 10 DAY CANCELLATION If yes. descnbe under SPECIAL PROVISIONS belay E L DISEASE - POLICY LIMIT IS500000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION C,ITRE-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO $O SHALL City of Rexburg PO Box 280 IIMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURERTS AGENTS OR Rexburg ID 83440 REPRESENTATIVES. AIJTFjpRI REPRESENTATIVE 1 AGVKD Z5 (ZUU1IUI3) © ACORD CORPORATION 1988 From: Colleen Rowan At: The Hartwell Corporation FaxlD: To: Brooke Date: U 2007 03:24 PM Page: 3 of 3 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. AcoRo z5 (zw11UU)