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HomeMy WebLinkAboutCERTIFICATES - 07-00052 - Gem State Fire Protection - Fire SafetACORDT, CERTIFICATr'OF LIABILITY INSURAV 060/207 /8' PRODUCER (208) 524-5858 FAX (2 S22-8049 Egan, Metcalf & Leavitt 3 780 N . Yellowstone PO Box 2498 Idaho Falls, ID 83403 THIS CERTIFICATE IS UED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Gem State Fire Prote PO Box 2620 Idaho Falls, ID 83403 INSURER A: RelMark Program Managers B0807 INSURER B: Un i gard 02 S 747 INSURER C: Idaho State Ins. Fund 36129 INSURER D: INSURER E: COVFROGFS 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. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE M OCCUR D3 S S S9978 01/01/2007 01/01/2008 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 100,000 MED EXP (Any one person) S 5,000 PERSONAL & ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICYF_j PRO-LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,000 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BA6OS86S 06/01/2007 06/01/2008 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG S $ A EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ BE3964196 01/01/2007 01/01/2008 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1000000 $ 1,000,000 $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? It yes, describe under SPECIAL PROVISIONS below 566643 01/01/2007 01/01/2008 WC STATU- OTH- E.L. EACH ACCIDENT $ S00, 000 E.L. DISEASE - EA EMPLOYEE $ S00,000 E.L. DISEASE - POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS nsured's Operations City of Rexburg 19 E Main Street Rexburg, ID 83440 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 MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Jaime Bradley/JB ACORD 25 (2001/08) ©ACORD CORPORATION 1988 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. ACORD 25 (2001/08) ACORD CERTIFICAT OF LIABILITY INSURAt 'E iliis�26 PRODUCER (208) 524-5858 FAX (2 522-8049 THIS CERTIFICATE IS SUED AS A MATTER OF INFORMATION Egan, Metcalf & Leavitt ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3780 N. Yellowstone HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO Box 2498 Idaho Falls, ID 83403 INSURERS AFFORDING COVERAGE NAIC # INSURED Gem State Fire Prote INSURERA: RelMark Program Managers PO Box 2620 INSURERS: Unigard 025747 Idaho Falls, ID 83403 INSURERC: Idaho State Ins. Fund 36129 INSURER D: INSURER E: CnVPRARFIC 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. INSR ADD - TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE IMMIDDNYI POLICY EXPIRATION LIMITS GENERAL LIABILITY D35559978 01/01/2007 01/01/2008 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED IF, SPRFMIsRR 100,000 CLAIMS MADE rX I OCCUR MEO EXP (Anyone person) S S , 000 A PERSONAL BADVINJURY S 1,000,00D GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PROECT LOC J AUTOMOBILE LIABILITY ANY AUTO BA605865 06/01/2006 06/01/2007 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X B ALL OW NED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per person) $ X BODILY INJURY (Peraoddent) $ X PROPERTVDAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY -FA ACCIDENT S OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGO EXCESS/UMBRELLA LIABILITY BE9300294 01/01/2007 01/01/2008 EACH OCCURRENCE $ 1,000,000 OCCUR ❑ CLAIMS MADE AGGREGATE S A 1000000 S 1,000,00 S DEDUCTIBLE S RETENTION S WORKERS COMPENSATION AND 566643 01/01/2007 01/01/2008 WC STATU I orH- PR C EMPLOYERS' LIABILITY ANY PROPRIETOWPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ SOD, OOO E.L. DISEASE- EA EMPLOYEE $ 500,000 OFFIEER/MENISER EXCLUDED? — - If yes. describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ SD0,00 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS E: Insureds Operations City of Rexburg 19 E. Main Street Rexburg, ID 83440 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 MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Jaime Bradley/JB ACORD 25 (2001/08) ©ACORD CORPORATION 1988 0 NATIONAL INSTITUTE FOR CERTIFICATION IN ENGINEERING TECHNOLOGIES" HEREBY- CERTIFIES THAT Marshall I Gardaer HAS ATTAINED THE ORADE OF LEVEL III IN FIRE PROTECTIbN'ENGINEERING TECHNOLOGY AUTOMATIC SPRINKLER SYSTEM LAYOUT AND RECOGNIZES THAT THROUGH EDUCATION, EXPERIENCE, AND KNOWLEDGE THIS PERSON HAS MET THE STANDARDS SET FORTH BY THIS INSTITUTE Certification Valid through April 1, 2008 CERTIFICATION NUMBER 86396 �zJl� , CHAANTIHMERD OF OO ERNORS, NICE'r SPONSORED BY THE NATIONAL. SOCIETY OF PROFESSIONAL ENGINEERS