HomeMy WebLinkAboutCERTIFICATE - 07-00074 - BYUI Spirit Week - Torch Parade1 d : �. F'PR Pq . 7AA7
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ACORQ CERTIFICA OF LIABILITY INSURANr "T
DATE i o0
PRODUCER (208) 524-5858 FAX (208) 522-8049
Egan, Metcalf & Leavitt
3780 N. Yellowstone
PO Box 2498
Idaho Falls, ID 83403
THIS CERTIFICATE IS ISSUED 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 #
MsUREO Elite Pyrotechnics, LLC
217 N 3 rd West
Rexburg, ID 83440
INSURERA: National Fire Marine
20079
-&
INSURER B:
INSURERC:
INSURER D:
INSURER E:
CCIVEROGEB
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
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MfWDQ1YYl1
POLICY EXPIRATIONIMINSRE
DATE ffi"AQQ1YYl1
LIMITS
GENERALLIABILITY
72LPS001171
05/30/2006
05/30/2007
EACH OCCURRENCE
$ 1,000.00
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
$ 100,001
CLAIMS MADE rR] OCCUR
MED EXP (Any one person)
$ 5,00
A
PERSONAL & ADV INJURY
$ ] 000 OQ
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ EXCLUDE
POLICY PRO.
LOC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
$
ANY AUTO
(Ea accident)
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS
(Per person)
BODILY INJURY
$
HIRED AUTOS
NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
$
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESSA)MBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
S
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
OR STATUS OTH
Y LIMITSEMPLOYERS'
LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOY
$
OFFICER/MEMBER EXCLUDED?
It yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS $ VEHICLES I EXC USIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
E: Insured's operations for 2/28/07 show.
r C0TIC1r%ATC unl n1=Q nAmr =ll I e'rimm
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
BYU Idaho
� DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Attn: Activities Committee
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
52 5 South Center
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHOR®REPRESENTATIVE 11-ynette
Rexburg, ID 83460
Fountain LYFOUN�
ACORD 23 (2001I08) FAX: 496-5888 OACORD CORPORATION 1989
. •
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)