HomeMy WebLinkAboutCERTIFICATES - 05-00069 - Fire Protection Services A-1 Fire Pro - Fire Safety CertificationREXBURG-NUDISON COUNTY EMERGENCY SERVICES
26 NORTH CENTER,- STREET
I 0 1 1 11 f
P 16
208-359-3010
Fire Protection Services
921 Northgate Mile
Idaho Falls, Idaho 83401
Dear Fire Protection Services,
February 17., 2005
Enclosed please find Safety System Certification Permit application as rewired
by the City of Rexburg. A safely system certification permit is required to install, modify,
maintain, or service all new and existing fire extinguishers fire suppressions systems, fire
alarm systems, and other life safety systems within the City of Rexburg.
Please complete the application and fees and return it to..
City of Rexbur
9
Community Development
19 East Main Street
Rexburg, Idaho 83440
Please provide a copy of those certifications that apply
as outlined in the aunlicaion_ Without a�1en,�ntP �-P,�-;fr-�+;n��
to your specific discipline
:. ---- - .-----.-�---�.-.���-�� yvi Ls11VU.L1VElw7 your application w��l be
denied. The permit will be valid until December 31. _ 2005 Once. a„�-n«�P� t�
allow you to work within
and operational permits.
_, _ _ . � ___„ wV�,s„ , „u ",u �,ermit will
Ll city Iim�ts. Separate fees will be charged for construction
If you have any questions please feed free to contact me.
Sinceretv.
Chris Huskinson
Fire inspector
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ACORD,CERTIFICATE OF LIABILITY INSURANCE °"'E`M"'°°'m",
PRODUCER (2[}5) 522-7775
Caste Lake I nsurance
P.O. Box 2751
Idaho Balis, !D 83403
Bruce Wa I dram
INSURED Dan Ru Id dba
DBA: A-1 F 'Ir, P r -o
PO Bnx 2961
Idaho Falls, I D 83403
uVi
FAX (208)522-04-04 THIS CERTIFICATE f5 ISSUED A5 A MATTER OF INFORMATION'
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLOER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING ' E A E NAIC
INSURER A: Tudor Insurance Company
INSURER B.- - -
I ISI U R EES :
INSURER D -
IIS SURE.-
,
COVERAGES
THE POLICIES OF INSURANCE ILI TED BELOW HAVE BEEN ISSUED TO TIDE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
ANY NOTWITHSTANDING
I
REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHERDOCUMENT T WITH RESPECT PECT T +'i---IICH THIS CERTIFICATE A. BE ISSUED
MAY PERTAIN, F
THE INSURANCE CE AFF RDED Ear' THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS E
POLICIES. A [ E ATE LIMITS SHOWN �A HAVE BEEN REDUCED B PAID L .If' . SUCH
INLIE %tSjj-E SR AD01,TYPE OF INSURANCE POLI 1JM� POLICY EFFECTVE POLICY EXPIRATION
LIMIT
GENERAL LIABILITYP L7 1 06/ 8/2004 06/2'8/2005 EACH. OCCURRENCE I
IF'XI C MMER.+ I GENERAL LIABILITY I'CLAMS MADE OCCUR
w
I
GEN'L AGGREGATE LJMIT APPLIES PER:
POLICYR�! F�
J ECT LOC
AUTOMOBILE LIABILITY
ANY AUTQ
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
ISO ° ' N ED AUTOS
ARA E LIABILITY
A N AU T
EXCE55NMBRElLA LIABILITY
OCCUR � � CLAIMS MADE
DEDUCTIBLE
RETENTION
WORKERS OMPEN ATION AND
EMPLOYERS' LIABIUT`Jt"
AN Y PRO PR,IETOF E TN E RIEXEC UTIVE
OFFICER/MEMBER EXCLUDED?
If yes, dri be under
SPECIAL PROVISJONS below
OTHER
DESCRIPTION OF OPERATIONSI LOCATIONS i VEHICLIES VEHICLESI EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PE.D I ON
CERTIFICATE HOLDER
City of Rexburg
Attn: Kathy Winters
19 E Main
Rexburg, I D 83440
ACQRD 25 (2001108)
UrAW) T FEN iE
E�IJ�ify
_ r
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MED ESP (Any one pe -son)
PERSONAL & ACV INJURY
GENERAL AGGREGATE
$
5 x
1; 000foo
2f000,
CC)
P FZ0 DU CT - COM 131 R AGG
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nnn
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COMBINED SINGLE U IT
(Ea accident)
B DI LY IIS JUICY
r"Per rao
BODILY 1 NJUR
( Per a ca -de t )
PROPERTY DAMAGE
(Per- acddent)
AUTO ONLY - EAACCIDENT 1 $
OTHER THAN EA ACC
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AUTO ONLY;
AGG
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S
EACH OCCURRENCE
AGGREGATE
WC TATU- OTH-
TO �
L J JI I S � R
E -L, EACH ACCIDENT
E.L. [DISEASE - EA EMPLOYEE S
E. L_ [DISEASE POLICY LIMI`f
CANCELLATION
SHOULD ANY OF 7HE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION ATION CRATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
DAYS WRrrTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEI -T
CUT FAILURE TO MAIL SUCH NOTICL SHAL IMPQ E NO OBLIGATION Or LIABILITY
OF ANY IND UPON THS471NSLIRER, ITS A � PRE�"ENT TIVE ;,RUTH IzFzLD ,REPRE EN9� E
v
A! RD CORPORATION 1988