Page 67 - April Sound Closeout Manual

DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 6/29/2017
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 POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
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).
PRODUCER CONTACT Tia Chambers
NAME:
Higgins & Rutledge Insurance, Inc. PHONE 208-343-7741 FAX
1661 Shoreline Dr., Suite 100 (A/C, No, Ext): (A/C, No): 208-343-9371
Boise ID 83702 E-MAIL TiaC@higginsrutledge.com
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A :Cincinnati Insurance Company 10677
INSURED YOUNG-3 INSURER B :Wesco Insurance Co 25011
Young, Swenson & Cross Paving Inc INSURER C :
1329 E Gibson Lane
Phoenix AZ 85034 INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 47497728 REVISION NUMBER:
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
A X COMMERCIAL GENERAL LIABILITY Y Y EPP 0200261 7/8/2017 7/8/2018 EACH OCCURRENCE $1,000,000
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) $500,000
MED EXP (Any one person) $10,000
PERSONAL & ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
POLICY X PRO- LOC PRODUCTS - COMP/OP AGG $2,000,000
JECT
OTHER: $
A AUTOMOBILE LIABILITY Y Y EBA 0200261 7/8/2017 7/8/2018 COMBINED SINGLE LIMIT $ 1,000,000
(Ea accident)
X ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (Per accident) $
$
A X UMBRELLA LIAB X OCCUR Y Y EPP 0200261 7/8/2017 7/8/2018 EACH OCCURRENCE $2,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000
DED X RETENTION $0 $
B WORKERS COMPENSATION Y WWC3260474 2/23/2017 2/23/2018 X PER OTH-
ER
STATUTE
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $1,000,000
OFFICER/MEMBER EXCLUDED? Y N / A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
April Sound 43rd Ave & Thunderbird Phoenix, AZ

CERTIFICATE HOLDER CANCELLATION

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
JWC Construction Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
dba Jon Wayne Construction and Consulting ACCORDANCE WITH THE POLICY PROVISIONS.
April Sound HOA
8160 E Butherus Dr, Ste 10
Scottsdale AZ 85262 AUTHORIZED REPRESENTATIVE

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