Homestead COL7 ®
,a►R o CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
03/05/2021
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(les) 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
NAME:
PHON u (g55) 222-5919 C No
Next First Insurance Agency, Inc.
PO Box 60787
Palo Alto, CA 94306
E-MAIL
ADDRESS: support@nextinsurance.com
INSURERS AFFORDING COVERAGE NAIC it
INSURER A: Next Insurance US Company 16285
INSURED
INSURER B
adam holmstedt
HOMESTEAD SOLUTIONS
INSURER c :
INSURER D :
7724 N 38th St
Omaha, NE 68112
INSURER E :
INSURER F:
COVERAGES CERTIFICATE NUMBER: 4424546 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
LTR
TYPE OF INSURANCE
ADDL
SUBR
POLICYNUMBER
POLICY EFF
MM/DD
POLICY EXP
MMIDDIYYYY
LIMITS
X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $1,000,000.00
CLAIMS -MADE [K]OCCUR
DAMAGE TO TED
PREMISES Ea olccurrrence $100,000.00
MED EXP (Any one person) $15,000.00
PERSONAL &ADV INJURY $1,000,000.00
A
X
NXTZ6AUVNK-00-GL
02/28/2021
02/28/2022
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE $2,000,000.00
MGEN'L
POLICY � PRO- ❑JECT LOCPRODUCTS-COMP/OPAGG
$2,000,000.00
$
OTHER:
AUTOMOBILE
LIABILITY
(CEO, acMBcidentINED SINGLE LIMIT $
BODILY INJURY (Per person) $
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident) $
PROPERTY DAMAGE $
Per accident
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE $
AGGREGATE $
EXCESS LIAB
CLAIMS -MADE
DED I I RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE
STATUTE EOR
E.L. EACH ACCIDENT $
OFFICER/MEMBEREXCLUDED7 ❑
NIA
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
If yes, describe under
DESCRIPTION OF OPERATIONS below
Each Occurrence: $25,000.00
A
Contractors Errors and Omissions
X
NXTZ6AUVNK-00-GL
02/28/2021
02/28/2022
Aggregate: $50,000.00
DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space is required)
Certificate Holder is an Additional Insured on the General Liability policy per the Additional Insured Automatic Status Endorsement. All Certificate Holder privileges apply only if required
by written agreement between the Certificate Holder and the insured, and are subject to policy terms and conditions.
GtK I WIGA It: HULUtK UANt rLLA I IL11V
CITY OF BLAIR
CTY HALL, BLAIR FIRE HALL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
218 S 16th St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Blair, NE 68008 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE /I
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ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD