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Home My WebLink About107737 ISLAND GROVE REGIONAL TREATMENT CENTER - INSURANCE CERTIFICATEClient# 13740 ISLGR ACOW. CERTIFICATE OF LIABILITY INSURANCE 0417107 ""' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood 8r Peterson Insurance Inc 211 First Street ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Eaton, CO 80615 970 454-3381 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A. Granite State Insurance Island Grove Regional 1140 M Street Greeley, CO 80634 INSURER B INSURER C INSURER D ,SURER E COVERAGES 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 LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIODIYY POLICY EXPIRATION DATE MMIDO/Y1' LIMITS A GENERAL LIABILITY 02LX89985871 04/01107 04/01/08 EACH OCCURRENCE $1000000 DAMAGE TO RENTED PREMISES Be occdrr,dc,� $1 OO OOO X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR MED EXP (Anyone person) $5 000 PERSONAL & ADV INJURY $1000000 GENERAL AGGREGATE s3,000,000 GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS COMPIOPAGG $1000000 POLICY JEC LOG A AUTOMOBILE LIABILITY ANY AUTO 02CA40783061 04/01/07 04/01/08 COMBINED SINGLE LIMIT (Ea accdent) _ $1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTOONLV EAACCIDENT $ OTHER THAN EA ACC $ ANYAUTO R $ AUTO ONLY AGO EXCESWUMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND TATU WORY C LIMIN OTH E L EACH ACCIDENT $ EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE E L DISEASE EA EMPLOYEE $ OFFICERIMEMBER EXCLUDED' If yes describe under SPECIAL PROVISIONS below EL DISEASE POLICY LIMIT $ A OTHER Professional 02LX89985871 04101/07 04/01/08 $1,000 000 Each Occur Liability $3,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS City of Fort Collins, CO, A Municipal Corp is listed as Additional Insured, as their interest may appear City of Fort Collins, CO, A Municipal Corp PO Box 580 215 N Mason Street Fort Collins, CO 80522 OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION )F, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _30DAYS WRI FTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE I-/ocu� T AA-dP1SenJ .LNi✓.^aw/f�% , 2;.JC—. ACORD 25 (2001108) 1 of 2 #M377637 CSP @ ACORD CORPORATION 1988 OCT/17/2007//WED 11,27 AM HUB INTERNATIONAL FAX No 303-694-0434 P,003/011 eF e� Za`v i nwTa lmwICDIYY) a .e 1,2 r �° x MINOR* �i UKC3� P N a,,s�< °l0/17/2007 ,' a 3°npso �ro u ., .,i., _ 4 2 - 'dkNt'Y�zt�YxW bx' %ik r°..kp. x on PRODUCER Ed 1-%m ingsland THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HUB International Southwest Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER_ THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 9351 Grant St Ste 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Denver, CO 80229-4375 COMPANIES AFFORDING COVERAGE COMPANY Pi1naC01 ASSuranCe Company 303-444-4443 . faX303-449-7365 A INSURED Island Grove Regional Treatment Center COMPANY B 1140 M Street Greley 00 80631 I cDC�"v I COMPANY • I ?¢Aa��: �Y' F.ONdxww 0`LX �':. a.w.y F0. P�w��:Q��^�?4�A: w ��w'�yy�q THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE INDICATED, NOTW ffHSTANDING ANY REQUIREMENT, TERM OR CONDITION CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED TD r� wgy pyqp pyp y A `,,e{ep # N aft8 S 5w•y^+,� d^•��^ �^�"°`iC BII. N°,PeFb%°FSF MVuaxc,Lx nCS`SD,BY�a 6.vlux BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PE8r00 OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS 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 CO LTA TYPE OF INSURANCE POLICY NUMBER P040Y ORTE(MMID EFFECTIVE NYI POLICY EXPIRATM DAM(MM(DDNY) LIMITS GENERAL UARTUTY GENERALAOWEGATE PRODUCTS-COMP(OPAGG 8 COMMERCIAL GENERAL LIABILITY I vy PERSONAL & ADV INJURY 8 CLAIMS MADE ❑ OCCUR EACH OCCURRENCE i OWNERS& CONTRACTOR'& PROT FIRE DAMAGE IAm Pn. R-4 i ` MED EXP(Any we PBron) i AUTOMOBILE DA91LITY _ COMBINED SINGLE LIMIT B ANY AUTO — BODILY WARY Tw "t ) i ALLOWNEDAUTOS SCHEDULED AUTOS BODILY INJURY (Per;,wd.nQ 9 HIRED AUTOS wprv-owrvED wurOs PROPERTY DAMAGE GARAGE UAe1Lr1Y ANY AUTO AUTO ONLY, EA ACCIDENT OTHER THAN AUTO ONLY RRe EACHADCIOENT 8 AGGREGATE 8 EXCESS UAMUTY EACH OCCURRENCE S AGGREGATE 8 UMBRELLA FORM X 1 TORY LIMiU` OTH-„ 8 In a•k xy S C ` aF A OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND 4061756 0/01/2007 0/01/2008 EL EACH ACCIDENT a100,000 EMPLOYERS UABIUTY EL OISEA6E-POLICY LIMIT s 500 000 THEPROPRIffOR! X INCL PARTNERS11=TIVE OFFICERSARE. EKCL EL DISEASE EA EMPLOYEE i 100 000 OTHER DESCRIPTION OF OFERATIONSA.00ATIONSNBRCLE818PECIwL ITEMS , ..vA� <S .. ,^,.'^Jg°9• � _ wwa City Of FortR Collins, Colorado, a municipal Corp �P t �?bK bIgrga .Few b. tl.6�'3•,o"i. �Yo, °�.s�+�ia�`�«p+a SHOULD ANY OF THE ABOYE DESCRIBED POLICIES BE CANCELLED BEFORE THE ECPINATJON DATE THEREOF. THE tSSUING COMPANY WILL ENDEAVOR TO •'V' iL P O 'BOX 580 390 LaPorte Ave 3 0 DAYS WRITTEN NOTICE TO YHE Cse YWCATE 40L)ER NAMED TO THE LEFT Stf-3aps notice for non-Deyment BUT FAILURE TO MAIL SUCH NOTICE SHALL L POSE NO OBLIGATION OR ❑ABIL{ T y Fort Collins CO 60522 p RIND UPON THE COMPANY. TS AOE -S OR REPRESENTATIVE;. A R R ENTATIVE " �.� x nv a`a`m"T° a'Pttl�GTea'"'1 LOx"e"ae ' aKve'a »w °a aw. ° mfiC�'�,R Fa100 QdSEF30364S5 ISLAG-1