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Home My WebLink AboutHARMONY IMAGING CENTER LLC - INSURANCE CERTIFICATEACORD- CERTIFICATE OF LIABILITY INSURANCE 0DATE (MM/D 3/26/08DmYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Insurance Inc 4821 Wheaton Drive ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW P O Box 270370 Fort Collins CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED Harmony Imaging Center LLC 1951 Wilmington Dr Fort Collins CO 80528 INSURERA Copic Companies INSURER B Pinnacol Assurance INSURERC INSURER INSURER 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 MMIDDIVY POLICY EXPIRATION DATE MM/DD/YY LIMITS A GENERAL LIABILITY HCC0008522 04/01/08 04101109 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $500000 X I CLAIMS MADE FxI OCCUR MED EXP (Any one person) $5 000 PERSONAL& ADV INJURY $1000000 X Malpractice Liability Included GENERAL AGGREGATE $3 OOO OOO GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS COMPIOPAGG $1000000 POLICY D PRO 7 lOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY IN (Per accitledt) nt) $ HIRED AUTOS NON OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTOONLV EAACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY AGG A EXCESSIUMBRELLA LIABILITY UCC0009293 04/01108 04/01/09 EACH OCCURRENCE $ I or OOO 0- 0- 0- X1 OCCUR CLAIMS MADE AGGREGATE $10 000 000 $ DEDUCTIBLE $ X RETENTION $ 10000 B WORKERS COMPENSATION AND 4054$94 04101/08 04/01/09 X I WC 0 STATU OTH EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $1OO OOO E L DISEASE EA EMPLOYEE $100 000 OFFICER/MEMBER EXCLUDED If yes tlescribeuntler SPECIAL PROVISIONS below L EL DISEASE POLICY LIMIT $500000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Health Professional Liability Persons Included (if applicable) Professional employees of the named Insured other than physicians Professional students of the named Insured other than residents Volunteers of the named Insured other than physicians and residents City of Fort Collins 256 W Mountain Ave PO Box 580 Ft Collins CO 80522 ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL IE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR ACURD 25 (20Bt1o8) 1 of 2 #M409946 DXS 0 ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED the policy(ies) must be endorsed A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) If SUBROGATION IS WAIVED subject to the terms and conditions of the policy certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s) authorized representative or producer and the certificate holder nor does it affirmatively or negatively amend extend or alter the coverage afforded by the policies listed thereon AUUKU ZD 5 (ZUU91Ut$) 2 of 2 #M409946