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Home My WebLink About107737 ISLAND GROVE REGIONAL TREATMENT CENTER - INSURANCE CERTIFICATE (2)ACORDr., CERTIFICATE OF LIABILITY INSURANCE DIVVYY) 0DATE 4/04/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 211 First Street 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 Island Grove Regional 1140 M Street Greeley, CO 80634 INSURER A: Granite State Insurance INSURER B: ...._.....__.....-..—.-_--_—.... INSURER Q INSURER U: 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 MFFECTIY DATE EXPIRATION POLICY EXPIRATION MIDDVYYJ LIMITS A GENERAL LIABILITY 02LX89985871 04/01/08 04/01/09 EACH OCCURRENCE $1 000.000 X COMMERCIAL GENERAL LIABILITY _ CLAIMS MADE O OCCUR DAMAGE TO RENTFD e PRLMI'E E $10Oi000 MED EXP (Any one person) $5 000 PERSONAL &ADV INJURY $1000000 GENERAL AGGREGATE s3,000,000 GEHL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $1000000 POLICY PRO LOC ECT A AUTOMOBILE LIABILITY ANY AUTO 02CA40783062 04/01/08 04/01/09 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUl OS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR F-ICLAIMS MADE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEEACH E.L. ACCIDENT -- $ E.L. DISEASE - EA EMPLOYEEI — 5 OFFICER/MEMBER EXCLUDED' If yes, describe under " '- IS SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT A OTHER Professional 02LX89985872 04/01/08 04/01/09 $1,000,000 Each Occu Laibility $3,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I 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 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ID DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 9R 19nnv1"IRt4 so JNIAAA A090 ran n nrnan rnaana ATlnM IQRS 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. ACORD 25-S (2001/08) 2 of 2 #M411289