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Home My WebLink About446619 NORTH RANGE BEHAVIORAL HEALTH - INSURANCE CERTIFICATEACOW. CERTIFICATE OF LIABILITY INSURANCE OF ID D DATE(MM/DD/YYYY) 11 NORTH12 08 22 08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rich & Cartmill Ins of CO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE of Colorado LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 8213 W. 20th Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Greeley CO 80634 Phone: 970-356-8030 Fax: 970-356-8032 INSURERS AFFORDING COVERAGE NAIC t! INSURED INSURER A. Granite Insurance Company INSURER 8: Pinnacol Assurance North Range Behavioral Health INSURER C. National onion Fora ins Co. 1300 N. 17th Avenue INSURER D. Greeley CO 80631 _ IN91IRFR F' 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 WTH 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, IN DD' 150-0ffEFFECTIVE POLICY EXPIRATIDN LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE JMMIDDi DATE MMIDDIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X X COMMERCIAL GENERAL LIABILITY 02LX09055771000 07/01/08 07/01/09 AMAGETO RENTED-- PREMISES (Ea occurence) s50,000 CLAIMS MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $1,000,000 X Professional Liab GENERAL AGGREGATE $3,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $3,000,000 _.._.. POLICY Pti LOC Em Ben. .._..___ 1,000,000 AUTOMOBILE LIABILITY GLE LIMIT CO BINEl) $1,000, QQQ A X ANY AUTO 02LX09055771000 07/01/08 07/01/09 (EaCOMBIident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC - $ - - AUTO ONLY: AGO $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $2,000,000 C X OCCUR CLAIMSMADE — 29UD02444181000 07/01/08 07/01/09 AGGREGATE $2,000 000 -- _1_._.___— DEDUCTIBLE X RETENTION $ 10 , 000 WORKERS COMPENSATION AND X A Y LIMBS ER B EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 4044331 07/01/08 07/01/09 —'--'---- _-ER E.L. EACH ACCIDENT ____ -------- $100000 OFFIC ER/MEEXCLUDED? C.L. DISEAS[ - EA EMPLOYEE $ 100000 If yes, describe under ------------- ---- SPECIAL PROVISIONS belm E.L. DISEASE-POLICYLIMIT $5000QQ OTHERRFC p{ /pp $�"-'^ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Fort Collins, Colorado, A Municipal Corporation is listed as AUG 2 J� additional insured as pertains to the general liability policy. 2009 FORT COLLINS MUIVICIAq(, CCU,: City of Fort Collins, Colorado A Municipal Corporation 300 LaPorte Ave PO Box 580 Fort Collins CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI, DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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 REPRESENTATIVES. ceT:Tn 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 (2001/08)