Loading...
HomeMy WebLinkAboutAPS HEALTHCARE - INSURANCE CERTIFICATE (2)ACORD CERTIFICATE OF PROPERTY INSURANCE DATE D/YY) /09 04/1309 PRODUCER 1-818-539-2300 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Arthur J. Gallagher & Co. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Insurance Brokers of California, Inc. License #0726293 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 505 North Brand Boulevard, Suite 600 COMPANIES AFFORDING COVERAGE Glendale, CA 91203-3944 COMPANY A Great Northern Ins Co INSURED COMPANY APB Healthcare, Inc. B APE Healthcare Northwest, Inc. Attn: Debbie Payne COMPANY C 21 Governors Dr. Suite 210 ----- ----------- ------ ---- ------ Windsor Mill, MD 21244 COMPANY D COVERAGES 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 PEHTAIN, 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. CO TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION POLICY NUMBER COVERED PROPERTY LIMITS LTR DATE (MMIDO/YY) DATE (MM/DD/YY) A X PROPERTY 35809570 04/15/08 06/30/09 BUILDING $ CAUSES OF LOSS X PERSONAL PROPERTY $ 2, 000, 000 BASIC BUSINESS INCOME $ BROAD EXTRA EXPENSE $ X SPECIAL BLANKET BUILDING $ EARTHQUAKE BLANKET PERS PROP S FLOOD BLANKET BLDG & PP $ X No Coinsurance $ X Replacement Cost $ INLAND MARINE S TYPE OF POLICY $ $ CAUSES OF LOSS NAMED PERILS $ OTHER S CRIME $ TYPE OF POLICY $ BOILER & MACHINERY _$ S OTHER S S S LOCATION OF PREMISES/DESCRIPTION OF PROPERTY SPECIAL CONDITIONS/OTHER COVERAGES Evidence of Insurance only. CERTIFICATE HOLDER CANCELLATION*10 day notice for non-payment of premium. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE The City of Fort Collins EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30*. DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Attn: Purchasing Dept. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY P 0 Box 580 OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Fort Collins, CO 85022 USA ACORD 24 (1/95) mramglen © ACORD CORPORATION 1995 11611102 ACOR ,,,, CERTIFICATE OF LIABILITY INSURANCE 04/13 /09 YYV) PRODUCER 1-818-539-2300 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Arthur J. Gallagher & Co. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Insurance Brokers of California, Inc. License #0726293 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 505 North Brand Boulevard, Suite 600 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Glendale, CA 91203-3944 INSURERS AFFORDING COVERAGE NAIC # INSURED APS Healthcare, Inc. INSURERA Great Northern Ins CO 20303 APB Healthcare Northwest, Inc. INSURER B: FEDERAL INS CO 20281 Attn: Debbie Payne INSURER C: TWIN CITY FIRE INS CO CO 29459 21 Governors Ct. Suite 210_ Windsor Mill, MD 21244 INSURERD: 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. INSR ADD' POLICYEFFECTIVE POLICY EXPIRATION L POLICYNUMBEfl DATE MM D Y LIMITS A GENERAL LIABILITY 135809570 04/15/08 06/30/09 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY _DAMAGE TTORENTED PREMISES (Ea occurence) CLAIMSMADE I XOCCUR ME_D EXP(Any one person)_ _$11000,000 PERSONAL& ADV I NJURV .$10,000 _ $ 1,000,000 AGGREGATE $2,000,000 SENT AGGREGATE LIMIT APPLIES PER: -GENERAL PRODUCTS COMP/OPAGG $Included F PRO- POLICY LOD AUTOMOBILE LIABILITY COMBINED SINGLE LIMA ANY AUTO (Ea accident) $ __.... ..... ALL O WNED AUTOS BODILY INJURY SCHEDULEDAUIOS (Per person) $ 111RED AUTOS BODILY INJURY $ NON OWNED AUTOS (Pereccitlent) PROPERTY DAMAGE $ (Peraccidenl) GARAGE LIABILITY AUTO ONLY-EAACCI DENT S OTHERTHAN EA ACC_ $ ANYAUTO _ S AUTO ONLY: AGO B EXCESS/UMBRELLA LIABILITY 79842253 04/15/08 06/30/09 EACH OCCURRENCE $ 5,000,000 X OCCUR CLAIMS AGGREGATE S 5,000 000 $ DEDUCTIBLE _. $ RETENTION S $ C WORKERS COMPENSATION AND 72WBZ00501 04/15/09 06/30/09 X ORY ",U- GTH- . LGRY LIMIL$ �` EMPLOYERS'LIABILITY E.L._EACH ACCIDENT $1,000,000 ANY PROPRIETOWPARTNER/EXECUTIVE E.L. DISEASE � EA EMPLOYEE $1, 000, 000 OFFICER/MEMBER EXCLUDED? If yes, d esculse under SPECIAL PROVISIONS UeImv E.L.DISEASE - POLICY LIMIT S1,000,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS The City of Fort Collins is added as Additional Insured for General Liability only as respects operations of the Named Insured. Subject to policy terms, conditions, limitations and exclusions. CERTIFICATE HOLDER CANCELLATION •10 day notice for non-payment of premium. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION The City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30' DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO $0 SHALL Attn: Purchasing P 0 Box 580 Dept. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. q AUTHORIZED REPRESENTATIVE Fort Collins, CO 85022 USA _J v�H/W4�e� ACORD 25 (2001/08) mramglen O ACORD CORPORATION 1988 11611003 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