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HomeMy WebLinkAbout446619 NORTH RANGE BEHAVIORAL HEALTH - INSURANCE CERTIFICATE (2)Amw CERTIFICATE OF LIABILITY INSURANCE OP ID DP DATE (MMIDD/(YYY) NORTHI2 06/19 09 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 I i Phone:970-356-8030 Fax:970-356-8032 INSURERSAFFORDING COVERAGE 'NAIC# North Range Behavioral Health 1300 N. 17th Avenue Greeley CO 80631 OVERAGES INSURER A: Granite Insurance Compar INSURERS' Pinnacol Assurance _._ .._. .....__.... ....... INSURER C' National Union Fir. Lna Co. _.......... — ..... -- INSURER 0 INSURER E. v THE POLICIES OF INSURANCE LISTED BELOW HAVE DEEM ISSUED TO TI IE 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 INSRO TYPE OF INSURANCE POLICY NUMBER I DATE IMMIDDIYYI I DATE MMIDDIYY LIMITS A X GENERAL LIABILITY XICOMMEP.CIALGENERAL LIABILITY T CLAIMS MADE I •- ! OCCUR 02LX0009055773000 07/01/09 - 07/O1/10 I EACH OCCURRENCE I $ 1 , OOO, OOO_ ..D.l'MXGETTi OE 7IEG ---., PREMfSES(Ea occurence) i $50,000 __ MED F_XP (Any one person) $ 10000 PERSONAL BADVINJURY 51,000,000 X I P_r_ofessional Liab I 4J` GENERAL AGGREGATE s3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: f PRODUCTS - COMPIOP AGG r$ 3, 0 0 0 r 0 0 0 Em Ben. 1,000,000 X POLICY PRO- �LOC JECT E A AUTOMOBILE X LIABILITY ANY AUTO 02LX0009055773000 07/0'1/09 j 07/01/10 COMBINED SINGLE LIMrr (Ea accident) $ 1 , O00 , 0OO ALL OWNED AUTOS SCHEDULEDAUTOS I I + BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ i ....._. HIRED AUTOS NON-OWNEDAUTOS if i ! ....... PROPERTY DAMAGE (Per accident) $ I _-.. ............ ........ _.-..._. 1 1 � I j 1 GARAGE LIABILITY ANY AUTO I j I + i ! AUTO ONLY - EA ACCIDTEN $ OTHER THAN EA ACC AUTO ONLY: AGG I $ -_,- $ iIf II-X EXCESS/UMBRELLA LIABILITY I ' OCCUR fLMSMADE i29UD00024 DEDUCTIBLE ! 07/01/09 ( 07/01/1O(AGGREGATE I EACH OCCURRENCE _ s2,000,000 2_,..0...-00,000 ..........- $$ ------------------ !-'""-.... iX ( RETENTION $ 10 , 000 1 ( $ �13 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PHOPRIETORIPARTNERIEXECUTiVE OFFICER/MEMBER EXCLUDED? ( r ! 4044331 07/01/09 1 I , i•--- 07/01/10 ; I X TORY UM1TS ER ....•. -- EACH ACCIDENT E.L F�cHAcc@ENT {s ...._-..._.. _. 100000 -$ ZOOOOO - E.Lr_.DISEASE-EA EMPLOYE ..------..._....... If Yes. describe under SPECIAL PROVISIONS below ! ( --� E.L. DISEASE - POLICY LIMIT s 500000 OTHER f I ? i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Fort Collins, Colorado, a Municipal Corporation, is listed as additional insured as their interest may appear. L,Cr( I II II.A 1 C MVLLJCR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins, Colorado DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN A Municipal Corporation NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 300 LaPorte Ave IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR PO Box 580 Fort Collins CO 80522 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Michael J Schmitt CIC ACDRD 2512001/081 © ACORD CORPORATION 1988