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HomeMy WebLinkAboutHOSPICE OF LARIMER COUNTY DBA PATHWAYS HOSPICE - INSURANCE CERTIFICATEClient#: 25370 HOSPLAR ACORD- CERTIFICATE OF LIABILITY INSURANCE D 1 6123/2ID/23I2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER CONTACT (NAME: IMA of Colorado, Inc. PHONE FAX, (uc Nu Est): 303 534.4567 (ac No): 303.534.0600 1550 17th Street, Suite 600 E-MAIL ADDRESS: Denver, CO 80202 INSURER(S)AFFORDING COVERAGE NAICp 303 534-4567 INSURER A: American Alternative Ins.(') 19720 INSURED INSURER B : Hospice of Larimer County dba Pathways Hospice INSURER C 305 Carpenter Road NSURER 0: Fort Collins, CO 80525 INSURER E: *Glatfelter Insurance Group INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 CONTRACTOR 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR rypE OF ADDLSUBR INSR WVD POLICY NUMBER POLICY Err MMIDDIYYYY POLICY EXP LIMITS MYYYY MIDDI A GENERAL LIABILITY VHHHHG305361202 0510112011 05I01/2012 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY X CLAIMS -MADE El OCCUR PAEAISES ERENTED rce S1 000000 MED EXP (Any we person) $50000 PERSONAL B ADV INJURY 51,000,000 AGGREGATE s3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PGENERAL PRODUCTS-COMPIOP AGG $3,000,000 POLICY ECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ILY INJURY (Par person) BODBODILY $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS INJURY (Per recreant) $ PROPERTY DAMAGE Per accident S NON -OWNED HIRED AUTOS AUTOS 5 UMBRELLA LIAB OCCUR I EACH OCCURRENCE $ AGGREGATE S EXCESS LIAB CLAIMS -MADE OED RETENTION$ 5 I WORKERS COMPENSATION I WC STATU- I OTH- ITQRYI AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? NIA E.L. EACH ACCIDENT 5 E.L. DISEASE - EA EMPLOYEE 5 (Mandatory in NH) If yas describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule. If more space is required) RE: Event for "Breakfast in the Park" July 23, 2011. City of Fort Collins is included as Additional Insured on the General Liability Policy if required by written contract or agreement subject to the policy terms and conditions. City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S720103IM720058 MCW1