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HomeMy WebLinkAboutCOLORADO PHYSICAL THERAPY SPECIALISTS PLLC - INSURANCE CERTIFICATEACORO® CERTIFICATE OF LIABILITY INSURANCE `� DATE 'MYD°"rn 10/08/2014 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 endorsements . /\ PRODUCER COMTA NAYS: JOHN C. BECRETT & ASSOCIATES, INC. _ jHON wR. E.n: (970) 484-2805 Na): (970) 484-2885 220 Smith Street E-MAILDDE tim®beckettinsurance.com PRODUCER CUSTOMER N /: INSURER(S) AFFORDING COVERAGE NAICR Ft. Collins CO 80524- INSURED INSURER A :HARTFORD CASUALTY INS. CO. 129424 Colorado Physical Therapy Specialists PLLC INSURER 8:PINNACOL ASSURANCE 210 W. Magnolia, Suite 110 INSURER C:PROASSURANCE SPECIALTY INS CO INSURER D :ASPEN SPECIALTY INS CO INSURER E Fort Collins CO 80524- 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 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR MDL SUBR POLICY EFF POLICY UP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (Y1101) YI (MWDDM'YY) LIMITS A GENERAL LIABILITY 349BAUx7263 06/04/2014 06/04/2015 EACH OCCURRENCE $ 2,000,000 COMMERCIAL GENERAL LIABILITY DAMAX fEaor TO RENTED PREMISES PREMISES Ea occurrence $ 300000 CLAIMS -MADE Ex] OCCUR / / / / MED EXP (Any one person) $ 10000 _ PERSONAL A ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGO $ 4,000,000 / / / / X1 POLICY PRO- LOC iECT / / / / $ AUTOMOBILE LIABILITY NO COVERAGE / / / / COMBINED SINGLE LIMIT $ / / / / IEa accitlenl) BODILY INJURY (Per person) $ ANY AUTO ALL OWNED AUTOS / / / / BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS / / / / (Per accident) $ NON -OWNED AUTOS UMBRELLA UAB OCCUR NO COVERAGE / / / / EACH OCCURRENCE $ —I 1 AGGREGATE $ EXCESS LIAR CI -AIMS -MADE / / / / / / / / DEDUCTIBLE $ RETENTION $ / / / / $ B WORKERS COMPENSATION 4136145 12/01/2013 12/01/2014 X WC STATU- OTH- TQRY LIMITS ER ARO EYPLOTERS' LUBILRY Y(H E.L. EACH ACCIDENT 8 100, 000 4NY PROPFFTOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ NIA (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ 100,000 If yes, descnpe Under / / / / I DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 C PROFESSIONAL LIABILITY 10/11/2014 10/11/2015 PER OCCURRENCE 1,000,000 D PRIVACY LIABILITY �AFC9266914 P78203 '07/05/2014 107/05/2015 AGGREGATE PROFESSIONAL 3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AN,cN ACORD 101, AWRI R.naM1F ScMduN, IT — p ie rpuind) CERTIFICATE HOLDER IS AN ADDITIONAL INSURED PER WRITTEN CONTRACT ON THE GENERAL LIABILITY FOR THE ONGOING OPERATIONS OF THE INSURED. ( ) - (970) 221-6775 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CITY OF FORT COLLINS ACCOUNTING DEPARTMENT AUTHORMED REPRESENTATIVE _ PO BOX 580 FORT COLLINS CO 80522-0580 ACORD 25 (2009/091 © 1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD