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HomeMy WebLinkAbout223028 THE FAMILY CARE CONNECTION INC - INSURANCE CERTIFICATE (6)OP ID: CT `� kk. R CERTIFICATE OF LIABILITY INSURANCE DATE /08/2019 02/0812019 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 Phone: 970-223-1804 Front Range Insurance Group 2002 Caribou Drive, Ste. 101 Fax: Fort Collins, CO 80525 David A. Wooldridge LUTCFAAI CONTACT PHONE FAX (A/C, No, ExU: E-MAIL PRODUCER CUSTOMER ID #: FAMIL-2 INSURER(S) AFFORDING COVERAGE NAIC # INSURED Family Care Connection INSURER A: Scottsdale Insurance Company Inc 707 3rd St, Unit E1 INSURER B : Plnnacol Assurance _ 41190 - Windsor, CO 80550 INSURERC: INSURER D : INSURER E : 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF MM/DD POLICY EXP MMIDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 PREMISES _R occurrence)$ 100,000 A X COMMERCIAL GENERAL LIABILITY X CPS2785935 02/14/2019 02/14/2020 CLAIMS -MADE I I OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 X Errors or Omissio GENERAL AGGREGATE $ 2,000,000 CPS2785935 02/14/2019 02/14/2020 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 PRO LOC X POLICY JECT $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS — $ BODILY INJURY (Per accident) SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) — $ NON -OWNED AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DEDUCTIBLE $ $ RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A 4199096 02/01/2019 02/01/2020 X WC STATU- OTH- T RY LIMITSER E.L. EACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOYEE $ 100,00 If yes, describe under DESCRIPTION OF OPERATIONS below I I I E.L. DISEASE - POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Fort Collins has been named as additional insured with respects General Liability and Auto Policy. UrK I IrIL A I C 11ULUCK I.AINI.tLLA I IUIN CITY OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. 215 N Mason St 2nd Floor Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE �Z G. ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD