The URL can be used to link to this page

Home My WebLink AboutSUMMITSTONE HEALTH PARTNERS - INSURANCE CERTIFICATEAC CERTIFICATE OF LIABILITY INSURANCE DATE (MIWDDI1 ") 7/8/2019 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 Professional Risk LLC 8213 W.20th St Greeley CO 80634 CONTACT NAME: Jennifer Hunter FAX PAIDNNExt,(970)356-8030 A/C NO; (970)356-0032 E-MAIL 3arnifer.hunter@proriskllc.com ADDRESS: INSURERS AFFORDING COVERAGE NAIL Y INSURERA:Philadelphia Insurance Co 18058 INSURED Summit$tona Health Partners 4856 Innovation Drive, Suite B Fort Collins CO 80525 INSURER B : INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:19-20 Event 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 MAYBE 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. INSRADOL LTR TYPE OF INSURANCE SUBR POLICY NUMBER POLICY EFF MM/DDrVY1'Y POLICY EXP MMIOD/YY1'Y LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE OX OCCUR DAMAGE TO PREMISES Ea occurrence S 100,000 MED EXP (Any one person) S 5,000 X PHPK2003065 7/1/2019 7/1/2020 PERSONAL BADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMPIOPAGG $ 3,000,000 POLICY a PRO. a LOC JECT Employee xenefita S 1,000,000 OTHER- AUTOMOBILE LIABdJTY COMBINED MBINED INL LIMI Ea a $ 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO ALL OWNED SCHEDULED AUTOS ALTNON-OWNED HIREDAUTOS AUTOS pxpX2003065 7/1/2019 7/1/2020 BODILY INJURY (Perawdenl) $ PROPERTY DAMAGE Per accident) $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DIED I I RETENTION S $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE R OTH- STATUTE ER EL EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? ONIA (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE S E.L OISEASE POLICY LIMIT is If yes. descnbe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, my oe attached If more space is required) Event: LatinX, September 7, 2019, Lee Martinez Park. The City of Fort Collins is listed as additional insured as pertains to the General Liability policy, per written contract. CERTIFICATE HOLDER CANCELLATION The City of Fort Collins PO 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 Perez/DP ACORD 25 (2014/01) INS025 (201401) ©1988.2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD