HomeMy WebLinkAboutCOLUMBINE MANAGEMENT SERVICES - INSURANCE CERTIFICATECERTIFICATE
LIABILITY INSURANCE
DATE (MWDDIYYYY)
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(ids) 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).
,Professional Risk LLC
8213 W.20th St
CO 80634
INSURED Columbine Management Services; Columbine .INSURER B.:..
Medi_ca_1..Eguipment.Inc._; Poudre_.Infusion Therapy Inc; lflsuRERc:
Front Range Theraphy Systems Inc. iNSURERD.:
862 W Drake Rd Ste 101 INSURERE:
Fort Collins Co 80526 INSURER F:
a56-e032
THIS 1S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED. BELOW
HAVE BEEN ISSUED TO'THE INSURED'NAMEOABOVE 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 -
OC
S
. - . `.. '
UCYNUMBER. _
- POLICY EFF
D/YYYY
POUCYEXP
MMA)DIYYYY
- _ _ .LIMITS._
X.
COMMERCIAL GENERAL LIABILITY
EACH. OCCURRENCE._.__..
..$. 1,000, 000
�100,
A
CLAIMS -MADE ❑X OCCUR
-
A RENTED
.PREMI ES Ea. occurrence -
A. 000
X
MED EXP_(An..one. erson)- ._E_.
_.5,000
PROFESSIONAL LIABILITY
X
HRGCO010001OC17
7/1/2020
7/1/2021
...... _. _.. ...
'
_ .. -
.P.ERSONAL B.ADVINJURY
E.. 1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE. ___
$- 3,000,000
,.
POLICY JET a LOC
. PRODUCTS _COMP/OP _AGG-
$. _3,000,000
Employee Benefits
$ 1,000,000
-
..OTHER:_-
AUTOMOBILE LIABILITY
-
COMBINED IN L MI
(Ea accident) _.
3 '
BODILY INJURY (Per person)
E
ANYAUTO
ALL OWNED F__j SCHEDULED
AUTOS AUTOS.-
BODILY INJURY (Per accident)
- -
$
PROPERTY.pAMA E -
-Per. accident - -
$
NON -OWNED
HIREDAUTOS - AUTOS -
UMBRELLA LIAB
OCCUR
EACH. OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
_.DED
_ .RETENTION.$ _
____.__-.
$
__.
__...
._—_"
...-
_
WORKERS COMPENSATION -
AND EMPLOYERS' LIABILITY Y
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICERIMEMBER EXCLUDED? - -
NIA
.._,
PER. OTH-
STATUTER.
E.L. EACH ACCIDENT
$
-
(MandatoryinNH) _�
E.L. DISEASE - EA EMPLOYEE
$
-.
If yyes, describe undo
DESCRIPTION.OF OPERATIONS.balow_
-
E.L. DISEASE -POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORO 101; AddKlonalRBrilerki
Schedule, may be attached! If more space Is required)
Re: License C1=8. City of Fort Collins is listed
as additional insured as pertains to the General
Liability_.policy, per written contract.
City of Fort Collins
PO Box 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXFIRATION DATE THEREOF, NO-fidi ILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Dionne Perez/DP /L_.1.ev.e..Eo
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
INS025 (201401)