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Home My WebLink About543224 SUMMITSTONE HEALTH PARNTERS - INSURANCE CERTIFICATEi ACCO V 'CERTIFICATE OF LIABILIV INSURANCE DATE(MMD°"""' 7/2/2020 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 h'oldei is an ADDITIONAL INSURED, the terms and conditions of the policy, certain policies may require certificate holder in lieu of such endorsement(s). the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to an endorsement. A statement on this certificate does not confer rights to the — -.:_ PRODUCER Professional Risk LLC 8213 w.20th St Greeley CO 80634 CONTACT Dionne Perez NAME: PHONE (970)356-8030 AX No): (970)356-8032 ADDRESS: dionne.perez@proriskllc.com INSURERS AFFORDING COVERAGE NAIC 0 INSURERA:Philadel hia Insurance Co 18058 INSURED SummitStone Health Partners 4856 Innovation Drive, Spite B Fort Collins CO 80525 _ INSURER 8 INSURERC: INSURER D: INSURER E : .. INSURER F-: CQVERAGES CERTIFICATE. NUMBER:20-21 Event _-- _ REVISION _NUMBER: _ - THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE. LISTED BELOW HAVE BEEN ISSUED -TO THEINSURED NAMED ABOVE FOR THE POLICY PERIOD " - INOICATED. NOTTHSTANDINGANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH.RESPECTTO WHICH THIS IM 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. ' _. TYPE OF INSURANCE D BR POLICY NUMBER POLICY EFF MIWDD/YYYY -POLICY EXP MM/DDIYYYY - LIMITS X CO MMERCUILGENERALLIABILITY EACH OCCURRENCE $ 1,000,000 rA CLAIMS -MADE OX OCCUR DAMAGET RENTED .PREMISES Ea o mence . 100, 000 S-_ --_-.... _ __ WED. EXP.(Any me peson). $_ .. 5,000 X PBPR2151926 7/1/2020 7/1/2021 - .PERSONAL. & ADV.INJURY. $ 1 , 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE. $ 3,000,000 POLICY ❑ PRO- JECT LOC .PRODUCTS -.COMP/OPAGG $__ - 3, 000,000 Employee Sonata $ _ 1,000,0_°0_ .OTHER: - .. _ AUTOMOBILE LIABILITY OMBINED I LE IMT g" - -i 000, 000 _BODILY INJURY (Perperson)ALL A ANY AUTO OWNED SCHEDULED AUTOS - AU7 PHPK2151926 7/1/2020 7/1/2021 JR BODILY INJURY(Per aaident) $ PROPERTY DAMAGE Per accident E NON-0WNED HIRED AUTOS AUTOS UMBRELLALJAB OCCUR EACH OCCURRENCE E_ AGGREGATE. E _ EXCESS LIAR CLAIMS -MADE _ OED. .RETENTION.$ WORKERS COMPENSATION ANDEMPLOYERS'LIABWTY Y/N - - E - H- - T T T R - - - ANY PROPRIETOR/PARTNER/EXECUTIVE _E.L..EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA - - - -- .. (Mandatory. In NH) E.L. DISEASE _-.EA EMPLOYEE $ if yes, describe under DESCRIPTIONOF.OPERATIONSbelox ._ ___.._ _._._ - __.__.-.__ __. _...______.-__. ELICY LIMIT .. E__ fDISEA*9E DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached S mon 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 p licy, per written contract. 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 01988-2014 ACI ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401) 1 tD CORPORATION. All rights reserved.