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COLORADO PHYSICAL THERAPY SPECIALISTS PLLC - INSURANCE CERTIFICATE (3)
A�oRU CERTIFICATE OF LIABILITY INSURANCE 1E (MM/DDIYYYY) F5/7/2018 THIS CERTIFICATEIS 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 have ADDITIONAL INSURED provisions or 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 JOHN C BECKETT&ASSOC, INC/PHS 344505 P: (866) 467-8730 F: (888) 443-6112 PO BOX 33015 SAN ANTONIO TX 78265 CONTACT NAME: (AICO,NNE..EO: (866) 467-8730 (IA� (888) 443-6112 Ao ESS: INSURER(S) AFFORDING COVERAGE NAIGk INSURERA: Hartford Casualty IRS CO INSURED COLORADO PHYSICAL THERAPIES SPECIALISTS, PLLC 210 W MAGNOLIA ST STE 110 FORT COLLINS CO 80521 INSURER B: INSURER C: INSURER INSURER E: INSURER IF 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 TYPE OF INSURANC'8 ADDI SUBR POLICYNUMBER POLICTEFF 61M/DD1 YY POLICYEXP LIMAS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s2,000,000 CLAIMS -MADE � OCCUR DAMAGE PREMISES T(Ea occurrence) O RENTED s 3 0 Or O O O X X M ED EXP (Any one person) $101000 A General Liab 34 SBA U17263 06/04/2018 06/04/2019 PERSONAL d ADV INJURY s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [7 E T ❑X LOC GENERAL AGGREGATE s4,000,000 PRODUCTS - COMP/OP AGG g 4, 000, 000 $ OTHER- AUTOMOBILE LIABILITY A COMBINED SINGLE LIMIT (Ea accident) s2,000,000 BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS 34 SBA U17263 06/04/2018 06/04/2019 BODILY INJURY (Per accident) ;, PROPERTY DAMAGE (Per accident) X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DE RETENTION $ W06dEQ5 COMPENS427ON. AIDE.'UPLOYERS'LrA "IT PER OTH- STATUTE ER E.L. EACH ACCIDENT ANY PROPRIETOR/PARTNER/EXECUTIVEYIN OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) AVA E.L. DISEASE- EA EMPLOYEE ' EL DISEASE - POLICY LIMIT ' If yes. describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICPMRD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 attached to this policy. CERTIFICATE HOLDER CANCELLATION 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. ©1988-2015 ACORD CORPORATION. All rights resery ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD