Compass Health 4/12/2021 - Laserfiche WebLink

AccPRO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 41.......-i 3/1/2022 3/2/2021 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 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 endorsement(s). CONTACT PRODUCER Lockton Companies NAME: 8110 E Union Avenue PHONE FAX Suite 700 E-MAIL No.Est): (A/C,No): Denver CO 80237 ADDRESS: (303)414-6000 INSURER(S)AFFORDING COVERAGE NAIC# `INSURER A:Scottsdale Insurance Company 41297 INSURED Compass Health INSURER B:Philadelphia Indemnity Insurance Co. 18058 1075167 4526 Federal Avenue INSURER C:A. F. Beazley 2623/623 52666 Everett,WA 98203 INSURER D:Endurance American Insurance Company 10641 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 3973501 REVISION NUMBER: XXXXXXX 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 INSURANCE ,ADDL SUBR [OLICY EFF POLICY EXP ' LIMITS LTR ,INSD W POLICY NUMBER VD ,(MM/DD/YYYY) (MM/DD/YYYY) A :.X COMMERCIAL GENERAL LIABILITY Y ! N I OPS0069942 3/1/2021 3/1!2022 EACH OCCURRENCE $ 1,000,000 ' CLAIMS-MADE X OCCURDAMAGE TO RENTED A ! WASHINGTON STOP GAP 3/1/2021 3/1/2022 PREMISES(Ea occurrence) $ 100,000 A 1 X 1 Prof. Liab.$1M/S3M 1 UMB-XLS0112683 3/1/2021 3/1/2022 MED EXP(Any one person) $ 5,000 IX Umb.$1M ! PERSONAL&ADV INJURY 1$ 1,000,000 1! GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE 1$ 3,000,000 PRO- ' POLICY X LOC� PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER. I --- $ B !AUTOMOBILE LIABILITY N N PHPK2241714 3/I/2021 3/1/2022 COMBINED SINGLE LIMIT :(Ea accident) $ 1,000,000 x ANY AUTO BODILY INJURY(Per person) $ XXXXXXX OWNED SCHEDULED BODILY INJURY(Per accident) $ XXXXXXX AUTOS ONLY ! AUTOS X HIRED X NON-OWNED ', 'I PROPERTY DAMAGE $ XXXXXXX AUTOS ONLY AUTOS ONLY • (Per accident) '... $ XXXXXXX C !. UMBRELLA LIAB OCCUR N N W2EI F5210101 3/1/2021 3/1/2022 EACH OCCURRENCE '$ 2,000,000 X EXCESS LIAB X CLAIMS-MADE AGGREGATE 1 $ 2,000,000 DED RETENTION$ $ XXXXXXX I WORKERS COMPENSATION NOT APPLICABLE , PER 1 OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ XXXXXXX OFFICER/MEMBER EXCLUDED° 1 N/A I ! I -- (Mandatory in NH) !! E.L.DISEASE-EA EMPLOYEE$ XXXXXXX If yes,describe under DESCRIPTION OF OPERATIONS below l E.L.DISEASE-POLICY LIMIT I$ XXXXXXX D Excess Liability Y : N HLCI0015154800 3/1/2021 3/1/2022 S2M Excess of S4M Underlying DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Everett, its officers,employees and agents as additional insured's are included as Additional Insured with regard to Professional Liability and General Liability. CERTIFICATE HOLDER CANCELLATION See Attachment 3973501 City of Everett Human Needs Grant SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE e Avenue, Suite 8A THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2930 Wetmor Everett,WA A I ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE CD1988-20 ACORD CORP TION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD