Compass Health 12/13/2021 - Laserfiche WebLink

,----1 ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) L...---'- 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). ACT PRODUCER Lockton Companies NAME: 8110E Union Avenue PHONE FAX Suite 700 (A/C,No,Ext): (A/C,No): E-MADenver 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 Endurance American Insurance Company10641 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 10480742 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 SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD IMM/DD/YYYY)(MM/DD/YYYY) A x COMMERCIAL GENERAL LIABILITY Y N OPS0069942 3/1/2021 3/1/2022 EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE OCCUR WASHINGTON STOP GAP 3/1/2021 3/1/2022 DAMAGE RDOTE ence) $ 100,000 A X UMB-XLS0112683 3/1/2021 3/1/2022 PREMISES X Prof.Liab.$I M/$3M MED EXP(Any one person) $ 5,000 X Umb.$1 M PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY 78: X LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: $ AUTOMOBILE LIABILITY N NPHPK2241714 3/1/2021 3/1/2022 COMBINED SINGLE LIMIT 13 COMBINEDt) $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ XXXXXXX - AAUTOS ONLY SCHEDULED BODILY INJURY(Per accident $ XXXXXXX X AUTOS ONLY X AU OS ONLY PROPERTY (Per accident) $ XXXXXXX $ XXXXXXX C UMBRELLA LIAB _OCCUR N N W2E1F5210101 3/1/2021 3/1/2022 EACH OCCURRENCE $ 2,000,000 X EXCESS LIAB X CLAIMS-MADE AGGREGATE $ 2,000,000 DED RETENTION$ $ XXXXXXX WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N NOT APPLICABLE STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ XXXXXXX OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ XXXXXXX If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ XXXXXXX D Excess Liability N N HLC10015154800 3/1/2021 3/1/2022 $2M Excess of$4M Underlying DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Everett,its officials,agents and employees are Additional Insured on the General Liability as respects their interest in the operations of the Named Insured,if required by written contract and subject to the Terms and Conditions of the Policy. CERTIFICATE HOLDER CANCELLATION See Attachment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10480742 AUTHORIZED REPRESENTATIVE City of Everett 2930 Wetmore Avenue,Suite 8B Everett,WA 98201 a X � _____/ ACORD 25(2016/03) ©1988-2015 ACORD CORP RATION.All rights reserved The ACORD name and logo are registered marks of ACORD