Compass Health 2/7/2018 (2) - Laserfiche WebLink

AcoRO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YWY) `.� 3/1/2019 2/27/2018 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). NT PRODUCER Lockton Companies NAMEACT 8110 E.Union Avenue PHONE FAX Suite 700 EE--MANo.Ext): (A/C,No): IL Denver CO 80237 ADDRESS: (303)414-6000 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Arch Specialty Insurance Company 21199 INSURED Compass Health,Inc. INSURER B:Philadelphia Indemnity Insurance Co. 18058 1075167 4526 Federal Avenue INSURER C: Everett,WA 98203 INSURER D: 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MM/DD/YYYY) (MMIDD/YYYY) A X COMMERCIAL GENERAL LIABILITY Y N FLP005371305 3/1/2018 3/1/2019 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED AWASHINGTON STOP GAP 3/1/2018 3/1/2019 PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) X000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: $ B AUTOMOBILE LIABILITY N N PHPK1782682 3/1/2018 3/1/2019 COMBINED SINGLE LIMIT $ (Ea accident) 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ XXXXXXX OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS XXXXXXX X HIRED X NON-OWNED PROPERTY DAMAGE $ XXXXXXX AUTOS ONLY AUTOS ONLY (Per accident) $ XXXXXXX A UMBRELLA LIAB _ OCCUR N N FLP005371305 3/1/2018 3/1/2019 EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB X CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ $ XXXXXXX WORKERS COMPENSATION NOT APPLICABLE PER AND EMPLOYERS'LIABILITY STATUTE OTH- ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT 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 A Professional Liability Y N FLP005371305 3/1/2018 3/1/2019 $IM Each Claim/$3MAgg. DESCRIPTION OF OPERATIONS/LOCATIONS/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 Wetmore Avenue,Suite 8A THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2930 2930 Wtt,WA e Avenue, ACCORDANCE WITH THE POLICY PROVISIONS. EverAUTHORIZED REPRES AT VE JJ 1 a Q' 11!S /c rte!J ©1988- 015 ACORD CORPO TION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD