HomeMy WebLinkAbout950113.tiffPHICO Insurance Company
oiePffldO Drive, P. O. Box 85, Mechanicsburg, PA 17055-0085 (717) 766-1122
!• i L 3:
THIS CERTIFIE hPHICO Insurance Company (PHICO) has issued to the named insured a policy which provides
coverage Emily' to% Such policy is subject to the provisions, conditions and limitations contained therein. This
Certificate of IrisuFA oes4iot in any way amend, alter or vary the coverage afforded by the policy referred to herein. It is
simply a synopsis or summary of the actual insurance contract.
CERTIFICATE OF INSURANCE
CERTIFICATE ISSUED TO:
Name and Address
WELD COUNTY HEALTH DEPARTMENT
1516 HOSPITAL RD
GREELEY
CO 80631-0000
ATTN: WES POTTER- DIRECTOR HEALTH PR
Policy Number: HCL 920
Named Insured and Address
NORTH COLORADO MEDICAL CENTER
1801 16TH ST
GREELEY
CO 80631-0000
Policy Period: From: 09/29/1994 To: 09/29/1995
Health Care Providers Comprehensive Liability Policy
Coverages*
Limits of Liability
Each
Medical
Incident
Each
Occurrence
Each
Incident
Aggregate
A. INSTITUTIONAL PROFESSIONAL LIABILITY
1,000,000
N/A
N/A
3,000,000
B. PHYSICIAN PROFESSIONAL LIABILITY
NOT
COVERED
C. PERSONAL INJURY & PROPERTY DAMAGE LIAB.
N/A
1,000,000
N/A
1,000,000
D. STAFF PRIVILEGES PROTECTION
N/A
N/A
3,000,000
3,000,000
• Persons insured under Coverage A (if applicable) include (as indicated by an "X" below):
x ) Professional employees of the named insured, other than physicians.
x) Professional students of the named insured, other than residents.
x) Volunteers of the named insured, other than physicians and residents.
( )
• Persons insured under Coverage B (if applicable) include (as indicated by an "X" below):
( ) Physicians employed by, or under contract with, the named insured listed on the Schedule of Physicians.
( )
Special provisions, if any,
Evidence of Insurance
Producer:
Issued Date:
1*-
HP0,4TCLp15.1 (Rev. 01/92)
FLOOD & PETERSON INSURANCE INC
10/18/1994
AUTHORIZED COMPANY REPRESENTATIVE
PHICO will make every effort to give written notice by regular mail to the above -mentioned Certificate holder of any
material change in or cancellation of this policy, but assumes no liability for failure to do so or for any error.
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