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Home My WebLink About20252936.tiffChloe White From: Sent: To: Cc: Subject: Attachments: CTB Team, Doug Erler Friday, October 24, 2025 1:15 PM CTB Kim Peterson; Dianna Campbell Community Corrections Facility Related Intervention Inc - COI - Weld County Community Corrections 10.6.25.pdf For recordkeeping, please file this updated Certificate of Liability Insurance for our community corrections services vendor. This document should correspond with the most recent Lease Agreement on file to operate at our facility. Thanks. Doug Erler, Director Weld County Justice Services Department 901 10`h Avenue P.O. Box 758 Greeley, CO 80632 Office: 970-400-4847 I Cell: 970-673-2829 Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. CannrY)u rl I cwt; o1,Thg I 1103/ a5 cc.: pc)( 2025-2936 0'5000 sr INSR L.M. TYPE OF INSURANCE L.M. A X COMMERCIAL GENERAL LIABILITY X CLAIMS -MADE OCCUR A•rk3FIECxATE LIMIT APPLIES PER: frl'•I I - JPERb I X i LOC A . AUTOMOBILE LIABILITY INTEINC-69 _ _AS Q. AL CKI .4 CORE) CERTIFICATE OF LIABILITY INSURANCE DATE '5YY) 1170!61202/6/2025 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 ondorsoment(s). PRODUCER LICer15e # 60236 HUB International Three Rivers 2730 Sidney Street, Suite 330 Pittsburgh, PA 15203 INSURED Intervention Inc. Behavioral Treatment Services (BTS) 12600 W. Colfax Avenue, Bldg B-410 Lakewood, CO 80215-3750 C ACT Jean Kowatecki ONE (A C No, Ext)- (412) 992-2825 plc. Nn) -(412) 774-9277 Miss lcan.kowalecki@hubinternational.com INSURER(S) AFFORDING COVERAGE NAJC tl INSURER A Kinsale Insurance Company 38920 INSURERS Pirtnacol Assurance Company 41190 INSURER C INSURER D INSURER E INSURER F " 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. •ADDL SUER POLICYEFF POLICY EXP INS0_WW2_ POLICY NUMETER _ ...IMIYIIDI7IYYY .LIMMIDUI.YYYYI..•. _ _ LIMITS X 01002090173 1011/2025 10/1/2026 EACH OCCURRENCE 5 DAMAGE TO RENTED PREMISES (Ea r r. rrrwncl S MED EXP !Any nr,N nersnn) S E'EFt r);J7L A Al.r! INJURY GET4EitAL AC:,IdEt-'xIE F'i-0S pLIC I! I :'.cr OP MSG S Policy Aggregat 5 3,000,000 250,000 1,000,000 50,000 1,000.000 3,000,000 Included Ls!I.1ilPNtll'N+,„ I- I•!rflr { Ea ANY AUTO X 01002090173 10/1/2025 10/1/2026 fODIc YINluli, II'crr•!•Ir.,rns S OWNED SCHEDULED AUTOS ONLY AUTOS BOUII r rN.rUJIY p',., arr,,,,,r ) 5 X FRED PROPER IY OAI.I4'=•. AUTOS ONLY rPO •,,,,,14,1!1 X N[ rtI3L':!iF ti AL 11 rSE r l•il Y UMBRELLA LIAB EXCESS LIAR DED RETENTIONS OCCUR CLAIMS -MADE B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y + N ,ANY PROPR5-:IOlt"r"AVFTNERcEXcct:' II:I l'Nf IO5R,MEMDEI{ F Y.I:I VI:!I) r N / A IlHnlldulmy Vn NH) II y,!..' Ilisr:,I*- ,3FiC,;IF• NON UI l ISTSSE F I• 'NE !•-•:-,•x A Professional Liab A Abuse(Each Incident) 2019722 10/1/2025 10/1/2026 01002090173 X 01002090173 I-ACIi ii!.' ,51 ORE.CA I X PER ryTi 1• SrAFIJIF 113 FI" F'\(:I I 5'. rI+SENSE IA Lr.IE'E.+7 TS I; I (FISt SC - PCIJC.L L.1'111 10/1/2025 10/1/2026 Per Claim $1M / Agg 10/1/2025 10/1/2026 $250,000 / Agg 100,000 100,000 500,000 3,000,000 500,000 DESCRIPTION OF OPERATIONS r LOCATIONS I VERICLES (ACORD 101, Additional Remarks Schedule, may he auxclled If mnro ep.lce is I.tyurrad) Certificate Holder is recognized as Additional Insured with respects to liability policies (excluding Workers' Compensation) as required by written contract but only to the extent of such contract. CERTIFICATE HOLDER Weld County Community Corrections Weld County Justice Services Department 901 10th Avenue Greeley, CO 80632 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A`C]RD AGENCY UB International Three Rivers POLICY NUMBER EE PAGE 1 CARRIER EE PAGE 1 ADDITIONAL REMARKS AGENCY CUSTOMER ID: INTEINC-69 LOC #: 0 ADDITIONAL REMARKS SCHEDULE License # 60236 NAMED INSURED Intervention Inc. Behavioral Treatment Services (BTS) 12600 W. Colfax Avenue. Bldg B-410 Lakewood, CO 80215.3750 Denver County NAIC CODE SEE P1 EFFECTIVE DATE: SS€E PAGE 1 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 26 FORM TITLE: Certificate of Liability Insurance Additional Policies for 2025-2026 Term Sexual Abuse & Molestation: Carrier: Kinsale Insurance Company - #38920 (A) Policy#: 01002090173 Term: 10/1/2025-10/1/2026 Limits: $250,000 Each Incident / $500,000 Aggregate Excess Sexual Abuse & Molestation: Carrier: Beazley Excess & Surplus Insurance Inc. - #17520 (A) Policy#: D3ABAD250101 Term: 1011/2025-10/1/2026 Limits: $750,000 Each Victim Aggregate / $750,000 Policy Aggregate Cyber Liability Carrier: Fortegra Specialty Insurance Company - #16823 (A-) Policy #: C-4LVN-189564-CYBER-2025 Term: 10/1/2025-10/1/2026 Limits: Each Claim $1,000,000 / Aggregate $1,000,000 Accidental Death & Dismemberment Carrier: Philadelphia Indemnity Insurance company - #18058 (A++) Policy #: PHPA140666-006 Term: 10/1/2025-10/1/2026 Limits: Accidental Death $25,000 Accidental Dismemberment $50,000 Accidental Paralysis $50,000 Accident Medical Expense Benefits Maximum Benefit $25,000 Deductible Amount $0 Scope of Coverage: Full Excess i Commercial Auto - Hired & Non -Owned Autos Only Carrier: Kinsale Insurance Company - #38920 (A) Policy #: 01002090173 Term: 10/1/2025-10/1/2026 Limits: Liability - $250,000 Combined Single Limit JKOWALECKI Page 1 of 1 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Hello