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CERTIFICA <br />CERTIFICATE OF LIABILITY INSURANCE <br />NUMBER:REVISION NUMBER <br />@ 1 988-201 6 ACORD CORPORATION. Att rights reseryed. <br />The ACORD name and logo are reglstered marks of ACORD <br />DAIE I$M/ODTYYVY) <br />finano21 <br />THIS CERTIFICATE IS ISSUE8 AS A MATTER OF INFORTI'ATION ONLY AND CONFERS NO RIGHTS UPOI'I THE CERTIFICATE HOLDER. THIS <br />CERNFrcATE DOES NOT AFFIRI,ATIVELY OR NEGATIVELY ATUIEND, EXTENO OR ALTER THE COVERAGE AFFORDEO BY THE PoLIcIEs <br />SELOW- THIS CERTIFICATE OF IIISURANCE OOES NOT COa{STffUTE A COT,ITRACT BETWEEN THE ISSUING TNSURER{S), AUTHORTZED <br />REPRFSENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />lMPoRTANT:lfthece*ificateholderisanADDlTloNALlNsuRED,thepolicy(ies}mui{trivndo]8od. <br />ll SUBROGATION lS WAlvED, subject to the terms and conditlons of lhe policy, certain poilcls$ may require an endor€oment. A slalement on <br />this cortiflcate does not confer rights to the certilicate holder in ligu ofsuch endonsement(3). <br />PRODUCER <br />CM&F Group lnc. <br />11014&st 40th Street <br />1oth Floor, Suite 1000/100'l <br />Na,rrYork, NY 10018 <br />CM&F <br />1-800-2214904 <br />INSURERTSI AFFOROING COVERAGE NAIC # <br />INSURERA; MEDICAL PROTECTIVE COMPANY- MPC <br />INSURED <br />Ellensburg Family Medicine <br />2,I56 PAYNE RD <br />ELLENSBURG, WA98926.78S8 <br />INSURER B : <br />INSURER C : <br />INSURER O : <br />INSURER E ; <br />INSURER F : <br />THIS IS TO CERTIFY THAT THg POLICIES OF INSURANCH LISTED BELOW HAVE BEEN ISSUED TO THE <br />IHOICATED. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDI1ION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERIAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOVIN MAY HAVE BEEN REDUCED BY PAID CLAIMS- <br />INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INSRIE TYPE OF INSURANCE POUCY NUIIllEEP Ltilrts <br />EACH OCCURRENCE s 1,000,000 <br />s 1,000,000 <br />MED EXP tAny one torsonl E <br />PERSONAL & AOV INJURY r 1,000,000 <br />GENERALAGGREGATF s 6,000,000 <br />PRODUCTS. COMP/OF AGG s 6,000.000 <br />A COMMERCIALGENERAL LNAILITY <br />GEN'LAGGREGATE LIMIT <br />X <br />X <br />nf--l pno- <br />L,- J JECTxPOUCY <br />CLAIMS.MADE OCCUR <br />PFR: <br />LOC <br />X u5466 t 11t29t2021 11t29t2022 <br />I <br />BOOILY INJURY tPer pelsl ! <br />EODILY INJURY {Per a6idsnt} <br />$ <br />AUTOMOBILE LIABIUTY <br />SCHEDULED <br />ALTTOS <br />NON"OWT.JED <br />AUTOS ONLY <br />AUIOS <br />ITIRED <br />AUTOS ONLY <br />ONLY <br />ANY AUTO <br />OW\]ED <br />$ <br />FACH OCCURRENCE DUMSRELLAUAE <br />EXCESS UAB <br />OCCUR <br />CLAIMS.MAOE AGGREGATE I <br />DED RFTFNTION S <br />tstsKGTA'I ITF UIH.FR <br />E.L. EACH ACCIDENT <br />E.L. DISEASE - EA EMPLOYEE E <br />ANI' EMPLOYERS' LIAdILITV tlEXCLUOED?N/A <br />E,L. DISEASE . POUCY IIMIT <br />A Professional Liability u54661 11t29n921 11t29t2022 Per lncidenl <br />Aggregate <br />'1,000,000 <br />6,000,000 <br />DESCHPfiONOFOPFRATIONSILOCAIONSTVEHICLES {ACOR0 lOt,AddldonalRemrksSqhedsls,mybeettscieditmorcrpa@'rtsquindl <br />Occunence Coverage General Liability Additional lnsured: <br />Kiltitas County <br />Nurse Practilioner Grcup 230 Grant Rd-Ste 827 <br />Ellensburg, WA989?6 <br />$HOULD ANY OF THE ABOVE DE$CRIBED POLICIE$ EE CAITICELLED SEFORE <br />THE EIPIF.ATION DATE THEREOF, NONCE WLL BE DELTVERED II{ <br />ACCORDAHCE IIVITH THE POLICY PROVISIONS. <br />Kitlitas County <br />230 Grant Rd Ste 827 <br />205w5th Ave <br />Ellensburg,WA98926 <br />C.*t--€ffi=:4:-AU1TIORIZED REPRESENTATIVE <br />ACORD 25 (2016/03)