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CERTIFICATE OF LIABILITY INSURANCE <br />CERTIFICATE NUMBER:REVISION NUITIBER: <br />O 1S88-20teACORD CORPORATION. All rights reserued. <br />The ACORD name and logo are registered marks of ACORD <br />DA1E {MM/DD/YYYY) <br />11t1U2421 <br />THIS CERTIFICATE IS ISSUED AS A IIIATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE OOES NOT AFFIRMATIVELY OR NEGATIVELY AIIIEND, EXTEND OR ALTER THE GOVERAGE AFFORDED BY THE POLICIES <br />SELOW. THIS CERTIFICATE OF lltISURAllCE OOES NOT COilSrlTUTE A CONTRACT BETWEEN THE lSSUtNc IilSURER(S|, AUTHORTZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATF HOLDER. <br />the ceriilicatq holder is an ADDITIONAL INSURED,must have AODITIONAL INSURED provisions o. <br />lf SUBROGATION lS WAIVED, sublEct to the terms and conditions of the certaln pollcies may require an endorsement. A stai6m6nt on <br />thls certlficate does to thE certiflcate holder ln lleu of such <br />PRODUCER <br />CM&F Grorp lnc. <br />'110 Vlbst 40th Street <br />1oth Floor, Suite 100011001 <br />NewYork, NY 10018 <br />1-80a-2214904 <br />MPC <br />INSURED <br />Ellensburg Family Medicine <br />2156 PAYNE RD <br />ELLENSBURG, WA98926-7898 <br />INSURER 8 : <br />INSURERC: <br />INSUNER O : <br />INSUR€R E : <br />INSURER F: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED <br />INDICATED. NOTWTHSTANDING ANY RHQUIR€MENT, TERM OR <br />BELOW HAV€ BEEN ISSUEO 10 THg INSURED NAMEO ABOVE FOR lHE POLICY PERIOD <br />CONDITION OF ANY CONTRACI OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, TH€ INSURANCE AFFORDED 8Y IHH POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIFS, LIMITS SHO'TiN MAY HAVE BEEN RFDUCED BY PAID CLAIMS. <br />INSR TYFE OF INSURANCE poLleY NililEFt POUCY EFF <br />LIMITS <br />A X COMMERC'AL 6ENER.AL UABILITY <br />CLAIMS.MADE OCCUR <br />GEN'L AGGREGATE LIMIT l PERi <br />LOCX"o''""l l588f <br />X <br />u54661 11t29t2021 11t29t2022 EACH @CURRENCE o 1,000,000 <br />s 1,000,000 <br />MED EXP (Any one D€mnl i <br />PERSOML & ADV INJURY e 1,000,000 <br />GENFRAL AGGREGATE s 6,000,000 <br />PRODUCTS. COMP/OF AGG r 6,000,000 <br />$ <br />AUTOilOAILE LIAAIL|TY <br />AI.IY AUIO <br />owNED <br />AUTO$ ONLY <br />HIRED <br />AUTOS ONLY <br />SCHEDULED <br />AUTOS <br />NON"OW!ED <br />AUIOS ONLY <br />g <br />BODILY INJURY {Per psrson)$ <br />BOO,LY INJURY (P6r accideno s <br />$ <br />UMBRELI-ALIIE <br />EXCESS LIAS <br />occuR <br />CLAIMS-MADE <br />EACH OCCURRENCE I <br />AGGREGATE s <br />oFn FFTFN?NN T e <br />WORI(ERS COMPEiI$AION <br />Y, trl <br />ANYPROPRIETOR/PARTNER,IEXECU'IVE <br />OFFICERN/!€MBER EXCLUDED? <br />(Mandatory ln I'lH) <br />lfyss, desdib€ undsr <br />nFSCRIPTION .}F OPFRAtIrrNq kltu <br />N'A <br />PTK <br />STAT! TF UIH-Fd <br />E.L, EACH ACCIDENI $ <br />E-1. D'SEASE . EA EMPLOYEF $ <br />E.t, DISEASE. POUCY IIMIT I <br />A Professional Liability us66'1 't1t29t2121 11t29t2fr22 Per lncidenl <br />Aggregate <br />1,000,000 <br />6,000,000 <br />DESGRIPIIONOFOPERAIONSTLOCAnONSTVEHICLES {ACORDl0l,AddltiomlR€mfftGSchedute}maybaafiacfiedilmonrlrc6irr.qutrurt} <br />Occunence Coverage <br />Nurse Praclitioner Group <br />SHOULD AIiIY OF THE ABOVE DESCRIBED POLICIES BE CANCELL€D BEFoRE <br />THE AXPIRATION OATE TTIEREOF, NOTICE WILL B€ DELIVERED II{ <br />ACCORDA''ICE ffiTH THE POLICY PROVISIONS. <br />Kitlita$ County <br />e*-z*ffii-AU1HORIZ€O NEPRESEITITATIYE <br />ACORD 25 (2016/031