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Certificate of Liability Insurance

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The Certificate of Liability Insurance is only available to view on a computer browser.

Please view on a computer browser or contact Anne Marie Decker to obtain a printable PDF copy.

To obtain a printable PDF version of this certificate, please contact Anne Marie Decker.

Acord Logo

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)
6/30/2016

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 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).

PRODUCER

Arthur J. Gallagher Risk Management Services, Inc. 12444 Powerscourt Drive St. Louis MO 63131

 

CONTACT NAME: Susan J. Fleming

 

PHONE (A/C, No, Ext):

314-800-2296

FAX (A/C, No):

866-947-2801

E-MAIL ADDRESS: susan_fleming@ajg.com

INSURER(S) AFFORDING COVERAGE

NAIC #

INSURER A: United Educators Ins

10020

INSURED

Rockhurst University as a member of CURMA 1100 Rockhurst Road Kansas City, MO 64110-2508

 

INSURER B:

 

INSURER C:

 

INSURER D:

 

INSURER E:

 

INSURER F:

 

 

COVERAGES

CERTIFICATE NUMBER: 253723008

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.

INSR LTR

TYPE OF INSURANCE

 

ADDL

INSD

SUBR

WVD

POLICY NUMBER

POLICY EFF (MM/DD/YYYY)

 

POLICY EXP (MM/DD/YYYY)

 

LIMITS

 

 

▢ COMMERCIAL GENERAL LIABILITY

▢▢CLAIMS MADE ▢ OCCUR

▢ _____________

▢ _____________

GEN'L AGGREGATE LIMIT APPLIES PER:

▢ POLICY ▢ PROJECT ▢ LOC

▢ OTHER:

 

 

 

 

 

EACH OCCURRENCE

$

DAMAGE TO RENTED PREMISES (Ea occurrence)

$

MED EXP (Any one person)

$

PERSONAL & ADV INJURY

$

GENERAL AGGREGATE

$

PRODUCTS - COMP/OP AGG

$

 

$

 

AUTOMOBILE LIABILITY

▢ ANY AUTO

▢ ALL OWNED AUTOS

▢ SCHEDULED AUTOS

▢ HIRED AUTOS 

▢ NON-OWNED AUTOS

 

 

 

 

 

 

COMBINED SINGLE LIMIT

(Ea accident)

$

BODILY INJURY (Per person)

$

BODILY INJURY (Per accident)

$

PROPERTY DAMAGE

(Per accident)

$

 

 

 

▢ UMBRELLA LIAB ▢ OCCUR

▢ EXCESS LIAB ▢ CLAIMS-MADE

▢ DED ▢ RETENTION $

 

 

 

 

 

EACH OCCURRENCE

$

AGGREGATE

$

 

$

 

WORKERS COMPENSATION AND EMPLOYERS’ LIABILITY

ANY PROPRIETOR / PARTNER / EXECUTIVE

OFFICER / MEMBER EXCLUDED?

▢ Y/N 

(Mandatory in NH)

If yes, describe under

DESCRIPTION OF OPERATIONS below

 

 

 

N/A

 

 

 

 

▢ PER STATUTE ▢ OTHER

 

E.L. EACH ACCIDENT

 

$

E.L. DISEASE - EA EMPLOYEE

 

$

E.L. DISEASE - POLICY LIMIT

 

$

A

Licensed Prof. Liability

 

 

 

LPD201600072800

 

7/1/2016

 

7/1/2017

 

Each Claim

1,000,000

Annual Aggregate

3,000,000

 

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

 

Occupational Therapy, Speech Pathology, Physical Therapy and Athletic Training Programs

 

Evidence of Coverage

 

 

CERTIFICATE HOLDER

CANCELLATION

EVIDENCE OF COVERAGE

 

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

Signature

ACORD 25 (2014/01)

© 1988-2014 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

Physical Therapy

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