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AGENCY CUSTOMER ID: 5576 <br />�—n LOC <br />r?n"° ADDITIONAL REMARKS SCHEDULE <br />Page 1 of 1 <br />AGENCY <br />INSURED <br />TAPCO- KL (5576) <br />HEALTHY OUTCOMES INC. <br />7897 E 24TH AVE <br />DENVER, CO 80238 <br />POLICY NUMBER <br />MTK1565488A <br />CARRIER <br />NAIC CODE <br />EFFECTIVE DATE: 3/13/2021 <br />United States Liability Insurance Company <br />25895 <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br />COVERAGE PART LIMITS <br />Businessowners Liability <br />Liability and Medical Expenses <br />$1,000,000 <br />Medical Expense (per person) <br />$10,000 <br />Damages To Premises Rented To You (Any One Premises) <br />$300,000 <br />Hired and Non -owned Auto Each Occurrence <br />Included <br />Hired and Non -owned Auto Aggregate <br />Included <br />General Aggregate <br />$2,000,000 <br />Technology Professional Liability <br />Each Claim Limit $2 000 000 <br />Annual Aggregate Limit <br />$2,000,000 <br />Deductible <br />$0 <br />Intellectual Property Each Claim <br />$1,000,000 <br />Intellectual Property Aggregate <br />$1,000,000 <br />Privacy Breach Expense and Defense of Regulatory Claims Each Claim <br />$1,000,000 <br />Privacy Breach Expense and Defense of Regulatory Claims Aggregate <br />$1,000,000 <br />Retroactive Date <br />03/13/2020 <br />ACORD 101 (2008/01) Copyright 2008 ACORD I <br />The ACORD name and logo are registered marks of ACORD <br />�I?i �,S 2, <br />� ' <br />®1 <br />RlekMwganmt Divieimt <br />REVIEWED&IIM�rRCVMBr, <br />F'Aa,G ram, vjt" AI <br />- <br />Ruk Management Analyst <br />