HEALTHY OUTCOMES, INC. DBA BALANCING ACT

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Digitally signed by Ton Pierson Tori Pierson Dt, 2021011510:10:12-07'00 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 03/7/2022 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 TAPCO- KL (5576) PO Box 286 Burlington, NC 27216 CONTACT NAME PHONE (A/C No, Ext): FAX (A/C No): EMAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED HEALTHY OUTCOMES INC. 7897 E 24TH AVE DENVER, CO 80238 INSURER A: United States Liability Insurance Company 25895 INSUREB B: 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY MTK1565488B 3/13/2022 3/13/2023 EACH OCCURENCE $1,000,000 ES ERENTED RMI a occurrence) $300,000 MED EXP (Any one person) $10,000 CLAIMS -MADE M OCCUR PERSONAL & ADV INJURY p` GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG X POLICY PRO LOC i El $ AUTOMOBILIE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ANY AUTO ATTQNED �SYODULED BODILY INJURY (Per accident) $ (eacdet�AMAGE Prrcin $ NON -OWNED HIRED AUTOS AO UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSASION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N QFFICER/MFMRn7 EXCLUDED? (Mandatory in ) N / A WC STgTU- OTH- TORY LIMITS I ER E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DrCRIPT(ON"FeOrPERATIONSbelow A Technology Professional Liability MTK1565488B 3/13/2022 [3/13/2023 EACH CLAIM $2,000,000 ANNUAL AGGREGATE $2,000,000 DEDUCTIBLE EACH CLAIM $0 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (See attached Acord 101 for additional liability limits) Technology Professional Package. The City of Santa Ana, officers, agents, employees and volunteers are named as additional insureds with respects to general liability. Includes a waiver of subrogation (waiver of transfer of rights of recovery against others to us). BP-134 06/09 Blanket Additional Insured is part of this policy. CERTIFICATE HOLDER CANCELLATION The City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Risk Management EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE Division POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE k' Santa Ana, CA 92702 IN) m & frzcr+rExr ACORD 25 (2010/05) Copyright 1988-2010 ACORD CO The ACORD name and logo are registered marks of ACORD rzisk Mar,agemmc ClericxlA de