HEALTHY OUTCOMES, INC. DBA BALANCING ACT

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i CERTIFICATE OF LIABILITY INSURANCE THISCERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELYOR NEGATIVELY AMEND, EXTEND ORALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOTCONSTITUTEA CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the polWies) must have ADDITIONAL INSURED provisions or 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 CONTACT NAME, James Lundin LUNDIN JAMES(0713365 PHONE FAX 700 E 9TH AVE #105 (A/C, NO, Oft 303-433-4542 866-614-1373 E-MAIL DENVER CO 80203 ADDRESS: jiundin@farmersagent.com INSURER(S) AFFORDING COVERAGE NAIC INSURED INSURERA. Truck Insurance Exchange 21709 INSURERS: Farmers Insurance Exchange 21652 HEALTHY OUTCOMES, INC. 7897 E 24TH AVE INSURERC:* Mid Century Insurance Company 21687 INSURER D: Fire Insurance Exchange 21660 DENVER CO 80238-2451 INSURERE: INSURERF. COVERAGES CERTIFICATE NUMBER* REVISION NUMBER: THIS ISTO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAME 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 SUBJECTTO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I.TR TYPE OF INSURANCE ADOTL INSD SUBR Vivo POUCYNUMSER POLICY EFF (MM/DD/YYYY) POUCYEXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS MADE OCCUR DAMAGE TO RENTED P R E M I S E S (Ea Occurrence) $ MED EXP (Any one person) $ PFRSONAL&ADV INJURY . ......... $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ POLICY [—] PROJECT LOC PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANYAUTO BODILY INJURY (Per person) $ OWNEDAUTOS SCHEDULED ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ HIREDAUTOS NON -OWNED ONLY AUTOSONLY -.-...--------......_...-.-_..-....-.----... $ UMBRELLA UABI OCCUR EACHOCCURRENCE ........ .. . . . $ EXCESSLIAR CLAIMS -MADE AGGREGATE $ DED [� RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS'LIABIUTY JfHER $ D ANY PROPRIETOR/PARTNER/ Y/N EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) EYK N/A Y A04176360 01/17/2022 01/17/2023 E.L. EACH ACCIDENT $ 1,000,000 E.L.DISEASE-EA P YEE 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 lfyes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPCRATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached ffmore space Is required) ,ertificate holder is listed as Additional insured on the named Insured's general liability policy. Nalver of Subrogation applies in favor of the certificate holder on the workers compensation policy. The consultant hereby grant to Grantee a waiver of any right -o subrogation which any Insurer of said consultant may squire against City by virtue of the payment of any loss under such Insurance. Consultant agrees to )btain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether or not the City has received a AiMvPff_nf_qi ihffmatinn-AndarsArnAnt-fiTimAhaJnsa CERTIFICATE HOLDER Risk Management Division 20 Civic Center Plaza ACORD 25 (2016/03) 31-1769 11-15 =*W.WL*M SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCO AUTHORIZED REPRESENTATIVE James Lundl R.D & tUPROVED BY. 4, 1988-2015 ACORD C ftM_�ToToTqs7iTTiTj-7 Mis 577-71773,La t - .