HomeMy WebLinkAboutC15-362 University Physicians, Inc. a AGREEMENT FOR PROFESSIONAL SERVICES BETWEEN EAGLE COUNTY, COLORADO AND UNIVERSITY PHYSICIANS, INC. On behalf of the Kempe Center for the Prevention and Treatment of Child Abuse and Neglect THIS AGREEMENT("Agreement") is effective as of the ( e'day of , Pi t`AG E--, 2015 by and between University Physicians, Inc. ("UPI"or"University Physicians"), with a business address of 13199 E. Montview Boulevard,Aurora, Colorado 80045, a Colorado non-profit corporation established by the Board of Regents of the University of Colorado to serve as the fiscal and business agent for the University of Colorado School of Medicine("SOM") and its faculty members, including the Kempe Center for Prevention and Treatment of Child Abuse and Neglect(hereinafter"Consultant" or"KEMPE CENTER") and Eagle County,Colorado, a body corporate and politic (hereinafter"County"). RECITALS WHEREAS, the County, through its Department of Health and Human Services ("HHS") works to promote the health, safety and welfare of County residents of all ages; and WHEREAS,the County uses outside providers and professionals to enhance the ability of County to promote such health, safety and welfare; and WHEREAS,Consultant is authorized to do business in the State of Colorado and has the time, skill, expertise, and experience necessary to provide the Services; and WHEREAS, the University of Colorado has established University Physicians to serve as the business and fiscal agent of the University of Colorado School of Medicine; and WHEREAS, County has the need for professional services as defined below in Paragraph 1 and desires to secure the professional services of KEMPE CENTER, who are University of Colorado School of Medicine faculty members and employees; and WHEREAS, University Physicians is willing to contract on behalf of the University of Colorado School of Medicine for the provision of such services by the KEMPE CENTER; and WHEREAS,this Agreement shall govern the relationship between Consultant and County in connection with the Services. AGREEMENT NOW, THEREFORE, in consideration of the foregoing and the following promises Consultant and County agree as follows: C(C -3(g2, 1. Services. Consultant agrees to diligently provide all services, labor,personnel and materials necessary to perform and complete the services described in Exhibit A("Services") which is attached hereto and incorporated herein by reference. The Services shall be performed in accordance with the provisions and conditions of this Agreement. a. Consultant agrees to furnish the Services no later than May 31St, 2016 and in accordance with the schedule established in Exhibit A. If no completion date is specified in Exhibit A,then Consultant agrees to furnish the Services in a timely and expeditious manner consistent with the applicable standard of care. By signing below Consultant represents that it has the expertise and personnel necessary to properly and timely perform the Services. b. In the event of any conflict or inconsistency between the terms and conditions set forth in Exhibit A and the terms and conditions set forth in this Agreement,the terms and conditions set forth in this Agreement shall prevail. c. Consultant agrees that it will not enter into any consulting or other arrangements with third parties that will conflict in any manner with the Services. 2. County's Representative. The Children,Family and Adult Services Department's designee shall be Consultant's contact with respect to this Agreement and performance of the Services. 3. Term of the Agreement. This Agreement shall commence upon the date first written above, and subject to the provisions of paragraph 11 hereof, shall continue in full force and effect through the 31St day of May, 2016 4. Extension or Modification. This Agreement may not be amended or supplemented, nor may any obligations hereunder be waived, except by agreement signed by both parties. No additional services or work performed by Consultant shall be the basis for additional compensation unless and until Consultant has obtained written authorization and acknowledgement by County for such additional services in accordance with County's internal policies. Accordingly,no course of conduct or dealings between the parties, nor verbal change orders, express or implied acceptance of alterations or additions to the Services, and no claim that County has been unjustly enriched by any additional services, whether or not there is in fact an y such c unjust enrichment, shall be the basis of any increase in the compensation payable hereunder. In the event that written authorization and acknowledgment by County for such additional services is not timely executed and issued in strict accordance with this Agreement, Consultant's rights with respect to such additional services shall be deemed waived and such failure shall result in non-payment for such additional services or work performed. 5. Compensation. County shall compensate UPI(on behalf of Consultant) for the performance of the Services in a sum computed and payable as set forth in Exhibit A. The performance of the Services under this Agreement shall not exceed$7,000. Consultant shall not be entitled to bill at overtime and/or double time rates for work done outside of normal business hours unless specifically authorized in writing by County. 2 Eagle County HHS Prof Sery Final 5/14 • a. The parties acknowledge that UPI is an independent non-profit organization that serves as the centralized business and contracting agent for the University of Colorado School of Medicine(SOM) and all full-time employees of the SOM, including KEMPE CENTER, have assigned rights to any income earned from professional services to UPI. Income from such services is billed and collected by UPI and then disbursed to SOM in accordance with UPI policies and procedures. UPI performs centralized business and administrative functions on behalf of SOM and in no manner engages in the practice of medicine itself. The parties acknowledge and agree that UPI is authorized to bill for and collect from the County the fees arising from this Agreement. b. For reimbursement Consultant must submit invoices monthly. Invoices shall include a description of Services performed. If County is not satisfied with the completeness of a submitted invoice, County may request Consultant to either revise the invoice or provide additional information. Payment will be made for Services satisfactorily performed within thirty(30)days of receipt of a proper and accurate invoice. All invoices shall include detail regarding the hours spent,tasks performed, who performed each task and such other detail as County may request. All invoices must be mailed or delivered in-person to the following address to ensure proper payment. Invoices sent by fax or e-mail will not be accepted. Eagle County Health and Human Services Business Office 550 Broadway Post Office Box 660 Eagle,CO 81631 All payments shall be made to University Physicians, Inc. at the following payment remittance address: University Physicians, Inc. Finance Department P.O. Box 110247 Aurora,CO 80042-0247 c. Any out-of-pocket expenses to be incurred by Consultant and reimbursed by County shall be identified on Exhibit A. Out-of-pocket expenses will be reimbursed without any additional mark-up thereon and are included in the not to exceed contract amount set forth above. Out-of-pocket expenses shall not include any payment of salaries, bonuses or other compensation to personnel of Consultant. Consultant shall not be reimbursed for expenses that are not set forth on Exhibit A unless specifically approved in writing by County. d. If,prior to payment of compensation or reimbursement for Services but after submission to County of a request therefore by Consultant,County reasonably determines that payment as requested would be improper because the Services were not performed as prescribed by the provisions of this Agreement,the County shall have no obligation to make such payment. If, at any time after or during the term or after termination or expiration of this Agreement, County reasonably determines that any payment 3 Eagle County HHS Prof Sery Final 5/14 theretofore paid by County to Consultant was improper because the Services for which payment was made were not performed as set forth in this Agreement,then upon written notice of such determination and request for reimbursement from County, Consultant shall forthwith return such payment(s) to County. Upon termination or expiration of this Agreement,unexpended funds advanced by County, if any, shall forthwith be returned to County. e. All funds received by Consultant under this Agreement shall be or have been expended solely for the purpose for which granted, and any funds not so expended, including funds lost or diverted for other purposes, shall be returned to County. Consultant shall provide the County with progress reports upon County's request; or Consultant shall furnish progress reports as more specifically set forth in the attached Exhibit A. f. County will not withhold any taxes from monies paid to the Consultant hereunder and Consultant agrees to be solely responsible for the accurate reporting and payment of any taxes related to payments made pursuant to the terms of this Agreement. g. Notwithstanding anything to the contrary contained in this Agreement, County shall have no obligations under this Agreement after, nor shall any payments be made to Consultant in respect of any period after December 31 of any year, without an appropriation therefor by County in accordance with a budget adopted by the Board of County Commissioners in compliance with Article 25,title 30 of the Colorado Revised Statutes,the Local Government Budget Law (C.R.S. 29-1-101 et. seq.) and the TABOR Amendment(Colorado Constitution,Article X, Sec. 20). 6. Sub-consultants. Consultant acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of Consultant. Consultant shall not enter into any sub-consultant agreements for the performance of any of the Services or additional services without County's prior written consent, which may be withheld in County's sole discretion. County shall have the right in its reasonable discretion to approve all personnel assigned to the subject project during the performance of this Agreement and no personnel to whom County has an objection, in its reasonable discretion, shall be assigned to the project. Consultant shall require each sub-consultant, as approved by County and to the extent of the Services to be performed by the sub-consultant,to be bound to Consultant by the terms of this Agreement, and to assume toward Consultant all the obligations and responsibilities which Consultant, by this Agreement, assumes toward County. County shall have the right(but not the obligation) to enforce the provisions of this Agreement against any sub-consultant hired by Consultant and Consultant shall cooperate in such process. The Consultant shall be responsible for the acts and omissions of its agents,employees and sub-consultants or sub-consultants. 7. Insurance. Consultant agrees to provide and maintain at Consultant's sole cost and expense,the following insurance coverage with limits of liability not less than those stated below: i. As an employee of the University of Colorado, Consultant shall have professional liability coverage through the University of Colorado Self Insurance Trust and such other insurance as shall be necessary to insure against any medical malpractice claims which may arise out of direct patient care and other professional activities contemplated under this Agreement. 4 Eagle County HHS Prof Sery Final 5/14 ii. SOM self-insures (through the University of Colorado Self Insurance Trust) for professional liability insurance for itself and for its public employees who provide health care and other professional services pursuant to the Colorado Governmental Immunity Act (Colorado Revised Statutes, §§ 24-10-101 et. seq). The University of Colorado's self-insurance program provides coverage in accordance with the limits of the Colorado Governmental Immunity Act, which provides that the maximum amount that may be recovered against a public entity or public employee shall be: (a)For any injury to one person in a single occurrence,the sum of three hundred fifty thousand dollars ($350,000.00); and (b)For any injury to two or more persons in any single occurrence,the sum of nine hundred ninety thousand dollars($990,000.00); except in such instance recovery per person may not exceed three hundred fifty thousand dollars ($350,000.00). iii. Pursuant to the Colorado Governmental Immunity Act, SOM will be responsible for injuries sustained from an act or omission of a public employee occurring during the performance of the employee's duties and within the scope of his/her employment, unless the act or omission is willful and wanton or where sovereign immunity bars the action against SOM. iv. The parties hereto understand and agree that the County is relying on, and does not waive or intend to waive by any provision of this Agreement,the monetary limitations or rights, immunities and protections provided by the Colorado Governmental Immunity Act, as from time to time amended, or otherwise available to County, its affiliated entities, successors or assigns, its elected officials,employees, agents and volunteers. v. Consultant is not entitled to workers' compensation benefits except as provided by the Consultant,nor to unemployment insurance benefits unless unemployment compensation coverage is provided by Consultant or some other entity. The Consultant is obligated to pay all federal and state income tax on any moneys paid pursuant to this Agreement. 9. Ownership of Documents. All documents prepared by Consultant in connection with the Services shall become property of County. Consultant shall execute written assignments to County of all rights (including common law, statutory, and other rights, including copyrights)to the same as County shall from time to time request. For purposes of this paragraph,the term"documents" shall mean and include all reports,plans, studies,tape or other electronic recordings,drawings, sketches,estimates, data sheets, maps and work sheets produced, or prepared by or for Consultant(including any employee or sub- Consultant in connection with the performance of the Services and additional services under this Agreement). 10. Notice. Any notice required by this Agreement shall be deemed properly delivered when (i) personally delivered, or(ii)when mailed in the United States mail,first class postage prepaid, or(iii) 5 Eagle County HHS Prof Sery Final 5/14 when delivered by FedEx or other comparable courier service,charges prepaid,to the parties at their respective addresses listed below, or(iv) when sent via facsimile so long as the sending party can provide facsimile machine or other confirmation showing the date,time and receiving facsimile number for the transmission, or(v) when transmitted via e-mail with confirmation of receipt. Either party may change its address for purposes of this paragraph by giving five (5) days prior written notice of such change to the other party. COUNTY: Eagle County, Colorado Attention: Toni Rozanski 500 Broadway Post Office Box 660 Eagle,CO 81631 Telephone: 970-328-8852 Facsimile: 1-855-848-8826 E-Mail: toni.rosanski @eaglecounty.us With a copy to: Eagle County Attorney 500 Broadway Post Office Box 850 Eagle, Co 81631 Telephone: 970-328-8685 Facsimile: 970-328-8699 E-Mail: atty @eaglecounty.us CONSULTANT: University Physicians Inc. Kempe Center for Prevention and Treatment of Child Abuse and Neglect Attention: Rob Murchison 13199 E.Montview Boulevard Aurora,Colorado 80045 Telephone:303 864-5338 Facsimile: (303) 864-5367 E-Mail: Robert.Murchison @childrenscolorado.org 11. Termination. Either party may terminate this Agreement,in whole or in part, at any time and for any reason, with or without cause, and without penalty therefor with seven (7) calendar days' prior written notice to the other party. Upon termination of this Agreement, Consultant shall immediately provide County with all documents as defined in paragraph 9 hereof,in such format as County shall direct and shall return all County owned materials and documents. County shall pay Consultant for Services satisfactorily performed to the date of termination. 6 Eagle County HHS Prof Sery Final 5/14 12. Venue,Jurisdiction and Applicable Law. Any and all claims, disputes or controversies related to this Agreement, or breach thereof, shall be litigated in the District Court for Eagle County, Colorado, which shall be the sole and exclusive forum for such litigation. This Agreement shall be construed and interpreted under and shall be governed by the laws of the State of Colorado. 13. Execution by Counterparts;Electronic Signatures. This Agreement may be executed in two or more counterparts, each of which shall be deemed an original,but all of which shall constitute one and the same instrument. The parties approve the use of electronic signatures for execution of this Agreement. Only the following two forms of electronic signatures shall be permitted to bind the parties to this Agreement: (i) Electronic or facsimile delivery of a fully executed copy of the signature page; (ii) the image of the signature of an authorized signer inserted onto PDF format documents. All documents must be properly notarized, if applicable. All use of electronic signatures shall be governed by the Uniform Electronic Transactions Act,C.R.S. 24-71.3-101 to 121. 14. Other Contract Requirements. a. In rendering the Services hereunder,Consultant shall comply with the highest standards of customer service to the public. Consultant shall provide appropriate supervision of its employees to ensure the maintenance of these high standards of customer service and professionalism are maintained. The performance of such obligation shall be determined at the sole discretion of County. In the event County finds these standards of customer service are not being met by Consultant,County may terminate this Agreement, in whole or in part,upon seven(7) days' notice to Consultant. b. Consultant shall be responsible for the completeness and accuracy of the Services, including all supporting data or other documents prepared or compiled in performance of the Services, and shall correct, at its sole expense, all significant errors and omissions therein. The fact that the County has accepted or approved the Services shall not relieve Consultant of any of its responsibilities. Consultant shall perform the Services in a skillful,professional and competent manner and in accordance with the standard of care, skill and diligence applicable to Consultants performing similar services. This paragraph shall survive termination of this Agreement. c. Consultant represents and warrants that it has the expertise and personnel necessary to properly perform the Services and covenants that its professional personnel are duly licensed to perform the Services within Colorado. d. Consultant agrees to work in an expeditious manner, within the sound exercise of its judgment and professional standards, in the performance of this Agreement. Time is of the essence with respect to this Agreement. e. This Agreement constitutes an agreement for performance of the Services by Consultant as an independent Consultant and not as an employee of County. Nothing contained in this Agreement shall be deemed to create a relationship of employer-employee, master-servant,partnership,joint venture or any other relationship between County and Consultant except that of independent Consultant. Consultant shall have no authority to bind County. 7 Eagle County HHS Prof Sery Final 5/14 f. Consultant represents and warrants that at all times in the performance of the Services, Consultant shall comply with any and all applicable federal and state laws, codes,rules and regulations. g. Consultant shall comply with the Civil Rights Act of 1964 and Section 504, Rehabilitation Act of 1973,concerning discrimination on the basis of race,color, sex, age,religion, political beliefs,national origin or handicap. h. This Agreement contains the entire agreement between the parties with respect to the subject matter hereof and supersedes all other agreements or understanding between the parties with respect thereto. i. Consultant shall not assign any portion of this Agreement without the prior written consent of the County. Any attempt to assign this Agreement without such consent shall be void. j. This Agreement shall be binding upon and shall inure to the benefit of the parties hereto and their respective permitted assigns and successors in interest.Enforcement of this Agreement and all rights and obligations hereunder are reserved solely for the parties, and not to any third party. k. No failure or delay by either party in the exercise of any right hereunder shall constitute a waiver thereof. No waiver of any breach shall be deemed a waiver of any preceding or succeeding breach. 1. The invalidity, illegality or unenforceability of any provision of this Agreement shall not affect the validity or enforceability of any other provision hereof. m. Consultant shall maintain for a minimum of three years, adequate financial and other records for reporting to County. Consultant shall be subject to financial audit by federal, state or county auditors or their designees. Consultant authorizes such audits and inspections of records during normal business hours,upon 48 hours' notice to Consultant. Consultant shall fully cooperate during such audit or inspections. n. The signatories to this Agreement aver to their knowledge, no employee of the County has any personal or beneficial interest whatsoever in the Services or Property described in this Agreement. The Consultant has no beneficial interest,direct or indirect,that would conflict in any manner or degree with the performance of the Services and Consultant shall not employ any person having such known interests. o. The Consultant,if a natural person eighteen(18)years of age or older, hereby swears and affirms under penalty of perjury that he or she(i)is a citizen or otherwise lawfully present in the United States pursuant to federal law, (ii)to the extent applicable shall comply with C.R.S. 24-76.5-103 prior to the effective date of this Agreement. 15. Prohibitions on Government Contracts. 8 Eagle County HHS Prof Sery Final 5/14 As used in this Section 15,the term undocumented individual will refer to those individuals from foreign countries not legally within the United States as set forth in C.R.S. 8-17.5-101, et. seq. If Consultant has any employees or sub-Consultants, Consultant shall comply with C.R.S. 8-17.5-101, et. seq., and this Agreement. By execution of this Agreement, Consultant certifies that it does not knowingly employ or contract with an undocumented individual who will perform under this Agreement and that Consultant will participate in the E-verify Program or other Department of Labor and Employment program ("Department Program") in order to confirm the eligibility of all employees who are newly hired for employment to perform Services under this Agreement. a. Consultant shall not: i. Knowingly employ or contract with an undocumented individual to perform Services under this Agreement; or ii. Enter into a subcontract that fails to certify to Consultant that the sub-consultant shall not knowingly employ or contract with an undocumented individual to perform work under the public contract for services. b. Consultant has confirmed the employment eligibility of all employees who are newly hired for employment to perform Services under this Agreement through participation in the E-Verify Program or Department Program, as administered by the United States Department of Homeland Security. Information on applying for the E-verify program can be found at: http://www.dhs.gov/xprevprot/programs/gc 1185221678150.shtm c. Consultant shall not use either the E-verify program or other Department Program procedures to undertake pre-employment screening of job applicants while the public contract for services is being performed. d. If Consultant obtains actual knowledge that a sub-consultant performing work under the public contract for services knowingly employs or contracts with an undocumented individual, Consultant shall be required to: i. Notify the sub-consultant and County within three (3) days that Consultant has actual knowledge that the sub-consultant is employing or contracting with an undocumented individual; and ii. Terminate the subcontract with the sub-consultant if within three days of receiving the notice required pursuant to subparagraph(i) of the paragraph (d)the sub-consultant does not stop employing or contracting with the undocumented individual; except that Consultant shall not terminate the contract with the sub-consultant if during such three (3) days the sub-consultant provides information to establish that the sub-consultant has not knowingly employed or contracted with an undocumented individual. 9 Eagle County HHS Prof Sery Final 5/14 e. Consultant shall comply with any reasonable request by the Department of Labor and Employment made in the course of an investigation that the department is undertaking pursuant to its authority established in C.R.S. 8-17.5-102(5). f. If Consultant violates these prohibitions, County may terminate the Agreement for breach of contract. If the Agreement is so terminated specifically for breach of this provision of this Agreement, Consultant shall be liable for actual and consequential damages to County as required by law. g. County will notify the Colorado Secretary of State if Consultant violates this provision of this Agreement and County terminates the Agreement for such breach. By signing this Agreement,UPI is acting on behalf of SOM in UPI's capacity as SOM's designated business and fiscal agent. All services to be performed pursuant to this Agreement will be carried out by SOM and its employees/faculty members, who at all times will be subject to and covered by SOM administrative policies and all applicable Colorado state law and regulation governing public employees of the state of Colorado and its component units and departments, including the University of Colorado and the University of Colorado School of Medicine. //REST OF PAGE INTENTIONALLY LEFT BLANK// 10 Eagle County HHS Prof Sery Final 5/14 IN WITNESS WHEREOF, the parties have executed this Agreement the day and year first set forth above. COUNTY OF EAGLE, STATE OF COLORADO, By and Through Its COUNTY MANAGER By: .� B /2/. Y Brent 'cFall, ounty Manager UNIVERSITY PHYSICIANS,INC. By: Jane umaker Date Executive Director Senior Associate Dean for Finance and Administration University of Colorado School of Medicine 11 Eagle County HHS Prof Sery Final 5/14 EXHIBIT A SCOPE OF SERVICES, SCHEDULE,FEES Description of Services: Consultant shall arrange for and provide individual and family counseling services for families and children involved in Eagle County Children, Family and Adult Services Prevention and Intervention programs by licensed and trained professionals.This includes: families involved with Child Welfare, Wayfinder,Colorado Community Response, or Program Area 3. The goal of prevention programs is to prevent child abuse or neglect and/or youth delinquency. The goal of Child Welfare intervention services is to prevent unnecessary placement of children and youth in out-of-home care, support family preservation, and assist in family reunification. Additional Provisions: 1. Assessments and Planning. Consultant shall provide the County with an assessment and plan within thirty (30)days of enrollment or participation in services by a family or child.This plan shall include the treatment plan for the child's family, including specific objectives and target dates for accomplishment. Such plan shall be subject to review and approval by County. Thereafter, at monthly intervals, Consultant shall submit reports that include progress and barriers in achieving the goals and provisions of the treatment plan. Reimbursement for services relating to the plan is subject to the timely receipt of written assessment,plan, and reports. 2. Eligibility. County is responsible for determining the eligibility of each individual family for services under this agreement. County shall advise Consultant in writing of the authorized service plan within three(3) working days of receipt of the certification and service plan. There shall be no payment for services provided without prior authorization for such services by the County. Such authorization shall include the level of services to be provided,the nature and type of services provided and the time frames in which these services are to be provided. 3. Mandatory Reporting. Consultant shall notify HHS immediately of all reports of suspected child abuse or neglect involving Consultant, including,but not limited to, employees, volunteers and clients. HHS Consultants are considered to be mandatory reporters for suspected child abuse and neglect and are to make those reports directly to HHS Youth and Family Services Child Abuse and Neglect Hotline- (970) 328-7720. Payment and Fee Schedule: County will compensate Consultant for performance of services as follows: (1)Face to face contact with the client or family for individual and family counseling services -$90 per hour for In Office Services(2) Case management services -$35 per hour to perform services or participate in case conferences. The maximum contract amount is not to exceed$7,000. All payments shall be made to University Physicians, Inc. at the following payment remittance address: University Physicians, Inc. Finance Department P.O. Box 110247 Aurora,CO 80042-0247 12 Eagle County HHS Prof Sery Final 5/14 EXHIBIT B Insurance Certificate 13 Eagle County HHS Prof Sery Final 5/14 AREI® CERTIFICATE OF LIABILITY INSURANCE 7/31/2015 DmYY) 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 CONTACT NAME: Anita Bruner Arthur J.Gallagher Risk Management Services, Inc. PHONE Ext 303-889-2574 F'4X 303-889-2575 6399 S. Fiddlers Green Cir (A/C, r ram): E-MAIL anita_bruner a Greenwood Village CO 80111 ADDRESS: @ Jg•com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Continental Casualty Company 20443 INSURED INSURER B:Continental Insurance Company 35289 University Physicians, Incorporated INSURER C: P O Box 110247 INSURER D Aurora, CO 80042-0247 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:839473664 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 4016839624 7/1/2015 7/1/2016 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $300,000 _ MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY PRO T LOC PRODUCTS-COMP/OP AGG $2,000,000 JEC OTHER: $ B AUTOMOBILE LIABILITY 4016839607 7/1/2015 7/1/2016 COMBINED SINGLE LIMIT $ (Ea accident) $1,000,000 _ X ANY AUTO BODILY INJURY(Per person) $ AUTOS NED SCHEDULED BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) $ _ $ A X UMBRELLA LIAB X OCCUR 4016839610 7/1/2015 7/1/2016 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION$10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) RE: Evidence of coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Eagle County Health and Human Services ACCORDANCE WITH THE POLICY PROVISIONS. 551 Broadway P.O. Box 660 AUTHORIZED REPRESENTATIVE Eagle CO 81631 J ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD