HomeMy WebLinkAboutC25-036 Colorado Mountain MedicalAGREEMENT FOR PROFESSIONAL SERVICES BETWEEN EAGLE COUNTY, COLORADO AND COLORADO MOUNTAIN MEDICAL FOR MEDICAL DIRECTOR SERVICES THIS AGREEMENT (“Agreement”) is effective as of January 1, 2025 by and between Colorado Mountain Medical, a Colorado corporation (hereinafter “Contractor”) and Eagle County, Colorado, a body corporate and politic (hereinafter “County”). RECITALS WHEREAS, the County, through its Department of Public Health and Environment (“PHE”) 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, Contractor employs a team of primary care physicians, specialists and other practitioners with offices in Eagle County; and WHEREAS, Contractor employs Diane Voytko, M.D. who is licensed to practice medicine in the State of Colorado and has the time, skill, expertise, and experience necessary to provide the Services as defined below in paragraph 1 hereof; and WHEREAS, County desires to appoint Dr. Diane Voytko as Eagle County Public Health and Environment’s Medical Director to perform the Services defined in Exhibit A; and WHEREAS, this Agreement shall govern the relationship between Contractor and County in connection with the Services. AGREEMENT NOW, THEREFORE, in consideration of the foregoing and the following promises Contractor and County agree as follows: 1. Appointment. Until further order of the Board, County hereby appoints Diane Voytko as Eagle County Public Health & Environment Medical Director to provide the services required of Contractor hereunder. In the event that Dr. Voytko is unavailable to provide Medical Director Services as requested by County, County may either (a) approve of another Physician employed or retained by Contractor to render such services; or (b) elect to contract for the services of a Physician not employed or retained by Contractor. In the former event, such Physician must be specifically approved in writing by County prior to the rendering of such services. The County may revoke its approval of a Physician at any time by written notice of such revocation to Contractor. Docusign Envelope ID: FC3BEFD1-48ED-4B02-8E2E-A38699922623 The term "Physician" as used herein shall mean any physician employed or otherwise retained by Contractor and approved by County to furnish services pursuant to this Agreement. County may revoke its approval of a Physician at any time by written notice of such revocation to Contractor. The services of a Physician hereunder may be requested and activated by the Board of County Commissioners, County Manager, Public Health & Environment Director or designee. 2.Licensure and Staff Membership. Contractor warrants that any Physician performing services for County under this Agreement shall (a) at all times hold a currently valid and unlimited license to practice medicine in the State of Colorado; and (b) apply for, be awarded and maintain in good standing membership on the medical staff of Contractor with appropriate and unrestricted privileges, or receive and maintain temporary privileges, all in accordance with Contractor’s policies. Per Colorado State Board of Nursing requirements, collaborative agreements will be put into place to designate prescriptive authority relationships between all of County’s Advance Practice Nurses and Dr. Voytko. 3.Services. Contractor 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.Contractor agrees to furnish the Services no later than December 31, 2025 and in accordance with the schedule established in Exhibit A. If no completion date is specified in Exhibit A, Contractor agrees to furnish the Services in a timely and expeditious manner consistent with the applicable standard of care. By signing below Contractor 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.Contractor agrees that it will not enter into any consulting or other arrangements with third parties that will conflict in any manner with the Services. 4.County’s Representative. The Public Health & Environment Department’s designee shall be Contractor’s point of contact with respect to this Agreement and performance of the Services. 5.Term of the Agreement. This Agreement shall commence upon the date first written above, and subject to the provisions of paragraph 12 hereof, shall continue in full force and effect through the 31st day of December, 2025. 6.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 Docusign Envelope ID: FC3BEFD1-48ED-4B02-8E2E-A38699922623 work performed by Contractor shall be the basis for additional compensation unless and until Contractor 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 any such 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, Contractor’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. 7. Compensation. County shall compensate Contractor for the performance of Services of the in the amount of $1,000.00 per month ($12,000.00 per year) plus $2,000 per year to cover expenses associated with the provision of professional liability (malpractice) insurance. The performance of the Services under this Agreement shall not exceed $14,000. Contractor 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. a. Payment will be made for Services satisfactorily performed within thirty (30) days of receipt of a proper and accurate invoice from Contractor. All invoices shall include a description of services performed and such other details as County may request. b. Any out-of-pocket expenses to be incurred by Contractor 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 Contractor. Contractor shall not be reimbursed for expenses that are not set forth on Exhibit A unless specifically approved in writing by County. c.If, at any time during the term or after termination or expiration of this Agreement, County reasonably determines that any payment made by County to Contractor 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, Contractor 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. d. County will not withhold any taxes from monies paid to the Contractor hereunder and Contractor 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. e.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 Contractor 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 Docusign Envelope ID: FC3BEFD1-48ED-4B02-8E2E-A38699922623 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). 8.Sub-contractors. Contractor acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of Contractor. Contractor shall not enter into any sub-contractor 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. Contractor shall require each sub-contractor, as approved by County and to the extent of the Services to be performed by the sub-contractor, to be bound to contractor by the terms of this Agreement, and to assume toward Contractor all the obligations and responsibilities which Contractor, 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-contractor hired by Contractor and Contractor shall cooperate in such process. The Contractor shall be responsible for the acts and omissions of its agents, employees and sub-contractors or sub-consultants. 9. Insurance. Contractor agrees to provide and maintain at Contractor’s sole cost and expense, the following insurance coverage with limits of liability not less than those stated below: a. Types of Insurance. i.Workers’ Compensation insurance as required by law. ii.Auto coverage with limits of liability not less than $1,000,000 each accident combined bodily injury and property damage liability insurance, including coverage for owned, hired, and non-owned vehicles. iii.Commercial General Liability coverage to include premises and operations, personal/advertising injury, products/completed operations, broad form property damage with limits of liability not less than $1,000,000 per occurrence and $2,000,000 aggregate limits. iv.Professional liability insurance with prior acts coverage for all Services required hereunder, in a form and with an insurer or insurers satisfactory to County, with limits of liability of not less than $1,000,000 per claim and $2,000,000 in the aggregate. In the event the professional liability insurance is on a claims-made basis, Contractor warrants that any retroactive date under the policy shall precede the effective date of this Agreement. Continuous coverage will be maintained during any applicable statute of limitations for the Services and Project. b.Other Requirements. i.The automobile and commercial general liability coverage shall be endorsed to include Eagle County, its associated or affiliated entities, its successors and assigns, elected officials, employees, agents and volunteers as additional insureds. Docusign Envelope ID: FC3BEFD1-48ED-4B02-8E2E-A38699922623 ii.Contractor’s certificates of insurance shall include sub-contractors as additional insureds under its policies or Contractor shall furnish to County separate certificates and endorsements for each sub-contractor. All coverage(s) for sub-contractors shall be subject to the same minimum requirements identified above. contractor and sub-contractors, if any, shall maintain the foregoing coverage in effect until the Services are completed. In addition, all such policies shall be kept in force by Contractor and its sub-contractors until the applicable statute of limitations for the Services has expired. iii.Insurance shall be placed with insurers duly licensed or authorized to do business in the State of Colorado and with an “A.M. Best” rating of not less than A-VII. iv.Contractor’s insurance coverage shall be primary and non-contributory with respect to all other available sources. Contractor’s policy shall contain a waiver of subrogation against Eagle County. v.All policies must contain an endorsement affording an unqualified thirty (30) days notice of cancellation to County in the event of cancellation of coverage. vi.All insurers must be licensed or approved to do business within the State of Colorado and all policies must be written on a per occurrence basis unless otherwise provided herein. vii.Contractor’s certificate of insurance evidencing all required coverage(s) is attached hereto as Exhibit B. Upon request, Contractor shall provide a copy of the actual insurance policy and/or required endorsements required under this Agreement within five (5) business days of a written request from County, and hereby authorizes Contractor’s broker, without further notice or authorization by Contractor, to immediately comply with any written request of County for a complete copy of the policy. viii.Contractor shall advise County in the event the general aggregate or other aggregate limits are reduced below the required per occurrence limit. Contractor, at its own expense, will reinstate the aggregate limits to comply with the minimum limits and shall furnish County a new certificate of insurance showing such coverage. ix.If Contractor fails to secure and maintain the insurance required by this Agreement and provide satisfactory evidence thereof to County, County shall be entitled to immediately terminate this Agreement. x. The insurance provisions of this Agreement shall survive expiration or termination hereof. xi. 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 Docusign Envelope ID: FC3BEFD1-48ED-4B02-8E2E-A38699922623 amended, or otherwise available to County, its affiliated entities, successors or assigns, its elected officials, employees, agents and volunteers. xii.Contractor is not entitled to workers’ compensation benefits except as provided by the Contractor, nor to unemployment insurance benefits unless unemployment compensation coverage is provided by Contractor or some other entity. The Contractor is obligated to pay all federal and state income tax on any moneys paid pursuant to this Agreement. 10.Indemnification. Contractor shall indemnify and hold harmless County, and any of its officers, agents and employees against any losses, claims, damages or liabilities for which County may become subject to insofar as any such losses, claims, damages or liabilities arise out of, directly or indirectly, this Agreement, or are based upon any performance or nonperformance by Contractor or any of its sub- contractors hereunder; and Contractor shall reimburse County for reasonable attorney fees and costs, legal and other expenses incurred by County in connection with investigating or defending any such loss, claim, damage, liability or action. This indemnification shall not apply to claims by third parties against the County to the extent that County is liable to such third party for such claims without regard to the involvement of the Contractor. This paragraph shall survive expiration or termination hereof. 11. Ownership of Documents. All documents prepared by Contractor in connection with the Services shall become property of County. Contractor 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 Contractor (including any employee or sub- contractor in connection with the performance of the Services and additional services under this Agreement). 12.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) 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: Rebecca Larson 500 Broadway Post Office Box 850 Eagle, CO 81631 Telephone: 970-328-8840 E-Mail: rebecca.larson@eaglecounty.us Docusign Envelope ID: FC3BEFD1-48ED-4B02-8E2E-A38699922623 With a copy to: Eagle County Attorney 500 Broadway Post Office Box 850 Eagle, Co 81631 Telephone: 970-328-8685 E-Mail: atty@eaglecounty.us Contractor: Colorado Mountain Medical Attention: Diane Voytko 50 Buck Creek Road, Suite 200 Avon CO 81620 Mailing Address: P.O. Box 4330 Avon, CO 81620 970-926-6340 E-Mail: diane.voytko@vailhealth.org 13. Coordination. Contractor acknowledges that the development and processing of the Services for the Project may require close coordination between various contractors and consultants. Contractor shall coordinate the Services required hereunder with the other contractors and consultants that are identified by County to Contractor from time to time, and Contractor shall immediately notify such other contractors or consultants, in writing, of any changes or revisions to Contractor’s work product that might affect the work of others providing services for the Project and concurrently provide County with a copy of such notification. Contractor shall not knowingly cause other contractors or consultants extra work without obtaining prior written approval from County. If such prior approval is not obtained, Contractor shall be subject to any offset for the costs of such extra work. 14. Termination. County 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 Contractor. Upon termination of this Agreement, Contractor 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 Contractor for Services satisfactorily performed to the date of termination. 15.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. Docusign Envelope ID: FC3BEFD1-48ED-4B02-8E2E-A38699922623 16.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. 17.Other Contract Requirements. a.Contractor 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 Contractor of any of its responsibilities. Contractor shall perform the Services in a skillful, professional and competent manner and in accordance with the standard of care, skill and diligence applicable to contractors performing similar services. Contractor 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. This paragraph shall survive termination of this Agreement. b. Contractor 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. c. This Agreement constitutes an agreement for performance of the Services by Contractor as an independent contractor 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 Contractor except that of independent contractor. Contractor shall have no authority to bind County. d.Contractor represents and warrants that at all times in the performance of the Services, Contractor shall comply with any and all applicable laws, codes, rules and regulations. e. 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. f.Contractor 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. g.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. Docusign Envelope ID: FC3BEFD1-48ED-4B02-8E2E-A38699922623 h. 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. i. The invalidity, illegality or unenforceability of any provision of this Agreement shall not affect the validity or enforceability of any other provision hereof. j.Contractor shall maintain for a minimum of three years, adequate financial and other records for reporting to County. Contractor shall be subject to financial audit by federal, state or county auditors or their designees. Contractor authorizes such audits and inspections of records during normal business hours, upon 48 hours’ notice to Contractor. Contractor shall fully cooperate during such audit or inspections. k.The signatories to this Agreement aver to their knowledge, no employee of the County has any personal or beneficial interest whatsoever in the Services described in this Agreement. Contractor avers Contractor has no beneficial interest, direct or indirect, that would conflict in any manner or degree with the performance of the Services and Contractor shall not employ any person having such known interests. [REST OF PAGE INTENTIONALLY LEFT BLANK] Docusign Envelope ID: FC3BEFD1-48ED-4B02-8E2E-A38699922623 Docusign Envelope ID: FC3BEFD1-48ED-4B02-8E2E-A38699922623 EXHIBIT A SCOPE OF SERVICES, SCHEDULE, FEES 1.Physician Responsibilities/Services. Contractor shall ensure that the Physician provides the following services upon request: a.Medical consultation on topics including, but not limited to, communicable disease control, immunizations, preventative health, screening programs and any other health service provided by the County; b. Communication with and dissemination of information regarding health care needs and issues to private health care providers in coordination with PHE through the County’s Health Alert Network; c.Consultation with PHE, including evaluation of sanitary standards and abatement of nuisances, and consulting on cease and desist orders; d. Consultation with the PHE Director or designee on issues that impact the public’s health, as well as both preparedness and response for public health emergencies; e.Consultation to the Board of County Commissioners, Board of Health, Department of Public Health and Environment, including participation in Board of Health meetings as requested; f.Provision of written reports and recommendations regarding public health issues, upon reasonable request; g.Participation in training in the areas of emergency management, public health services and regulations, and child abuse and neglect reporting; h. Provide supervision of Eagle County’s Immunization and Disease Prevention program to include: i.Familiarity and understanding of the Vaccine for Children’s program; and ii.Provision of standing orders for administration of vaccines and management of the program iii.Provision of standing orders for travel immunizations and prophylactic prescriptions for travel iv.Familiarity and understanding of current Tuberculosis prevention, diagnosis, and treatment regimens i.Provide supervision of Eagle County’s home visiting programs, Nurse Family Partnership (“NFP”) and Family Connects (“FC”) to include: i.Familiarity and understanding of the NFP and FC programs and models; ii.To inform and guide NFP and FC staff on the specific nursing practices expected from the programs. j.Represent public health on identified community work groups or committees. 2. The parties anticipate that the time required of the Physician in the provision of such services under this Agreement will not exceed a total of 132 hours per calendar year. The services shall be performed in accordance with the provisions and conditions of this Agreement. 3. Requirements. In the provision of services hereunder, Contractor and Physician shall do the following: Docusign Envelope ID: FC3BEFD1-48ED-4B02-8E2E-A38699922623 a.Safeguard protected health information of individuals and the confidentiality of situations for which Physician's consultation is requested, in accordance with the rules of PH and the Health Information Portability and Accountability Act. b.Abide by the applicable provisions of County Media Policy; all media contacts to Physician in the role of Medical Director for the County are to be reported to the PH Director, who will coordinate with the County Manager, the County Attorney and the County Communications Director in providing appropriate responses to such media contacts. c.Comply with appropriate standards of customer service to the public and provide appropriate consultation in the development and implementation of PH protocols to promote the maintenance of high standards of customer service and professionalism. d. Comply with the requirements of the Civil Rights Act of 1964 and Section 504, Rehabilitation Act of 1973 concerning discrimination on the basis of race, color, sex, age, religion, national origin, or handicap. e.Notify immediately the Colorado Child Abuse and Neglect Hotline at 1-844-CO-4-KIDS, of all reports of suspected child or adult abuse or neglect made to or observed by or otherwise coming to the attention of Physician. f.Comply with all applicable laws, resolutions, and codes of the County, the State of Colorado, or the federal government. Docusign Envelope ID: FC3BEFD1-48ED-4B02-8E2E-A38699922623 EXHIBIT B Insurance Certificate Docusign Envelope ID: FC3BEFD1-48ED-4B02-8E2E-A38699922623 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY G 1,000,000 HPL-09130345 SEA-004046476-03 X X N/A Professional Liability 0 3,000,000 'Retro Date: 11/15/1976' 1,000,000 N/A N/A X 10/30/2024 11/01/2024 RE: Diane Voytko, MD. Retro Date: 9/24/2001 Claims Made X dba Colorado Mountain Medical, LLC 181 Meadow Drive Diane Voytko, MD Vail, CO 81658 X A N/A CN101378867-VHH-GpAUP-24-25 5,000 1,000,000 50,000 1225 17TH STREET, SUITE 1300 MARSH USA LLC. DENVER, CO 80202-5534 dba Colorado Mountain Medical, LLC Vail Clinic, Inc. Vail, CO 81658 181 Meadow Drive Vail Clinic, Inc. 11/01/2025 MAG Mutual Holding Company Docusign Envelope ID: FC3BEFD1-48ED-4B02-8E2E-A38699922623