Loading...
Certificates of Insurancef`_lionffi- R'4A1R4 A=Tkllklf' ACORDTm CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 2/11/2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Willis of Connecticut, LLC 185 Asylum Street y ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 25th Floor Hartford, CT 06103-3708 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Aetna Insurance Co of CT 36153 Aetna Inc. and its Affiliated Companies 151 Farmington Avenue, RE2T Hartford, CT 06156 INSURER B: INSURER C: INSURER D: INSURER E: 04e1T/ =1 :7.TN zw 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSRC TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES (Ea occurrence) $ CLAIMS MADE FIOCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO - CT LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO --r, $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY OCCUR F� CLAIMS MADE ..._. / EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? If yes, describe under E.L. DISEASE - POLICY LIMIT $ SPECIAL PROVISIONS below A OTHER Managed Care 88791410 02/01/10 02/01/11 $3,000,000 Per Claim Professional $3,000,000 Aggregate Liability DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Occurrence Coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Monroe County Board of County Commissioners DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL lfl DAYS WRITTEN Attn: Teresa Aguiar NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 1100 Simonton Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Suite 2-258 REPRESENTATIVES. 14,01;i Key West, FL 33040 THORIZED RE PRE ENTATIV4 'ACORD 25 (2001/08) 1 of 2 #S273203/M271885 TZM O ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. AWK0 25-5 (2001/08) 2 of 2 #5273203/M271885 ACORL7® CERTIFICATE OF LIABILITY INSURANCE DATE(/2011 YYYY) o3/1e/2o11 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, certa A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s). PRODUCER MARSH USA, INC. TWO LOGAN SQUARE PHILADELPHIA, PA 19103 MAR 2 8 201 CONTACT NAME: PHONE FANo): E-MAIL PRODUCER 429613-Hofiz-11-12 Horizo Lewisv INSURERS AFFORDING COVERAGE NAIC # INSURED MOMS Cotft4r Horizon Mental Health Management, Inc. RISK MANAGEM Go UHS of Delaware, Inc. INSURER A: /A N/A CE American Insurance Company 22667 INSURER C : Attn: Margaret Hill 367 S. Gulph Road King of Prussia, PA 19406 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: ATL-002597330-09 REVISION NUMBER: 1 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC PRODUCTS - COMP/OP AGG $ is $ 2000 000 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ISA H08634452 04/01/2011 J( �1 1 V y 1 01/01/2012 _ _ COMBINED SINGLE LIMIT (Ea accident) X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYI ANY PROPRIETOR/PARTNER/EXECUTIVE Ya OFFICER/MEMBER EXCLUDED' (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WLR C4647241A (A/O/S) SCF C46472421 (WI) 04/01/2011 04/01/2011 t % l/ 01/01/2012 01/01/2012 X I WC STATU- OTH- ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYE $ 2,000,000 E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER IS AN ADDITIONAL INSURED UNDER THE AUTO LIABILITY POLICY AS REQUIRED BY WRITTEN CONTRACT BUT LIMITED TO THE OPERATIONS OF THE INSURED UNDER SAID CONTRACT AND ALWAYS SUBJECT TO THE POLICY TERMS, CONDITIONS, AND EXCLUSIONS. CERTIFICATE HOLDER rANr1:1 I ATInKI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Teresa Aguiar 1100 Simonton St, Suite 2-258 Key West, FL 33040 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. C G . Juan Hernandez 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD .4cC?Rff CERTIFICATE OF LIABILITY INSURANCE DATE( YYYY) 05/101201/2011 1 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 MARSH USA, INC ONE STATE STREET HARTFORD, CT 06103 Attn: Hartford.certrequest@marsh.com Fax 212-948-0927 CONTACT NAME: PHONE FAX 1� No Ex�: A/C No :_ _ IL ADDRESS: PRODUCER Sd)STOMFER ID _-- INSURERMAFFORDING COVERAGE NAIC R 01800 -AETN-GAUW-11-12 _ INSURED AETNA INC. AND ITS AFFILIATED COMPANIES, INCLUDING HORIZON BEHAVIORAL SERVICES _ INSURER A: ACE American Insurance Company 22667 INSURER B : N/A N/A INSURER C : Commerce And Industry Ins Co --- 19410 151 FARMINGTON AVENUE HARTFORD,CT 06156 -- - -- INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: NYC-005313OM-15 REVISION NUMBER: d 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 LTR TYPE OF INSURANCE ADDL SUER WVDPOLICY NUMBER POLICY EFF MWDDNYYY POLICY EXP MWDDNYYY LIMITS A GENERAL LIABILITY HDOG2056072-1 04/01/2011 04/01/2012 URRENCE EACH OCCAMAGE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY D TO RENTED PREMISES (Ea occurrence) $ 1,000,000 CLAIMS -MADE OCCUR 10,000 L� MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 2,000.000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000;000 GEN'L AGGREGATE LIMIT APPLIES PER: I PRO- $ -- POLICY LOC AUTUMUBILt LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS' _ 6� BODILY INJURY SCHEDULED AUTOS (Per accident) $ PROPERTY DAMAGE $ f \ HIRED AUTOS (Per accident) $ NON -OWNED AUTOS C X UMBRELLA LIAB —X OCCUR BE 7251150 04I01/2011 04l01/2012 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB _ _ CLAIMS -MADE AGGREGATE $ 1,OOQ000 DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N fl-- E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICEFLMEMBER EXCLUDED? ❑ N / A E.L. DISEASE - EA EMPLOYEE - $ (Mandatory in NH) It yes, describe under — DISEASE - POLICY LIMIT .—._--- $ DESCRIPI ION OF OPERATIONS below oeE.L. _T11 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Evidence of General Liability and Excess insurance coverage. for Horizon Behavioral Services, an Aetna Company. Certificate holder is an Additional Insured under the General Liability policy as required by written contract but limited to the operations of the Insured under said contract and always subject to the policy terms, conditions and exclusions CC', 'E\ v`0- W e D . MONROE COUNTY BOARD OF COUNTY COMMISSION ATTN. TERESA AGUTAR 1100 SIMONTON ST. SUITE 2-258 KEY WEST, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Donald R. Eckberg " V_ zdd. U 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD �`� �CERTIFICATE OF LIABILITY INSURANCE DATE /YYYY) 12/29/2011® 2011 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 MARSH USA, INC. TWO LOGAN SQUARE CONTACT NAME: PHONE aC No): E-MAIL ADDRESS: PHILADELPHIA, PA 19103 INSURERS AFFORDING COVERAGE NAIC # INSURER A: WA N/A 429813-Horiz--12-13 Horizo Lewisv INSURED Horizon Mental Health Management, Inc. INSURER B : ACE American Insurance Company 22667 do UHS of Delaware, Inc. INSURER C : INSURER D Attn: Margaret Hill 367 S. Gulph Road King of Prussia, PA 19406 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: ATL-002771283-16 REVISION NUMBER:1 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ CLAIMS -MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO LOC $ B AUTOMOBILE LIABILITY ISA H08694680 01101/2012 01/01/2013 COMBINED SINGLE LIMIT Ea accident 2,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS IAUTOS AP V D BY R MANAGE BY WAN BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB OCCUR pp"" EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE P5(. C C . Le DED RETENTION $ L J I $ B WORKERS COMPENSATION WLR C46780358 (A/O/S) 01/01/2012 01/01/2013 X I WC STATU- I OTH- LIMITS ER B AND EMPLOYERS' LIABILITYTORY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) N / A SCF C46780383 (WI) 01101/2012 01/0112013 E.L. EACH ACCIDENT 2,000,000 $ E.L. DISEASE - EA EMPLOYE $ 2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E-L. DISEASE - POLICY LIMIT 2 000 000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) CERTIFICATE HOLDER IS AN ADDITIONAL INSURED UNDER THE AUTO LIABILITY POLICY AS REQUIRED BY WRITTEN CONTRACT BUT LIMITED TO THE OPERATIONS OF THE INSURED UNDER SAID CONTRACT AND ALWAYS SUBJECT TO THE POLICY TERMS, CONDITIONS, AND EXCLUSIONS. GtK 1 ItIGA I t MULUtK Monroe County Board of County Commissioners Attn: Teresa Aguiar 1100 Simonton St, Suite 2-258 Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Juan Hernandez !✓GlisC �6��—+->��`v7 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD C I ient#: 83469 AETNINC ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 2/06/2013 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 Willis of Connecticut, LLC CONTACT NAME: PHONE g60 278-1320 860-278-5776 A/C No Ext : A/C No 185 Asylum Street 25th Floor Hartford, CT 06103-3708 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC it INSURER A: Aetna Insurance Co of CT 36153 INSURED Aetna Inc. and its Affiliated Companies incl Horizon Behavioral Services, LLC 151 Farmington Avenue, RE2T Hartford, CT 06156 INSURER 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 CONTRACTOR 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. LTR TYPE OF INSURANCE ADDL NSR WVD POLICY NUMBER MM/DDY EFF MMIDDY� LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ea occu ante $ CLAIMS-MADE1:1 OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 17 POLICY PROECT El LOC J $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea act dent $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR U EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE/� / -1 AGGREGATE $ DED I I RETENTION $ $ I WORKERS COMPENSATION WC STATUTORY- I OTH- ER AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE OFF R EXCLUDED? N I A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ andatory in IN If yes, describe under DESCRIPTION OF OPERATIONS be E.L. DISEASE - POLICY LIMIT $ A Managed Care 8879142013 2/01/2013 02/01/201 $10,000,000 Per Claim Professional $10,000,000 Aggregate DVgcfflPhTN OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Occurrence Coverage. e C, Monroe County Board of County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ty THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Teresa Aguiar 1100 Simonton Street -Suite AUTHORIZED REPRESENTATIVE 2-258 '1'l pia �-�. (i��su wa-►-P Kiev West. FL 33040 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S359896/M359603 JHORA ACCW" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 01/04/2013 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 'Marsh USA, Inc. 1717 Arch Street Philadelphia, PA 19103 CONTACT NAME: PHONE FAX No. E AIC No E-MAADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A : NIA NIA 429813-Horiz-13-14 Horizo Lewisv INSURED Horizon Mental Health Management, LLC INSURER B: ACE American Insurance Company 22667 Go UHS of Delaware, Inc. INSURER C : INSURER D : Attn: Margaret Hill 367 S. Gulph Road King of Prussia, PA 19406 INSURER E : INSURER F : /`nvcOAGcc rERTIMATE NUMBER' CLE-003851349-20 REVISION NUMBER:1 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 LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MMIDDYEFF /YYYY MMIDDEXP LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR P V YRISI MANAGEME A fM� A� �a. " - Q f— ` �L EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC PRODUCTS - COMP/OP AGG $ $ B AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS AON--OSWNEO ISA H0671325A 01101/2013 01101/2014 COMBINED SINGLE LIMIT Ea accident 2,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAR EXCESS LIAB HOCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? F (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WLR C47128298 (AIO/S) 01/0112013 01/01/2014 X WC STATU- OTH- TORY LIMITS FIR E.L. EACH ACCIDENT 2,000,000 $ E.L. DISEASE - EA EMPLOYE 2,000,000 $ E.L. DISEASE - POLICY LIMIT 2,000,000 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) CERTIFICATE HOLDER IS AN ADDITIONAL INSURED UNDER THE AUTO LIABILITY POLICY AS REQUIRED BY WRITTEN CONTRACT BUT LIMITED TO THE OPERATIONS OF THE INSURED UNDER SAID CONTRACT AND ALWAYS SUBJECT TO THE POLICY TERMS, CONDITIONS, AND EXCLUSIONS. Monroe County Board of County Commissioners Attn: Teresa Aguiar 1100 Simonton St, Suite 2-258 Key West, FL 33040 ce/6�,� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee�+�� �^ V lytT6-LULU A\.VRu liV Rf•v Rf111V1e. '+u nyuw 16A01 •6Y. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AETNINC wienrfl:: oowov ACORDTM CERTIFICATE OF LIABILITY INSURANCE - DATE (MMIDD/YYYY) 1 3/03/2014 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 Willis of Connecticut, LLC CONTACT NAME: PHONE 860 278-1320 A/c, No : 860-278-5776 A/C No Ext 185 Asylum Street ao )Ress: INSURER(S) AFFORDING COVERAGE NAIC # 25th Floor Hartford, CT 06103-3708 INSURER A. Aetna Insurance Co of CT 36153 INSURED Aetna Inc. and its Affiliated Companies Insurance and Risk Finance Dept. 151 Farmington Avenue, RE2T Hartford, CT 06156 INSURER B INSURERC: INSURER D : INSURERE: INSURER F : �VICIn\I LAI I\IQCO. COVERAGES GtFC I frI1.A l e NUMOr-rc: -------- 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. LTR TYPE OF INSURANCE INSR ADDLISUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY , EACH OCCURRENCE $ DAMAGE TO RENTED ccurtence PREMISES Ea occurrence) $ CLAIMS-MADE1:1 OCCUR PP ONINT MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ WI / ' I e- _ PRODUCTS - COMP/OP AGG $ GEN'L AGGREGATE LIMIT APPLIES PER: PROECT LOC POLICY COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION WC STATU- OTH- E.L. EACH ACCIDENT $ AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Managed Care Professional 8879142014 3/01/2014 03/01/201 E.L. DISEASE - POLICY LIMIT $ $10,000,000 Per Claim $10,000,000 Aggregate A Liabilltv DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Occurrence Coverage This policy provides coverage to all Aetna Affiliated Companies including Horizon Behavioral Services, LLC. �1iai�r'V I� Monroe Count�qo AV CdGkt 19sioners Attn: Teresa Al'I -� 1100 Simonton r 2 ui 2-258 Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE nnerinnATlnW All e...Mc •ncn Afi ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD T711A AC40 V CERTIFICATE OF LIABILITY INSURANCE MIDDIYYYY °03/192014 ' 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). CONTACT PRODUCER MARSH USA, INC. NAME: PHONEFAX 20 CHURCH STREET ac No E-MAIL ADDRESS: HARTFORD, CT 06103 INSURERS AFFORDING COVERAGE NAIC # Attn: Don Eckberg - (860) 723-5640 ACE American Insurance Company 22667 01800 -AETNA-GAUWC-14-15 INSURER A: INSURED AETNA INC. AND ITS AFFILIATED COMPANIES, INSURER 8 : N/A WA INSURER C : Commerce And Industry Ins Co 19410 INCLUDING HORIZON BEHAVIORAL SERVICES INSURER D : 151 FARMINGTON AVENUE INSURER E HARTFORD, CT 06156 INSURER F : GUVCKAIaCJ %Ocn r IV wA I I- •-. - --------- -- - -- 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. INSRLTR A TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR ADDL UBR POLICY NUMBER HDOG27330939 POLICY EFF MM/DD/YYYY 04/0112014 POLICY EXP MM/DD/YYYY 04/01/2015 LIMITS EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISE Ea occurrence 2,000,000 $ MED EXP (Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 2'�'� GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP OP AGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: COMBINED SINGLE LIMIT $ X POLICY PRO LOC AUTOMOBILE LIABILITY Ea accident) BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ C X UMBRELLA LIAR EXCESS LIAS X OCCUR CLAIMS -MADE BE 7251236 04/01/2014 04/01/2015 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 WC STATU- OTH- $ DED X RETENTION $10,000 WORKERS COMPENSATION E.L. EACH ACCIDENT $ AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y E.L. DISEASE - EA EMPLOYE $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) N / A If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Evidence of General Liability and Excess insurance coverage. for Horizon Behavioral Services, an Aetna Company. Certificate holder is an Additional Insured under the General Liability policy as required by written contract but limited to the operations of the lrjsured u er said contract and always subject to the policy terms, conditions and exclusions. WAIVE NJ YE _ �hts'c MONROE COUNTY BOARD OF COUNTY COMMISSION ATTN: TERESA AGUTAR 91 :11 WV 8 Z IJ az 1100 SIMONTON ST. SUITE 2-258 7 KEY WEST, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Donald R. Eckberg " 2' J_'k , ._........ .a ^ .w- ^^Mnf%o Arlflal A11 ... 10. .ncu 011 ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD