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Certificates of Insurance7 t>p DATE (MM/DDNYYY) AC - CERTIFICATE OF LIABILITY INSURANCE 2/25/2011 41S CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS ,ERTIFICATE 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 Commercial Lines - (650) 413-4200 NAME: PHONE FAX Wells Fargo Insurance Services USA, Inc. - CA Lic#: OD08408 IA E-MAN Ext' ac No IL ADDRESS: 959 Skyway Road PRODUCER ENVISION CUSTOMER ID #: San Carlos, CA 94070 INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Darwin Select Insurance Co. 24319 Envision Pharmaceutical Holdings Inc. INSURER B 2181 East Aurora Road INSURER C : INSURER D : Twinsburg, OH 44087 INSURER E: INSURER F : rnvooer_ec !1C12T1C1!1AT0 kiiiluRPR• 2407004 RFVISIAN Nt]MRFR- See below 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 MOLICY EFF IPOLICY EXP LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE C] 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 PROJEC- LOC PRODUCTS - COMP/OP AGG $ $ — AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE / CX,> ` 1` EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA A WC STATU- OTH- T RY LIMIT ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A E&O - Professional 03035196 01/31/2011 01/31/2012 Each Claim $3,000,000 Rot. $50,000 08/28/2006 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required) Evidence of Insurance CERTIFICATE HOLDER CANCELLATION vision Pharmaceutical Holdings Inc. 81 Eash Aurora Road Twinsburg, OH 44087 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 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD ENVISION AC40061,�RDF CERTIFICATE OF LIABILITY INSURANCE E (MMIDDIYYYY) onT3/24/20111 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 Commercial Lines - (650) 413-4200 Wells Fargo Insurance Services USA, Inc. - CA Lic#: OD08408 959 Skyway Road CONTACT NAME: PHONE FAX No Ext : A/C No): EEC, IL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # San Carlos, CA 94070 INSURER A : Travelers Casualty Tl& Surety Co. of America 31194 INSURED Envision Pharmaceutical Services, Inc. INSURER B : INSURER C : 2181 East Aurora Road INSURER D : INSURER E : Twinsburg, OH 44087 INSURER F COVERAGES CERTIFICATE NUMBER: 2513577 REVISION NUMBER: R.. hel. 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 ADOL SUER POLICY NUMBER POLICY EFF MMIDD POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE ( RENTED PREMISESS Ea occurrence) $ CLAIMS -MADE E:1 OCCUR MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: _ PRODUCTS - COMP/OP AGG $ POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON-OWNEDJt,' AUTOS IIIIYYYY PROPERTY DAMAGE Per accident _ $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ _ $ WORKERS COMPENSATION WC STATU- I OTH- AND EMPLOYERS' LIABILITY Y / N TORY LIMITAER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under --- DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I $ A Crime 105559549 02/01/2011 02/01/2012 Employee Theft $1,000,000 - Ret. $10,000 ERISA - $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Evidence of Coverage. CERTIFICATE HOLDER Envision Pharmaceutical Services, Inc. 2181 E Aurora Road Twinsburg, OH 44087 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 n The ACORD name and logo are registered marks of ACORD ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) ENVISION ACC►RLY CERTIFICATE OF LIABILITY INSURANCE DATE29/DD/Y 9129/2011 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 Commercial Lines - (650) 413-4200 Wells Fargo Insurance Services USA, Inc. - CA Lic#: OD08408 959 Skyway Road CONTACT NAME: PHONENo, FAX Extis AIC No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC p INSURERA: Valley Forge Insurance Company 20508 San Carlos, CA 94070 INSURED Envision Pharmaceutical Services, Inc. INSURER B : INSURER C : 2181 East Aurora Road INSURER D INSURER E : INSURERF: Twinsburg, OH 44087 CAVFRAGFS CERTIFICATE NUMBER: 3330849 REVISION NUMBER: See helnw 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 MWDD/YYYY LICY EFF POLICY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY 4020038139 01/31/2011 01/31/2012 EACH OCCURRENCE $ 1,000,000 ffA_VA= RENTED PREMISES Ea occurrence $ 1,D00,000 CLAIMS -MADE L'J OCCUR MED EXP (Any one person) $ 10,000 BADVINJURY $ 1,000,000 -PERSONAL GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY PRO X LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 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 ,� �( EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE `U DIED I I RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER,IEXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N / A E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) G-147167-B99 (12/06) Monroe County Board of County Commissioners is included as Additional Insured for General Liability as respects the operations of the Named Insured, per endorsement attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Street ACCORDANCE WITH THE POLICY PROVISIONS. Suite 2-268 AUTHORIZED REPRESENTATIVE Key West, FL 33040 The ACORD name and logo are registered marks of ACORD ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) ENVISION CERTIFICATE OF LIABILITY INSURANCE I DATE2/1/2 D/YYYY) /1/2012 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 T BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CE TIFICATE IMPORTANT: If the certificate holder is an ADDI IONAL INSURED, the policy(les) mu s be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain p icies may require an endorsement. A tatement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCERFEB ACT Commercial Lines - (650) 413-4200 PHONe �FAx --__ _ _ .(_ALC. No. Ext): (A/C, No): Wells Fargo Insurance Services USA, Inc. - CA Lic#: 08408 MONROE CO E-MAIL ss: 959 Skyway Road RISK MANAGEMENT INSURERS AFFORDING COVERAGE NAIC # San Carlos, CA 94070 INSURER A : -"Alley Forge Insurance Company 20508 INSURED INSURER B : Envision Pharmaceutical Services, Inc. INSURER C : 2181 East Aurora Road INSURER D : INSURER E : Twinsburg, OH 44087 INSURER F : COVERAGES CERTIFICATE NUMBER: 3888303 REVISION NUMBER: See he1nw 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/DDM POLICY EXP MMIDD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY 4020038139 01/31/2012 01/31/2013 EACH OCCURRENCE _ DAMAGE ( RENTED- PREMISESS Ea occurrence)$ $ 1,000,000 _ 1,000,000 CLAIMS -MADE 1 ' OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 - AP MANAW GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- X LOC PRODUCTS - COMP/OP AGG $ 2,000,000 DA W $ AUTOMOBILE LUIBILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS G i �� nj��� C.0 Q COMBINED SINGLE LIMIT Ea ent) BODILY INJURY (Per person) — $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS I//'I / Yl Ajft i nLit _ _ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION TMTT-. OTH- AND EMPLOYERS' LIABILITY Y / N - ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N / A — -- E.L. DISEASE - EA EMPLOYE -- — $ (Mandatory In NH) 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) G-147167-699 (12/06) Monroe County Board of County Commissioners is included as Additional Insured for General Liability as respects the operations of the Named Insured, if and to the extent required by written contract or agreement, per endorsement attached. lh 3:f_I1➢ieS_l1 � aaJ � �J as Monroe County Board of County Commissioners 1100 Simonton Street Suite 2-268 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 551657 The ACORD name and logo are registered marks of ACORD ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 11111111111111111111111111111111111111111111111111111 IIIII IIIII 1111111111111111111111111111 rvn nnn mn �asm�malnlnmin• ENVISION ACUREP CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/7/2012 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(les) 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: Commercial Lines - (650) 413-4200 PHONE FAX Wells Fargo Insurance Services USA, Inc. - CA Lic#: OD08408 E-MAIL Ex A/c No ADDRESS: 959 Skyway Road INSURERS AFFORDING COVERAGE NAIC # San Carlos, CA 94070 INSURER A: Travelers Property Casualty Co of America 25674 INSURED INSURER B : Travelers Casualty & Surety Co. of America 31194 Envision Pharmaceutical Services, Inc. INSURER C : Darwin Select Insurance Co. 24319 2181 East Aurora Road INSURER D : INSURER E : Twinsburg, OH 44087 I INSURER F COVFRAGFS rFRTIRIRATF All IMRI=17• 40n4801 .. .Ill.. csrl 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 POLICY EXP MM/DDIYYYY11 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ CLAIMS -MADE E:IOCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO- LOC JEC $ AUTOMOBILE LIABILITY ANY AUTO I: Ri$ f INiANA BY pq r `� COMBINED SINGLE LIMIT Ea . D BODILY 'INJURY.(Per person)' $' ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS Wyo © r �J� CO-.1 - "`"� I� � 4e/ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB OCCUR a r,,k, 6. EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DIED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � N / A HJUB677M834712 01/31/2012 01/31/2013 X WC STATU- OTH- E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE $ 1,000,000 (Mandatory In NH) If yes, describe under E.L. DISEASE - POLICY LIMIT IS 1,000,000 DESCRIPTION OF OPERATIONS below B Crime 105559549 02/01/2012 02/01/2013 Employee Theft $1,000,000 - Ret. $10,000 ERISA - $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Evidence of Coverage. Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton St. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Suite 2-268 ACCORDANCE WITH THE POLICY PROVISIONS. Key West, FL 33040 AUTHORIZED REPRESENTATIVE 9e-4a�- I nu muumu name ana logo are registered marks of AGUKD W 1985-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) CID: ENVISION OTHER Coverage SID: 4004MI Certificate of Insurance (Con't) INSR TYPE OF INSURANCE ADDL WVD POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE LIMIT LTR INSR SUER (MMIDDA r (MMIDDIM C E&O - Pmfession2l Lab" 03035196 01/31/2012 01/31/2013 Each Um $3,000,000 Rat. S50,000 Retro date. OWSOM 284934 AC40Rc& CERTIFICATE OF LIABILITY INSURANCE DATE / 1 /28/2013 Y) 013 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(les) must be endorsed. If SUBROGATION IS WAIVED, sub)ect to the terns 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 Commercial Lines - (650) 413-4200 CONTACT Drew Bolger NAME: g PHONE0. . (650) 413-4390 FA//C No): DORE33: Wells Fargo Insurance Services USA, Inc. - CA Lic#: OD08408 -ADDRESS: INSURERS AFFORDING COVERAGE NAIC # 959 Skyway Road INSURER A: Valley Forge Insurance Company 20508 San Carlos, CA 94070 INSURED INSURER B : INSURER C : Envision Pharmaceutical Services, Inc. INSURER D : 2181 East Aurora Road INSURER E : INSURER F : Twinsburg, OH 44087 CnVFRAr:FS CERTIFICATE NUMBER. 5527209 REVISION NUMBER: See helow 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. TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDDPOLICY/YYYY MM/DD/YYYY LIMITS rA GENERALLIABILITY X COMMERCIAL GENERAL LIABILITY 4020038139 01/31/2013 01/31/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 1.000,000 CLAIMS -MADE FK OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO LOC JECTAUTOMOBILE It$ LIABILITY ANY AUTO Ap DA AO r L COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) - $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS W . C J ,�'t r/tf0.{ �tt PROPERTY DAMAGE Per.cadent $ $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION STATU- OTH- WCRY I ER AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N I A E.L. DISEASE - POLICY LIMIT $ If es, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) G-147167-1399 (12/06) Monroe County Board of County Commissioners is included as Additional Insured for General Liability as respects the operations of the Named Insured, if and to the extent required by written contract or agreement, per endorsement attached. GtK I It-IGA I t MULUtK WkF4 V r_LL#k I IVIV Monroe County Board of County Commissioners 1100 Simonton Street Suite 2-268 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 1.�(.CaMiA- ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD © 1988-2010 ACORD CORPORATION. All rights reserveq. ,- le AC�R� CERTIFICATE OF LIABILITY INSURANCE DATEtM11/DD/YYYI� 02/0712014 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. 200 PUBLIC SQUARE, SUITE 1000 CONTACT NAME: PHONE I FAX ac No): E-MAIL ADDRE S: CLEVELAND, OH 441141824 Attn: cWdand.certrequest@marsh.can INSURE S AFFORDING COVERAGE NAIC # INSURER A: Valley Forge Insurance Co 20508 745434-Prof-14-15 INSURED Envision Pharmaceutical Holdings, LLC 2181 East Aurora Road, Suite 201 INSURER B : Transportation Insurance Co 20494 INSURER C : Travelers Property Casualty Co. Of America 25674 INSURER D : WA WA Twinsburg, OH 44087 INSURER E : Darwin Select Insurance Company 24319 INSURER F CnVFRAGFS CERTIFICATE NUMBER: CLE-004045010-01 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 MM/DDY� UCYEXP MWDD/YYYY LIMITS A GENERAL LIABILITY 4020038139 01/31/2014 01/31/2015 EACH OCCURRENCE $ 1'0D0'000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 1�0000W MED EXP (Any one person) $ 5,000 CLAIMS -MADE M OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,0t10 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ X POLICY PRO- Ll LOC JECT B AUTOMOBILE LIABILITY 2098127370 01/31/2014 01/31/2015 COMBINED SINGLE LIMIT i entl__—___- 1000 000 --- BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE (Per accident) $ COMP/COLL DIED. $ 500 UMBRELLA UAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ C WORKERS COMPENSATION UB913363906 01/31/2014 01/31/2015 X I vucSTATU- OTH- 'I I AND EMPLOYERS' LIABILITY N ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? a (Mandatory in NH) N / A E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - FA EMPLOYE 1000 000 $ E.L. DISEASE - POLICY LIMIT 1,000,000 $ if yes, describe under DESCRIPTION OF OPERATIONS below E Professional Liability 0304-3221 01/31/2014 01/31/2015 Limit 5,000,000 Deductible 25,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) G-147167-1399 (12/06) Monroe County Board of County Commissioners is included as additional insured where required by written contract with respect to General Liability. P N GEM EM WADA R /A _ Y Monroe County Board of County Commissioners 1100 Simonton St., Suite 2-268, Key West, FL 33040 LO :I I NV OZ 83.E h10Z 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. Lizbeth Hartranft U 1953-201U AGOKD GOKPOKA 1 ION. All ngnts reserveu. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD C� cFRTIFICATE OF LIABILITY INSURANCE rvRTIFICI IIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS E tc HE COVE ORAGE AFFORDED EXTEND OR I ERTIFICATE DOES NOT AFFIRMATIVELY OR NENIOTLCO ST TU�TE A CONTRACT BETWEEN THE ISSUING INSURE ELOW THIS CERTIFICATE OF INSURANCE DOES EPRESENTATiVE OR PRODUCER, AND THE CERTIFICATE HOLDER. 51 policies may require an endorsement. A statement on this certificate does not APORTANT: If the certificate holder is an ADDITIONALoly SURED, the policy(ies) must be endorsed. If SUBROGATION I to terms and conditions of the policy, certain p ertificate holder in lieu of such endorsement(s). CONTACT NAME: FAX N IDUCER PHONE MARSH USA INC. E-MAIL 200 PUBLIC SQUARE, SUITE 1000 ADORE S: CLEVELAND, OH 44114-18244 INSURE SI AFFORDING COVERAGE Attu: d&Mand.cerffequest@marsh.com Federal Insurance Company 5434-Prof-15-16 PURED Envision Pharmaceutical Holdings, LL 2181 East Aurora Road, Suite 201 Twinsburg, OH 44087 Great Northern Insurance Company Darwin Select Insurance Company ATE (MMIDD/YYYY) 0210512015 HOLDER. THIS THE POLICIES I. AUTHORIZED I, subject to rights to the OVERAGES CERTIFICATE NUMBER: CLE-WO450IN5 r�crw......------- TO CH THIS OR CONDITION OF ANY CONTRACT OR OTHERED HEREEN S SUBJECTNT WITH P OTALLL THE TERMS, OD THIS IS TO C ERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUED NAMED ABOVE FOR HE POLICY PERT INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TER CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE OL CO EFFES DESCRIBED ELY CLAIMS. u ITS EXCLUSIONS AND CONDITIONS OF SUCH ADDLCIUB LIMITS SHOWN MAY HAVE BEEN REDUCED PMOLIC YYYY _ 1,000 MIDD POLICY NUMBER e TYPE OF INSURANCE 36030741 01/31/2015 01131/2016 GENERAL LIABILITY GENERAL LIABILITY X COM CLAIMS -MADE MADE FqOCCUR LIMIT APPLIES PER: AUTOMOBILE LIABILITY 7-1 ANY AUTO SCHEDULED ALL OWNED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAR OCCUR EXCESS LIAR CLAIMS JANY ORKERS COMPENSATION Y 1 N ND EMPLOYERS' LIABILITY PROPRIETOR/PARTNERIEXECU I IV" N I A FFICER/MEnNH) EXCLUDED?Mandatoryf es, describe underDESCRIPTION OF OPERATIONS below 0304 3221 0113112015 0113112016 rofessional Liability MED EXP (Any one Peen) 1,000,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPA G $ $ BODILY INJURY (Per BODILY INJURY (Per E.L. Limit Deductible DED. I at, Additional General Liability. DESCRIPTION OF oPERATIo�uM Board of CountylCLES Commiss Doers isis required) ch Cnd tided as additional nsured where required by written conUad with E G-147167-B99 (12106) Monroe Y AP , WANE /A /'liVi11 � Monroe County Board of County Commissioners 1100 Simonton St., Suite 2-268, Key West, FL 33040 ACORD 26 (2010105) S 1 :8 WV 61 833 SIOZ ijdC)Ad 803 03113 r— BE ELLED SHOULD ANY OF EXPIRAT143NH DATE THEREOF, DESCRIBEDPOLICIES 7ILLL BECDELIVERED BEFORE THEIN ACCORDANCE WITH THE POLICY PROVISIONS. — AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Lizbeth Hartranft ©1988-2010 ACORD The ACORD name and logo are registered marks of ACORD All rights reserved. �� ® DATE (MMIDD/YYYY) A C" CERTIFICATE OF LIABILITY INSURANCE F01272016 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 HOLDEW 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 certiticate holder in lieu of such endorsernent(s). -- CONTACT PRODUCER NAME;_ MARSH USA INC. PHONE FAX A/C, No Extl• (A/C No): — 501 MERRI f 7 E-MAIL NORWALK, CT 06856-6010 ADDRESS: - Attw NorwalK.certrequest@marsh.com INSURERS AFFORDING COVERAGE _ _ . NAIC # 416752-ENVIS-GAWXM-16-17 INSURER A: Allied World Assurance Company, Inc. 19489 INSURED INSURER B : Travelers Property Casualty Co. of America _ 25674 Envision Pharmaceutical Holdings, LLC N/A 2181 East Aurora Road, Suite 201 INSURER C : NIA Twinsburg, OH 44087 INSURER D : The Travelers Indemnity Company 25658 INSURER E : awl nn0007097 na Cr'l/ICInAi All IAARFR- I GUVtKAUtS I.Cr% 1 lrn.M 1 nU... . ... - - -- 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 LTP. TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE ix] OCCUR 0309-3594 01/31/2016 01/01/2017 EACH OCCURRENCE $ 5,000,000 DAMAGE TO RENTED PREMISES rEa occurrence $ 500,000 MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 5,000,000 GENERAL AGGREGATE $ 5,000,000 GENT AGGREGATE LIMIT APPLIES PER X� PRO ❑ POLICY ❑ JECT LOC PRODUCTS -COMP/OP AGG $ 5,000,000 B OTHER AUTOMOBILELIABILITY TC2JCAP-8049XO72-16 01/31/2016 01/U112017 oMBcdeDtSINGLELIMIT $ 5,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL. OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ _ X STATUTE OERH B TC2JUB-7442L10A-16 (ADS) 01131/2016 0110112017 DED RETENTION $ WORKERS COMPENSATION E.LEACH ACCIDENT . $ 2,000.000 D B AND EMPLOYERS' LIABILITY N Y ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS below NIA 111-16 AZ, MA TRKUB-7442L( ) TWXJUB-74421123-16(OH.OR)(Sir$1M) Excess WC 01131/2016 01/3112016 01/01/2017 01/01/2017 E.L.DISEASE -EA EMPLOYEE $ 2,000,000 E.L. DISEASE - POLICY LIMIT 1 $ 2,000,000 A Healthcare Facilities 03093594 01131/2016 01101;2017 SEE ATTACHED Medical Professional Liability (CLAIMS MADE) SEE ATTACHED DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) G-147167-B99 (12/06) Monroe County Board of County Commissioners is included as additional insured where required by written contract with respect to General Liability. ANPR E Y NAOEMENT L4,4 BY p� WAIVER N/A YES 1Nfi0 i 308,04 W U.�,,�,,_ I II I Ir ILA I t "L)LUCK Monroe County Board of County Commissioners 1100 Simonton St.. Suite 2-268, Key West. FL 33040 tl 'E ii8 S - 833 9i'. 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. Nancy Kalbfell w T1A\I All ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD HEALTHCARE FACILITIES MEDICAL PROFESSIONAL LIABILITY LIMITS EACH CLAIM: $5,000,000 AGGREGATE FOR ALL CLAIMS: $5,000,000 Insured Irrtt €..� w 50—u awtivo 24.0 t, iaia Services Corporation RedCi cc. LLC 4/111997 4rz&2005 RCMH, LLC 1f14�'2QfiL+ = 3��:cfiGltnicAsi�es Ir3C R Ckito of MD LLC 01+ y«, �ry ,.012014 RediClirr c of US, LLC _ _ ......m 1Tp12/008 .. jam(._.._. ,sit f � / + i C iiiiii E�€A.�1�$�r ofVA, b-lal.s 411f2015 .... .. ... .. RediGfine of E3 . LLC �r14�`s35 tk iCt is of DE, LLC .��� 511912015 ........ .w....� Hit t Lame, LLC{, n f!_ 4 Envision Ptdarm8ceuftual p((�p3 RX Options LLC _ 1,1.t2tttl9 nv n F'h rrrti r c�ra at, ervice& LLC ?i1;2009 Of'chwd Pharmacw t al Serves. LLC 1I11 99 Envision Medical SoMons Lt.0 Fast Roridahsurej,s of Tampa, L,LC 11112009 Advame Bettetds, LLC 111M% ._ Design Rx Holdinos LLC 111/20 9 Rx im iativ . L L, 111120€ � _ pr sirxciusiyes. LLC 11147009 Cn LAC _____..��.-.--�--..j t15 ti12 Asr: d Health Tec:'�nc!c Li,,C:n € Fnv n lr�surance Cnr€ san 1r1�2t 9 _L..wgker software,LLC 11t2a12f}13 W,edTrak Serv►cos i-L U 1:112009 s Eked€ 4 of 13a1tdPort-1 Vartfa: LLC 5ryM W2315 . e d,--fir - - Red€Cttme of ChicLLCw At Cad M Sf nwsionRx F'itOLi�ct3, It c 1Qi.?f d'2915 €R E3%%: iniq Austin.. LLC 2 41 M 14 m Rrdd,Clinic of �,;�tAe: LLC Q#�$ itJ4 Este Aid Pharmarya ownership interest onlyj 1.. 41112014 1 ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 02/11/2016 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: MARSH USA INC. PHONE FAX (AIC. No): 501 MERRITT 7 (A/C No. Ext): E-MAIL NORWALK, CT 06856-6010 ADDRESS: INSURERS AFFORDING COVERAGE NAIC M Attn: Norwalk.certrequest@marsh.com INSURER A: Allied World Assurance Company, Inc. 19489 416752-ENVIS-GAWXM-16-17 INSURED INSURER B : Travelers Property Casualty Co. of America 25674 INSURER C : N/A N/A Envision Pharmaceutical Holdings, LLC 2181 East Aurora Road, Suite 201 25658 Twinsburg, OH 44087 INSURER D : The Travelers Indemnity Company INSURER E : INSURER F L.VVCKAIOCJ 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 OF INSURANCE ADDLTYPE INSD SUER WVD POLICY NUMBER MMI IDY/YYYY MM/DDIYYYY LIMITS A X COMMERCIAL GENLR CLAIMS -MADE 0309-3594 01/31/2016 01/01/2017 EACH OCCURRENCE $ 5,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $PERSONAL & ADV INJURY $ 5,000,000 $ 5,000,000 $ 5,000,000 GEhrL X AGGREGATE LIM POLICY ❑ PR JEC GENERAL AGGREGATE PRODUCTS - COMP/OP AGG B AUTOMOBILE OTHER: LIABILITY TC2JCAP-8049X072-16 01/31/2016 01/01/2017 COMBINED SINGLE LIMIT Ea accident $ 5,000,000 BODILY INJURY (Per person) X ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON -OWNED $ $ $ _ BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE EXCESS LIAB CLAIMS -MADE $ DED RETENTIONS WORKERS COMPENSATION X STATUTE DERPER H _ B TC2JUB-7442L10A-16 (ADS) 01I31I2016 01/Ot/2017 $ E.L. EACH ACCIDENT $ 2,000,000 D B AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If es, describe under DESCRIPTION OF OPERATIONS below N /A TRKUB-7442L111-16 AZ, MA ( ) TWXJUB-74421123-16 OH,OR Sir$1M ( )( ) Excess WC 01/31/2016 0113112016 01/01/2017 01/01/2017 E.L. DISEASE - EA EMPLOYE $ 2,000,000 E.L. DISEASE - POLICY LIMIT $ 2,000,000 A Healthcare Facilities 03093594 01/31/2016 01/01/2017 SEE ATTACHED Medical Professional Liability (CLAIMS MADE) SEE ATTACHED DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) G-147167-1399 (12106) Monroe County Board of County Commissioners is included as additional insured where required by written contract with respect to General Liability. APPR ED GEMEM&DA At N/A -- CC� I�Pi MiapiI­�h ULKIIrIt.AltI Monroe County Board of County Commissioners KeyOWest, FLn33040uite 2-268,11 .6 NV z z 11 9I[�? U60J36 80.E 0311A 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. Nancy Kalbfell n ll�wTlnr.l All r; I'+'ruser,.nrl ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD HEALTHCARE FACILITIES MEDICAL PROFESSI1,-?P.1AL LIABILITY LIMITS EACH CLAIM: $5,000,000 AGGP.EGATE FOP. ALL CLAIMS: $51,0001,000 Insured Entity Retroactive Date 4/1/1997 Health Dialog Services Cor rationE RediCliinic LLC 4/2612005 ..,._.._�._CMH. LLC __�._. R 311212007 r 1/1412009 RedlClinic Associates, Inc RedClin al MD LLC 8/19,12014 RediCiryc of PA, LLC 812 Q014 RediGinic of US, LLC RediClinic of VA LLC 411trZ015ZO15 RediClinic of DG, LLC 5/1912015 RediCRnic of DE, LLC 511912015 Hunter Lane LLC 811312013 Envision PharmaceLdicaC Holdrct s LLC 1/1/2009 RX Options, LLC 1/1/2009 Envision Pharmaceutical Services LLC 1/1/2009 orchard Pharrrtaaeutical Services. LLC 1/1/2009 Envision Medical Sofutions LLC 1/112009 First Florida Insurers of Tampa, LLC 1/112009 Advance Benefrts, LLC 1 2009 Design Rx Haldin s LLC 1 /11/2009 Rx Initiatives, L L C 1/1120 9 _ Detrxclusives LLC li r 11112Q09 Design Rx, LLC 7/1/2004 Ascend Health Technola Y LLC 311512012 Envision Insurance Company 09 Laker Software LLC It25/ 111/20013 MedTrak Services L.L C 111/2009 RedtClinic of Dallas Fort -Worth, LLC 5t1912015 RediCliNc of Chicago, LLC 9/812015 EnvisionRx Puerto Rico, [no 10r,02045 RedsClinic Austin., LLC ?1110014 RediGhnic of WA, LLC B129d2Q.14 Rite Aid PhaMCYfot ownership interest 0 4/112014