COI Expires 06/02/2018ACORO® CERTIFICATE OF LIABILITY INSURANCE
TE
DA05/22/2017Y)
05/22/2017
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 have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
Doug Jones
c/o Artex Risk Solutions, Inc.
8840 E. Chaparral Rd.; Suite 275
CONTACT
NAME:
PHONE FAX
vc No Ex : (480) 951-4177 A/c No : (480) 951-4266
E-MAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC N
Scottsdale, AZ 85250
INSURER A: American Zurich Insurance Company 40142
INSURED
Oasis Acquisition, Inc Alt. Emp: DIMENSION HEALTH, INC
2054 Vista Parkway Suite 300
INSURER B :
INSURER C :
INSURER D :
}
West Palm Beach, FL 33411
_
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER:17FLO75789368 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
! TYPE OF INSURANCE
DDL
SUBR
POLICY NUMBER
POLICY EFF POLICY EXP
MM/DD/YYY MM D/YYYY
!
! LIMITS
COMMERCIAL GENERAL LIABILITY
'
CLAIMS -MADE OCCUR
�.
EACH OCCURRENCE
E
D—A—M—A—G—E—TORENTED
PREMISES Ea occurrence)
E
MED EXP (Any one person)
_
E
PERSONAL & ADV INJURY
E
AGGREGATE LIMIT APPLIES PER:
POLICY PE� LOC
GENERAL AGGREGATE
E
GEN'L
PRODUCTS - COMP/OP AGG
E
OTHER:
E
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accidents
1 E
!
ANY AUTO
BODILY INJURY (Per person)
E
OWNED SCHEDULED
_ AUTOS ONLY AUTOS
HIRED —� NON -OWNED
AUTOS ONLY AUTOS ONLY
BODILY INJURY (Per accident)!
E
PROPERTY DAMAGE
APEtr accident _
E
E
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
E
AGGREGATE 'E
EXCESS LIAB
CLAIMS -MADE
DED RETENTION E
E
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY y / N
ANYPROPRIETOR/PARTNE R/EX ECUT I VE
OFFICER/MEMBEREXCLUDED? �
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATION'
N/A:
I WC 29-38-687-15
06/01/2017 ', 06/01/2018
X ,OTH-
STATUTE ER
E.L. EACH ACCIDENT �
E 1 000 000
'
E.L. DISEASE - EA EMPLOYE
E 11000,000
IE.L. DISEASE - POLICY LIMIT E 11000,000
f
Location Coverage Period:
I
06/01/2017 06/01/2018
L
I Client# 6802-1
DESCRIPTION OF OPERATIONS I LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for DIMENSION HEALTH, INC
only thoseco-employees 5881 NW 151 ST STE 201
MENTP
of, but not subcontractors MIAMI LAKES, FL 33014 JIBY
to:
WAIV
HOLDER r_AFJrFI I ATIn1U
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
ATTN: RISK MANAGEMENT
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
1100 SIMONTON ST.
ACCORDANCE WITH THE POLICY PROVISIONS.
KEY WEST, FL 33040
AUTHORIZED REPRESENTATIVE
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ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD