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Certificates of Insurance- ATEMENT OF INSURANCE FOR MEDTRONIC, INC. INSURED: MEDTRONIC PHYSIO CONTROL Medtronic, Inc. 7000 Central Avenue N.E., M.S.324 Minneapolis, MN 55432 ISSUE DATE: 10/6/1999 COVERAGES: The policies of insurance and coverages listed below have been issued to the insured named to the left for the policy period indicated. The insurance afforded by these policies is subject to all of the terms, conditions and exclusions of the actual policies. This statement of insurance does not grant the recipient any rights under these policies. Limits shown may have been reduced by paid claims. CARRIER TYPE OF COVERAGE COVERAGE LIMITS PERIOD CIGNA General Liability excluding products/completed 5/1/99 - 5/1/00 Per Occurrence $1,000,000 (Pacific Employers Insurance Company) operations General Aggregate $2,000,000 Policy #HDOG 19893832 Self -Insurance Product Liability 5/1/99 - 5/1/00 CIGNA Automobile Liability (Pacific Employers Hired, Non -owned and 5/1/99 - 5/1/00 Combined Single Limit $1,000,000 Insurance Company) Owned Autos Policy #ISAH 07409175 CIGNA Workers' Compensation* Statutory Limits (Pacific Employers and Employers Liability 5/1/99 - 5/1/00 -Each Accident $500,000 Insurance Company) Policy #WLRC42658972 Policy #SCFC42659010 -Disease-Each Emp. $500,000 -Disease-Policy Limit $500,000 *MN and AZ self -insured COMMENTS: THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, ITS EMPLOYEES & OFFICIALS WILL BE INCLUDED AS ADDITIONAL INSURED AS IT RELATE T/O'� GENERAL LIABILITY. J DATE THIS STATEMENT ISSUED TO: COUNTY OF MONROE 490 63RD STREET SUITE 170 GMS CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED COVERAGES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF WE WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE STATEMENT HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. MARATHON, FL 33050 MED C, INC. TRISH BERKEN � b�� 1� DATE Gary Nelson VP Risk Management & INITIAL Legal Admin Services '... MARSH INC.'. CERTIFICATE CERTIFICATE NUMBER.... O1 'USA .4SVRMCE.:: CHI-000338166-00 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE PRODUCER Marsh USA Inc. 333 South 7th Street, Suite 1600 POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE Minneapolis, MN 55402-2400 AFFORDED BY THE POLICIES DESCRIBED HEREIN. _11 0 �n COMPANIES AFFORDING COVERAGE — — COMPANY q 3840 -GAW-- A PACIFIC EMPLOYERS INS CO INSURED COMPANY MEDTRONIC PHYSIO CONTROL CORP. B ACE AMERICAN INS CO — MEDTRONIC, INC. COMPANY 7000 CENTRAL AVENUE NE M.S. 324 C MINNEAPOLIS, MN 55432 COMPANY D COVERAGES 2 THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. c0 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS A GENERAL LIABILITY HDO G20306762 05/01/00 05/01/02 GENERAL AGGREGATE $ 5,000,000 X PRODUCTS - COMP/OP AGG $ 5,000,000 COMMERCIAL GENERAL LIABILITY CLAIMS MADE Fv� OCCUR PERSONAL & ADV INJURY $ 1,000,000 EACH OCCURRENCE $ 5,000,000 OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Any one fire) $ 1,000,000 MED EXP (Any oneperson) $ 10,000 A AUTOMOBILE LIABILITY ISAH07681951 05/01/00 05/01/02 COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS r,,^ -^ n "; .: .eP., '• :h ,-/t /l/�/ ]�) PROPERTY DAMAGE $ — --- , GARAGE LIABILITY _ AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT $ •-n, :�� ;' YCS ML5 AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM $ OTHER THAN UMBRELLA FORM A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WLR C43011893 05/01/00 05/01/01 X A �- TORY LIMITS ER ,. A SCF C43011935 A5/0V01 EL EACH ACCIDENT $ 500,Onn B THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERS OFFICERS ARE: EXCL Self Insured in MN and AZ XWC C42659009 AZ Excess 05/01/00 05/01/01 EL DISEASE -POLICY LIMIT $ 500,000 EL DISEASE -EACH EMPLOYEE $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS (LIMITS MAY BE SUBJECT TO DEDUCTIBLES OR RETENTIONS) RE: THE MONROE COUNTY BOARD OF COMMISSIONERS, ITS EMPLOYEES AND OFFICIALS ARE INCLUDED AS AN ADDITIONAL INSURED AS IT RELATES TO GENERAL LIABILITY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL A DAYS WRITTEN NOTICE TO THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR OFFICE OF EMERGENCY MEDICAL SERVICES LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES. 490 63RD ST., OCEAN VIEW SUITE 170 MARATHON, FL 33050 MARSH USA INC. BY: S. DeCrane Cavanor n MM1(9/89) VAUD AS OF: 08109/00 MARSH '..USA --'.INC.'.. '. CERTIFICATE CATE 01 4SURANCjr "";; CERTIFICATE NUMBER CHI-000298179-04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Marsh USA Inc. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE 333 South 7th Street, Suite 1600 POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE Minneapolis, MN 55402-2400 AFFORDED BY THE POLICIES DESCRIBED HEREIN. COMPANIES AFFORDING COVERAGE COMPANY 3840 -GAW-- A PACIFIC EMPLOYERS INS CO INSURED COMPANY MEDTRONIC PHYSIO CONTROL B ACE AMERICAN INS CO MEDTRONIC, INC. COMPANY 7000 CENTRAL AVENUE NE M.S. 324 C MINNEAPOLIS, MN 55432 . I COMPANY �^ D COVERAGES THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS A GENERAL LIABILITY HDO G20306162 05/01/00 05/01/02 GENERAL AGGREGATE $ 5,000,000 X PRODUCTS - COMP/OP AGG $ 5,000,000 COMMERCIAL GENERAL LIABILITY CLAIMS MADE lxl OCCUR PERSONAL & ADV INJURY $ 1,000,000 EACH OCCURRENCE $ 5,000,000 OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Any one fire) $ 1,000,000 MED EXP (Any oneperson) $ 10,000 A AUTOMOBILE LIABILITY ISAH07681951 05/01/00 05/01/02 COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS r; •f !1 - RY ' a p : �Ic ? X PROPERTY DAMAGE $ uY GARAGE LIABLITY ANY AUTO DATE -- / r t �� AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM OTHER THAN UMBRELLA FORM $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WLRC43011893 05/01/00 05/01/01 X TORY LIMITS ER A SCF C43011935 05/01/00 05/01/U1 EL EACH ACCIDENT $ 500,000 B THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE El OFFICERS ARE: EXCL Self Insured in MN and AZ XWC C42659009 AZ Excess 05/01/00 � � 05/01/01 EL DISEASE -POLICY LIMIT $ 500,000 EL DISEASE -EACH EMPLOYEE $ 500,000 THER DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/SPECIAL ITEMS (LIMITS MAY BE SUBJECT TO DEDUCTIBLES OR RETENTIONS) THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, ITS EMPLOYEES & OFFICIALS IS NAMED AS ADDITIONAL INSURED AS IT RELATES TO GENERAL AND AUTO LIABILITY. .,` CER*nFICATE,HOLDERTI _CAN LLA'1'I_ SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 1 DAYS WRITTEN NOTICE TO THE COUNTY OF MONROE ATTN: MARIA DEL RIO CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR 5100 COLLEGE ROAD LIABILITYOF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES. KEY WEST, FL 33040 MARSH USA INC. BY: S. DeCrane Cavanor M 1t9 i -.:. 1 AUk�,AS� : ,QW, 6/Oq_ ..: " a,, A'NG. CERTFC�-1 tRN�.E CERTIFICATE NUMBER A CHI-000298179-06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Marsh USA Inc. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE 333 South 7th Street, Suite 1600 POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE Minneapolis, MN 55402-2400 AFFORDED BY THE POLICIES DESCRIBED HEREIN. COMPANIES AFFORDING COVERAGE COMPANY 3840 -GAW-- X A PACIFIC EMPLOYERS INS CO INSURED �pI COMPANY MEDTRONIC PHYSIO CONTROL CORP. 7'` B ACE AMERICAN INS CO MEDTRONIC, INC. COMPANY 710 MEDTRONIC PARKWAY N.E. M.S. LC310 C MINNEAPOLIS, MN 55432 COMPANY D THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DDNY) LIMITS A GENERAL LIABILITY HDOG20306762 05/01/00 05/01/02 GENERAL AGGREGATE $ 5,000,000 X PRODUCTS - COMP/OP AGG $ 5,000,000 COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR PERSONAL & ADV INJURY $ 1,000,000 EACH OCCURRENCE $ 5,000,000 OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Any one fire) $ 1,000,000 MED EXP (Any one person $ 10,000 A AUTOMOBILE LIABILITY ISA H07681951 05/01/00 05/01/02 COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO _ X BODILY INJURY (Per person) — $ ALL OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS NON -OWNED AUTOS Lly `- , s I/� BODILY INJURY (Per accident) $ X PROPERTY DAMAGE $ GARAGE LIABILITY r,kTE AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY .. ANY AUTO �R �' -- EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM $ OTHER THAN UMBRELLA FORM A EMPLOYS COMPENSATION AND EMPLOYERS'LIABILITY WLR C43103313 05/01/01 05/01/02 X TORY LIMITS ER -w EL EACH ACCIDENT $ 1,000,000 A SCF C43103404 05/01/01 05/01/02 B THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERS ARE: EXCL Self Insured in MN and AZ XWC 014058 AZ EXCESS ) 05/01/01 05/01/02 EL DISEASE -POLICY LIMIT $ 1,000,000 EL DISEASE -EACH EMPLOYEE $ 1,000,000 H I 1 1 —7 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS (LIMITS MAY BE SUBJECT TO DEDUCTIBLES OR RETENTIONS) THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, ITS EMPLOYEES & OFFICIALS IS NAMED AS ADDITIONAL INSURED AS IT RELATES TO GENERAL AND AUTO LIABILITY. SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL .fl DAYS WRITTEN NOTICE TO THE COUNTY OF MONROE ATTN: MARIA DEL RIO CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR 5100 COLLEGE ROAD LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES. KEY WEST, FL 33040 MARSH USA INC. BY: Sarah Paasch or ",, b'' PRODUCER Marsh USA Inc. 333 South 7th Street, Suite 1600 Minneapolis, MN 55402-2400 3840 -GAW-- X INSURED MEDTRONIC PHYSIO CONTROL CORP. MEDTRONIC, INC. 710 MEDTRONIC PARKWAY M.S. LC310 MINNEAPOLIS, MN 55432 THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. coI TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE I POLICY EXPIRATION I (,NITS LTR DATE (MMJDD1YY) DATE (MM/DD/YY) A GENERAL LIABILITY HDOG20306762 05/01/02 05/01/03 GENERAL AGGREGATE $ 5,000,000 X COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $ 5.000.000 CLAIMS MADE Fx_] OCCUR PERSONAL & ADV INJURY $ 1,000,000 OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 5,000,000 FIRE DAMAGE (Any one fire) $ 1,000,000 MED EXP (Any oneperson) $ 10,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ISAH07681951 ARC g S BY____. DATE 05/01/02 AGEMEN 05/01/03 COMBINED SINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTO WAIVER N/A YES AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM / EACH OCCURRENCE $ AGGREGATE $ $ A A WORKFRSCOMPENSATION ANU EMPLOYERS' LIABILITY THE PROPRIETOR/ INCL PARTNERS/EXECUTIVEF1B OFFICERS ARE: EXCL WLRC42988819 SCFC42988777 Self Insured in MN and AZ XWC 014171 (AZ EXCESS) 05l01/02 05/01/02 05/01/02 05/01/03 05/01/03 05/01/03 X i WC-8raY[T----�'�- TORY LIMITS I I ER — - -- EL EACH ACCIDENT _ $ 1,000,000 EL DISEASE -POLICY LIMIT $ 1,000,000 EL DISEASE -EACH EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS (LIMITS MAY BE SUBJECT TO DEDUCTIBLES OR RETENTIONS) THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, ITS EMPLOYEES & OFFICIALS IS NAMED AS ADDITIONAL INSURED AS IT RELATES TO GENERAL AND AUTO LIABILITY. L;ANUt:LJLALIC, N SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL -1 DAYS WRITTEN NOTICE TO THE COUNTY OF MONROE ATTN: MARIA DEL RIO CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR 5100 COLLEGE ROAD LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES. KEY WEST, FL 33040 MARSH USA INC. BY: Sarah Paasch.� (�,`✓ MM1(9/99) VAUD AS OF: 04/17/02 CERTIFICATE NUMBER M�� ICAO r , ;J�w F CHI-000298179-09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MAl —R OF INFORMATION ONLY AND CONFERS Marsh USA Inc. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE 333 South 7th Street, Suite 1600 POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE Minneapolis, MN 55402-2400 AFFORDED BY THE POLICIES DESCRIBED HEREIN. COMPANIES AFFORDING COVERAGE COMPANY 3840 -GAW-- X A ACE AMERICAN INS CO INSURED COMPANY MEDTRONIC PHYSIO CONTROL CORP. B MEDTRONIC, INC. COMPANY 710 MEDTRONIC PARKWAY M.S. LC310 C MINNEAPOLIS, MN 55432 COMPANY D CIOVERAGES . i 4 THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Co LTR TYPE OF INSURANCE POLICY NUMBER _ POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS A GENERALLIA&UTY HDOG21731195 05/01/03 05/01/04 GENERAL AGGREGATE $ 10,000,000 X PRODUCTS - COMP/OP AGG $ 10,000,000 COMMERCIAL GENERAL LIABILITY CLAIMS MADE 1XI OCCUR PERSONAL & ADV INJURY $ 1,000,000 EACH OCCURRENCE $ 10,000,000 OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Anyone fire) $ 1,000,000 MED EXP (Any oneperson) $ 10,000 A AUTOMOBILEUABIUTY ISAH07685087 05/01/03 05/01/04 COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO X BODILY INJURY $ ALL OWNED AUTOS SCHEDULED AUTOS (Per person) X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS AP S ANAG N' X BY PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTO �r. V I��A WAIVER E R N A _. .YES AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY r EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM C $ OTHER THAN UMBRELLA FORM A A WORKERS COMPENSATION AND EMPIOYFRS' LIABILITY WLRC43522644 SCFC43522607 05/01/03 05/01/03 05/01/04 05/01/04 X TWC STATU ORY LIM TS ER EL EACH ACCIDENT $ 1,000,000 A THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE WLRC443522565 05/01/03 05/)1/04 EL DISEASE -POLICY LIMIT $ 1,000,000 EL DISEASE -EACH EMPLOYEE $ 1,000,000 OFFICERS ARE: EXCL OTHER WC: Self Insured in MN & AZ DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, ITS EMPLOYEES & OFFICIALS IS NAMED AS ADDITIONAL INSURED AS IT RELATES TO GENERAL AND AUTO LIABILITY. C_ CP �� T' U fr— kn Ct ✓i G. ip Cir t'!'IF� 1TE: 010ER CAI CE(:LATIC)N SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL _Ap DAYS WRITTEN NOTICE TO THE COUNTY OF MONROE ATTN: MARIA DEL RIO CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR 5100 COLLEGE ROAD LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTSOR REPRESENTATIVES, OR THE KEY WEST, FL 33040 ISSUER OF THIS CERTIFICATE. MARSH USA INC. BY: Sarah Paasch (244,Ae VALID AS OF 04/30/03 Hl ry4K $K 3�1 MARSH CERTIFICATE OF INSURANCE CERTIFICATE NUMBER CHI-000338166-04 PRODUCER Marsh USA Inc. 333 South 7th Street, Suite 1600 Minneapolis, MN 55402-2400 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN. COMPANIES AFFORDING COVERAGE COMPANY 3840 -GAW-- A ACE AMERICAN INS CO INSURED COMPANY MEDTRONIC PHYSIO CONTROL CORP. B MEDTRONIC, INC. 710 MEDTRONIC PARKWAY COMPANY M.S. LC310 C MINNEAPOLIS, MN 55432 COMPANY D HcSCrJE COVERAGES 6 THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. FCO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDD/YY) POLICY EXPIRATION DATE (MM/DDIYY) LIMITS q GENERALLIABILITY HDOG21731195 05/01/03 05/01/04 GENERAL AGGREGATE $ 10,000,000 PRODUCTS - COMP/OP AGG $ 10,000,000 X COMMERCIAL GENERAL LIABILITY PERSONAL & ADV INJURY $ 1,000,000 CLAIMS MADE Fx ] OCCUR EACH OCCURRENCE $ 10,000,000 OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Any one fire) $ 1,000,000 MED EXP (Any oneperson) $ 10,000 q AUTOMOBILE LIABILITY ISAH07685087 05/01/03 05/01/04 COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO X BODILY INJURY $ ALL OWNED AUTOS (Per person) SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS A i ti! BY OATS _. - -- AGEMEN X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE $ GARAGE LIABILITY PP n,�;,C, _.. ......FS AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ FORM $ ]UMBRELLA OTHER THAN UMBRELLA FORM A q WORKERS COMPENSATION AND EMPLOYERS'LIABWTY WLRC43522644 SCFC43522607 05/01/03 05/01/03 05/01/04 05/01/04 X I TORYLMTS ER - EL EACH ACCIDENT $ 1,000,000 EL DISEASE -POLICY LIMIT $ 1,000,000 A A THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERS ARE: EXCL WLRC443522565 WLR C43520556 05/01/03 05/01/03 05/01/04 05/01/04 EL DISEASE -EACH EMPLOYEE $ 1,000,000 OTHER WC: Self Insured in MN & AZ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS THE MONROE COUNTY BOARD OF COMMISSIONERS, ITS EMPLOYEES AND OFFICIALS ARE INCLUDED AS AN ADDITIONAL INSURED AS IT RELATES TO GENERAL LIABILITY AND AUTO LIABILITY WHEN REQUIRED BY CONTRACT. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 'In DAYS WRITTEN NOTICE TO THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR OFFICE OF FIRE RESCUE, ATTN: DARICE HAYES LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE 490 63RD ST., OCEAN VIEW SUITE 170 MARATHON, FL 33050 ISSUER OF THIS CERTIFICATE. MARSH USA INC. BY: Sarah Paasch MM1(3/02) VALID AS OF:'11/14103 MARSHC ERTI'�IGAT ,, "j ] RA C CERTIFICATE NUMBER I� CHI-000298179-10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Marsh USA Inc. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE 333 South 7th Street, Suite 1600 POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE Minneapolis, MN 55402-2400 AFFORDED BY THE POLICIES DESCRIBED HEREIN. COMPANIES AFFORDING COVERAGE COMPANY 3840 -GAW-- X A ACE AMERICAN INS CO INSURED COMPANY MEDTRONIC PHYSIO CONTROL CORP. B MEDTRONIC, INC. COMPANY 710 MEDTRONIC PARKWAY M.S. LC310 C MINNEAPOLIS, MN 55432 COMPANY D cov-EkAGES ' r g THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED" NAMED" HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE CTY) POLICY EXPIRATION DATE (MMFF DATE (MM/DD/TI LIMITS A GENERAL LIABILITY HDCG 21704842 05/01/04 05/01/05 COMMERCIAL GENERAL LIABILITY GENERAL AGGREGATE $ 10,000,000 X PRODUCTS -COMP/OP AGG $ill10,000,000 X CLAIMS MADE 1:1OCCUR I'.' PERSONAL & ADV INJURY $ 1,000,000 & CONTRACTOR'S PROT EACH OCCURRENCE $ 10,000,000 HOWNER'S FIRE DAMAGE (Any one fire) $ 1,000,000 - MED EXP An one person) $ 10.000 A AUTOMOBILE LIABILITY ISAH08016835 05/01/04 05/01/05 COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO X ALL OWNED AUTOS AP y P RISK lvAGEMENT BODILY INJURY $ SCHEDULED AUTOS (Per person) X HIRED AUTOS X NON -OWNED AUTOS R�` _ BODILY INJURY (Per accident) $ 7 �ii � PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY ,: EACH ACCIDENT $ AGGREGATE $ _ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM C AGGREGATE $ OTHER THAN UMBRELLA FORM $ A WOFK�R COMPENSATION AND EMPLOYERS'LIABILITY WLRC 43976849 AOS ( ) 05/01/04 05/01/05 X TORYLIMITS ER '� A SCFC43976801 (WI) 05/01/04 05/01/05 " ,- Yr; $ EL EACH ACCIDENT A THE PROPRIETOR/ INCL WLRC 43976722 ( NJ) 05/01l04 05/01/05 1000,000 A PARTNERS/EXECUTIVE EL DISEASE -POLICY LIMIT $ 1,000,000 OFFICERS ARE: FXCL WLRC4397676A(MO, NC, NE, OK) 05/01/04 05/01/05 OTHER EL DISEASE -EACH EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, ITS EMPLOYEES & OFFICIALS IS NAMED RELATES TO GENERAL AND AUTO LIABILITY. AS ADDITIONAL INSURED AS IT CERTIF(C 'FE HQl EER SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF MONROE COUNTY BOARD OF COUNTY THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL __An DAYS WRITTEN NOTICE TO THE COMMISSIONERS CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR RISK MANAGEMENT DEPT. 1100 SIMONTON STREET LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE KEY WEST, FL 33040 ISSUER OF THIS CERTIFICATE. MARSH USA INC. BAY::{{]� DebraBurrell b SE(IG�'fi t �� V A 0 L � 05/19/04 ;. MAR, H } CERTIFICATEsOF INSURANCE CERTIFICATE NUMBER ,, - CHI-001310818-01 PRODUCER Marsh USA Inc. 333 South 7th Street, Suite 1600 Minneapolis, MN 55402-2400 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN. COMPANIES AFFORDING COVERAGE COMPANY 3840 -EMERS-GAW- A ACE AMERICAN INS CO INSURED COMPANY MEDTRONIC EMERGENCY RESPONSE SYSTEMS INC B MEDTRONIC, INC. 710 MEDTRONIC PARKWAY COMPANY M.S.LC310 C MINNEAPOLIS, MN 55432 _ COMPANY D COVERAGES 2 THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT MATH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DDNY) POLICY EXPIRATION DATE (MM/DDNY) LIMITS A GENERAL LIABILITY HDCG2171933A 05/01/05 05/01/06 GENERAL AGGREGATE $ 10,000,000 PRODUCTS - COMP/OP AGG $ 10,000,000 X COMMERCIAL GENERAL LIABILITY X CLAIMS MADE 0 OCCUR PERSONAL & ADV INJURY $ 1,000,000 EACH OCCURRENCE $ 10,000,000 OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Any one fire) $ 1,000,000 MED EXP (Any oneperson) $ 10,000 A AUTOMOBILE LIABILITY ISAH07938032 05/01/05 05/01/06 COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO X BODILY INJURY $ ALL OWNED AUTOS (Per person) SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIREDAUTOS NON -OWNED AUTOS ,. X PROPERTY DAMAGE $ GARAGE LIABILITY -.-. _.._.._...___.. AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: ' ANY AUTO c._.. EACH ACCIDENT $ AGGREGATE $ z EXCESS LIABILITY �, ( EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM $ OTHER THAN UMBRELLA FORM A A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY WLRC44187383(AOS) SCFC44187280(N) 05/01/05 05/01/05 05/01/06 05/01/06 X TORYLMTS ER -' EL EACH ACCIDENT $ 1,000,000 EL DISEASE -POLICY LIMIT $ 1,000,000 A A THE PROPRIETOR/ N INCL PARTNERS/EXECUTIVE OFFICERS ARE: EXCL WLRC44187395 (MO, NC, NE, NJ & OK) 05/01/05 05/01/06 EL DISEASE -EACH EMPLOYEE $ 1,000,000 THER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED UNDER GENERAL LIABILITY AS REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION',.:,� SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 'A DAYS WRITTEN NOTICE TO THE Monroe County Board of County Commissioners CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR Monroe County Risk Management LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE P.O. BOX 1026 Key West, FL 33041-1026 ISSUER OF THIS CERTIFICATE. MARSH USA INC. BY: Jan M. Oxendale�'— �'' MMI(3,02) VALID AS OF: 07/20/05 � � � CERTIFICATE NUMBER MARSHCHI-000298179-12 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Marsh USA Inc. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE Mar South In Street, Suite 1600 POLICY. TNIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE Minneapolis, St 55, S2-2400 AFFORDED BY THE POLICIES DESCRIBED HEREIN. COMPANIES AFFORDING COVERAGE COMPANY 3840 -EMERS-GAW- X A ACE AMERICAN INS CO INSURED MEDTRONIC EMERGENCY RESPONSE SYSTEMS INC COMPANY B COMPANY C MEDTRONIC, INC. 710 MEDTRONIC PARKWAY M.S.LC310 COMPANY MINNEAPOLIS, MN 55432 D COVOkA6E3 8 THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY POLICY NUMBER EFFECTIVE DATE (MM/DDIYY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY X CLAIMS MADE OCCUR OWNER'S & CONTRACTOR'S PROT HDCG2171933A 05/01/05 05/01/06 GENERAL AGGREGATE $ 10,000,000 PRODUCTS - COMP/OP AGG $ 10,000,000 PERSONAL & ADV INJURY $ 1,000,000 EACH OCCURRENCE $ 10,000,000 FIRE DAMAGE (Anyone fire) $ 1,000,000 MED EXP An one erson $ 10,000 A AUTOMOBILE LIABILITY ISAH07938032 05/01/05 05/01/06 COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS APPM) a � ��{f ° i.'''(. 1Y 1 BODILY INJURY (Per person) $ X_ AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ XHIRED X DATE _ ___ _ .. �� — -- — PROPERTY DAMAGE $ GARAGE LIABILITY WAIVER �` , �' AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM OTHER THAN UMBRELLA FORM $ A A A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOR/ X INCL PARTNERS/EXECUTIVE E: OFFICERS AREXCL WLRC44187383 (AOS) 05/01/05 SCFC44187280 (WI) 05/01/05 WLRC44187395 (MO, NC, NE, NJ 05/01/05 & OK) 05/01/06 05/01/06 05/01/06 X I ORY LIMITSER _ EL EACH ACCIDENT $ 1,000,000 EL DISEASE -POLICY LIMIT $ 1,000,000 EL DISEASE -EACH EMPLOYEE $ 1,000,000 TH DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, ITS EMPLOYEES & OFFICIALS IS NAMED AS ADDITIONAL INSURED UNDER GENERAL AND AUTO LIABILITY AS REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDEN CANCELLATION SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL _ 111 DAYS WRITTEN NOTICE TO THE MONROE COUNTY BOARD OF COUNTY CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR COMMISSIONERS RISK MANAGEMENT DEPT. LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE 1100 SIMONTON STREET KEY WEST, FL 33040 ISSUER OF THIS CERTIFICATE. MARSH USA INC. BY: Jan M. Oxendale �C7"' Yet` °' � $1 2 VALID AS OF: 08/29/05 �® - -- --- - ---- f ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/28/2009 PRODUCER Marsh USA Inc. THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 333 South 7th Street, Suite 1600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Minneapolis, MN 55402-2400 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 43840-MEDTR-GAWAl-09/10 INSURERS AFFORDING COVERAGE NAIC # INSURED MEDTRONIC, INC. INSURER A: ACE American Insurance Company :1 22667 — ----- -- -- -- — --- - -- INSURER B: 710 MEDTRONIC PARKWAY M.S. LC310 M I N N EAPOL I S, MN 55432-5604 INSURER C: INSURER D: INSURER E: i COVERAGE5 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. ISR ADD' POLICY EFFECTIVE POLICY EXPIRATION .TR INSR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YYYY) DATE (MM/DD/YYYY) LIMITS i A X IGENERAL LIABILITY HDC G24930786 05/01/2009 05/01/2010 EACH OCCURRENCE 10,000,00011 X COMMERCIAL GENERAL LIABILITY XF-1 CLAIMS MADE: OCCUR GENERAL AGGREGATE LIMIT APPLIES PER X POLICY LOC A AUTOMOBILE LIABILITY ISA H08577419 05/01/2009 05/01/2010 X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS T GARAGE LIABILITY -1 ANY AUTO EXCESS / UMBRELLA LIABILITY OCCUR L CLAIMS MADE 1 1 DEDUCTIBLE C(.. ' RETENTION $ A WORKER9 COMPENSATION AND WLR C45697502 (AOS) 05/01/2009 05/01/2010 A EMPLOYERS' LIABILITY SCF C4 5697514 (WI) 05/01/2009 05/01/2010 A ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? ---NT WLR C45697526 MO, NC, NE, OK ( 05/01/2009 05/01/2010 A SCF C45697538 (NJ) 05/01/2009 05/01/2010 (Mandatory in NH) If yes, describe under SPECIAL PROVISIONS below OTHER 4rro 1W DAMAGE TO RENTED PREMISES Ea occurrence 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 10,000,000, PRODUCTS - COMP/OP AG 10,000,000, I COMBINED SINGLE LIMIT (Ea accident) 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) i $ I AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EACH OCCURRENCE $ AGGREGATE $ $ I $ i X WC STATU- ET- .L. EACH ACCIDENT ;:0 1,000,UUU .L. DISEASE - EA EMPLOYEE $ 1,000,000, .L. DISEASE - POLICY LIMIT $ 1,000,000 , DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Monroe County, Florida Government is included as additional insured under general liability as required by written contract. CERTIFICATE HOLDER CHI-002692766-01 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Monroe County Government EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Attn: Maria Slavik 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 490 63rd Street, Suite 160 BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND Marathon, FL / UPON QQ gg THE INSURER, ITS AGENTS OR REPRESENTATIVES. of ADRLVUS IncSENTATIVE Q �;, Mary Radaszewski ACORD 25 (2009/01) © 1998-2009 ACORD CORPORATION. All Rights Reserved The ACORD name and logo are registered marks of ACORD ® CERTIFICATE OF LIABILITY INSURANCE DATE 06104/2012 /YYYY) 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(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. 1301 5th Avenue, Suite 1900 No. E _ AIC. Not: Seattle, WA 98101 EMAIL Attn: Jenelle May 206-214-3082 ADDRESS: INSURER 3 AFFORDING COVERAGE NAIC N 184424-IS5-CAS-12-13 INSURER A: National Fire Insurance Cc Of Hartford 20478 INSURED INSURER B : N/A WA Physio-Control International, Inc. Physio-Control, Inc. INSURER C 11811 Willows Road NE INSURER D : Redmond, WA 98052 INSURER E : rfIMMMAcce 1`9=DTICIr ATC Kit IMRFD• SFG-nn939Rtn9-n1 RFVI.RION NIIMRFR- 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 I ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MM/DD/YYYY A GENERAL LIABILITY 4030507381 01/30/2012 01/30/2013 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE T RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) 5,000 $ CLAIMS -MADE F_x] OCCUR PERSONAL & ADV INJURY $ 1,000,000 A BN D P 11R ECM ANTRA N i� �t �S GENERAL AGGREGATE $ 2,000,000 GEML AGGREGATE LIMrr APPLIES PER: PRODUCTS - COMP/OP AGG $ EXCLUDED $ X POLICY PRO- LOC JEQI f �C: AUTOMOBILE LIABILITY 4029265138 (AOS) I 01/30/2012 01/30/2013 COMBINED Ea accident SINGLE LIMIT 11000,000 BODILY INJURY (Per person) $ A X ANY AUTO 4029265172 (MA) 01/30/2012 01/30/2013 BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS ND HIRED AUTOS AUTOS AUTOS PROPERTY DAMAGE Per accident $ COMP / COLL DED. $ 1,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ A WORKERS COMPENSATION 4030507378 (AOS) 01/30/2012 01/30/2013 X WC STATU- OTH- I ER A AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) N / A 4030507364 CA) ( 01/30/2012 01/30/2013 E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE 1,000,000 $ E.L. DISEASE - POLICY LIMIT 1,000,000 $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Board of County Commissioners of Frederick County, Maryland is included as additional insured (except workers' compensation) where required by written contract. vA9 Cf.' 64,- CERTIFICATE HOLDER l./HrvI.CLLA I IVIV Monroe County Board of SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE County Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton St. ACCORDANCE WITH THE POLICY PROVISIONS. Key West, FL 33040 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Tracy L. Elliott <_'rY� de `f✓C ( M V IVtSt$-ZUTU AL VKU L.VKrVhrAI Ivry. All ngnts reserveu. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ® DATE (MMIDD/YYYY) ,4C — CERTIFICATE OF LIABILITY INSURANCE o6'04 2C12 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 NAME: - Marsh USA, Inc. PHONE I FAX 1301 5th Avenue, Suite 1900 iAIC, Ng. E : A/C. /C Not: Seattle, WA 98101 E-MAIL ADDRESS: Attn: Jenelle May 206-214-3082 _.._ 184424-IS5-CAS-12-13 INSURER A : National Fire Insurance Co Of Hartford 20478 INSURED INSURER B : N/A N/A Physio-Control International, Inc. Physio-Control, Inc. INSURER C 11811 Willows Road NE INSURER D : Redmond, WA 98052 INSURER E INSURER F : r�or1011-ATc ullluncD• ere-nr9z9A1ro111 RFVI_CIAN NIIMRFR-1 vTHIS ,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 I LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDDY EXP LIMITS A GENERAL LIABILITY 4030507381 01/30/2012 01/30/2013 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMA E TO RENTED PREMISES Ea occurrence 1,000,000 $ MED EXP (Any one person) $ 5,000 CLAIMS -MADE 7 OCCUR I3 D R PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 'IV -Z YES — r�' �•� D _S GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ EXCLUDED $ X POLICY PRO LOC G� R A AUTOMOBILE LIABILITY 4029265138 (AOS) 01/30/2012 01/30/2013 COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO 4029265172 (MA) 01/30/2012 01/30/2013 BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS NON AUTOS OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ COMP / COLL DED. $ 1,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED I J RETENTION $ $ A WORKERS COMPENSATION 4030507378 (AOS) 01/30/2012 01130/2013 X wC STATU- O IR E.L. EACH ACCIDENT 1,000,000 $ A AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4030507364 (CA) 01/30/2012 01/30/2013 E.L. DISEASE - EA EMPLOYE 1,000,000 $ E.L. DISEASE -POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Board of County Commissioners of Frederick County, Maryland is included as additional insured (except workers' compensation) where required by written contract. P =C lC1!` A= Un1 nCD (.ANt.tLLA I IUN Monroe County Board of County Commissioners 1100 Simonton St. 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. Tracy L. Elliott 1 .3r)CL� de `j wa- V lytf rf-LD IV HI.Vr[V liVRh VRHI IVIV. Fi11 11911tZ, 1tlJC1 VUU. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ACORU® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) �. 01/16/2013 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 CONTACT NAME: Marsh USA, Inc. PHONN FAX 1301 5th Avenue, Suite 1900 No: E-MAIL ADDRESS: Seattle, WA 98101 Attn: Seattle.CertRequest@marsh.com / F: 212-948-4326 INSURERS AFFORDING COVERAGE NAIC # INSURER A: National Fire Insurance Co Of Hartford 20478 184424-IS5-CAS-12-13 INSURED Physio-Control International, Inc. INSURER B : NIA NIA Physio-Control, Inc. INSURER C : INSURER D 11811 Willows Road NE Redmond, WA 98052 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: SEA-002343415-05 REVISION NUMBER:24 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 A GENERAL LIABILITY 4030507381 01/30/2012 05/01/2013 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR DAMA E TO RENTED PREMISES Ea occurrence $ 1,000,000 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 $ EXCLUDED X POLICY F7 PRO- LOC $ A AUTOMOBILE LIABILITY 4029265138 (ADS) 01/30/2012 05/01/2013 COMBINED SINGLE LIMIT Ea cident ac 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO 4029265172 (MA) 01/30/2012 05/01/2013 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED AUTOS NON -OWNED AUTOS COMP / COLL DIED. $ 1,000 UMBRELLA LIAR HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR DIED I I RETENTION $ A WORKERS COMPENSATION 4030507378 (ADS) 01/30/2012 05/01/2013 X I WC STATU- OTH- LIMITS ER AANY AND EMPLOYERS' LIABILITYTORY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICERIMEMBER EXCLUDED? � (Mandatory in NH) N / A 4030507364 (CA) 01130/2012 0510112013 E.L. EACH ACCIDENT $ 1'600'060 E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) / Re: Monroe County Board Of Commissioners ✓tD V I' MAlvio� N1ENT Additional Insured Status Applies Only If It Is Reflected In Your Written Contract. Monroe County Board of Commissioners is included as Additional Insured under General Liability and Auto Liability as required by written contrVA �� WAIV L c , K✓ Monroe County Board of County Commissioners 1100 Simonton Street Key West, FL 33050 C c— * 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. Cheryl Bermudez @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ,aco CERTIFICATE OF LIABILITY INSURANCE D13BG20IDD/YYYYI L � 1013 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 Marsh USA, Inc. NAME: 1301 5th Avenue, Suite 1900 PHONE FAX A/C No E A/C No): _ Seattle, WA 98101 ADDRESS: Attn: Seattle.CenRequest@marsh.com / F: 212-948-4326 - -- INSURER(S) AFFORDING COVERAGE NAIC # 184424-IS5-CAS-13-14 INSURER A : Valley Forge Insurance Co 20508 INSURED INSURERS: National Fire Insurance Co Of Hartford 20478 Physio-Control International, Inc. — - Physio-Control, Inc. INSURER C : N/A N/A 11811 Willows Road NE INSURER D : Redmond, WA 98052 INSURER E : INSURER F : COVERAGES CERTIFICATE NLIMRFR- sFA-nf943R9d1-n1 RFVIA1f1m All IMRFR• 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 _ ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD1 POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A GENERAL LIABILITY 4030507381 05/01/2013 05/01/2014 EACH OCCURRENCE $ 1,000,000 JCIOMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR $ 1,000,000 DAMAGE To RENTED PREMISES Ea occurrence MED EXP (Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000.000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ EXCLUDED X POLICY 7 PRD LOC $ B AUTOMOBILE LIABILITY 4029265138 (ADS) 05/01/2013 05/01/2014 COMBINED accident SINGLE LIMIT Ea 1,000,000 B X ANY AUTO 4029265172 (MA) 05/01/2013 05/01/2014 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS $ BODILY INJURY (Per accident) NON -OWNED HIREDAUTOS AUTOS $ PROPERTY nDAMAGE COMP / COLL DED. $ 1.000 UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE EXCESS LIAB $ DED RETENTION$ $ B WORKERS COMPENSATION 4030507378 (ADS) 05/01/2013 05/01/2014 X I WC STATU- OTH- AND EMPLOYERS' LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? N (Mandatory In NH) N/A 4030507364(CA) 05/01/2013 05/01/2014 E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Additional Insured status applies only if it is reflected in your written contract. (:FFHI IFI(:A I - H(11 IIFR rAMrP:l I ATlnAl Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Street ACCORDANCE WITH THE POLICY PROVISIONS. Key West, FL 33050 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Cheryl Bermudez U 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AC"R& CERTIFICATE OF LIABILITY INSURANCE ��. ❑ATE(MM1D6fYYYY) 1013012013 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(fes) 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. 1301 5th Avenue, Suite 1900 CONTACT NAME: PHONE FAX C No xt E-MAIL ADDRESS_. Seattle, WA 98101 Attn: SeaBie.CerlRequest@marsh.com I F: 212-948.4326 INSURE S AFFORDING COVERAGE NAIC p INSURER A: Valley Forge Insurance CD 20508 1844241$5-CAS-13-14 INSURED Physio-Control international, Inc. Physio-Conlroi, Inc. INSURERS: National Fire Insurance Co Of Hartford 20478 INSURER C : N/A NIA INSURER Q : 11811 Willows Road NE Redmond, WA 98052 INSURER E : INSURER F : I rnvooAn_CQ r`COTICH-ATC AIIIMRCO• (Nd_nn9A1A9d1-n1 PF:VIrIr)N NI IMRF;R-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 A L BR---��-- - POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP.____ MMlDDIYYYY LIMITS A I GENERAL LIABILITY 4030507381 05101r2013 0510112014 EACH OCCURRENCE s-UAM1,000,000 X COMMERCIAL GENERAL LIABILITY AGE-T6TiENTED PREMISES Ea occurrence - 1,000,000 S MED EXP (Any one person) S 5,000 CLAIMS -MADE M OCCUR PERSONAL 6 ADV INJURY $ 1,000,000 GENERAL AGGREGATE --- S 2,000,000 .�._�_ ...... ................. ......... ...._ PRODUCTS - COMP/OP AGG $ EXCLUDED -- GEN'L AGGREGATE LIMIT APPLIES PER. S I X POLICY PRO-E,T LOC B AUTOMOBILE LIABILITY 4029265138 (ADS) 05101t2013 05/01/2014 COMBINED SINGLE LIMIT I (Ea accident I 1,�0,000 BODILY INJURY (Per parson) $ B x ANY AUTO 4029265172 (MA) 05101/2013 0510112014 BODILY INJURY (Per acddsnq S ALL OWNED SCHEDULED i AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE j_,(Per accident $ COMP / COLL DEC). S 1,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE I S AGGREGATE--- ..........................its j EXCESS LAB c CLAIMS -MAC., O£p P,ET ENTIONS S B g WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIRlEXCLUDED XEGUTIVE InNOFFICER/MEMBER EXCLUDED? (Mandatory (Mandatory In NH) NIA I4030507378 (AOS) 4030507364 (CA) 05,10112013 0510112013 W0112014 05/01/2014 WC STATU- OTH- Eft... _......__.. EL EACH ACCIDENT 1,000,000 $ £ L DISEASE - EA EMPLOYE $ 1,000,000 E 1. DISEASE -POLICY LIMIT 1,000,000 S If es, describe under DESCRIPTION OP OPERATIONS below THIIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is requlnsdl Additional Insured status applies only it it is reflected in your written contract. c P �MGEM59,,-, WAIV R N/ACC GtK I IFIGA I t HULULK L I.ANI—MLLA I IUn Monroe County Board of County Commissioners 1100 Simonton Street Key West, FL 33050 L.v - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. O1330 �1I0Z AUTHORIZED REPRESENTATIVE of Marsh USA Inc. i ) � I Cheryl Bermudez `J lUdk$-ZUIU At.:UKU UUKYUKA 1IUr4. Au rlgnts reserveG. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD ACC) CERTIFICATE OF LIABILITY INSURANCE ATE D04/29/20014 Yy) 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. 13015th Avenue, Suite 1900 Seattle, WA 98101 Attn: Seatfle.CertRequest@marsh.com I F: 212-948-4326 CONTACT NAME: PHONE FAX A/c No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC N INSURER A: Continental Casualty Company 20443 184424-STND-GAWUp-14-15 INSURED Physio-Control International, Inc. PhysicControl, Inc. INSURER B : National Fire Insurance of Hartford INSURER C : WA NIA 11811 WAlows Road NE Redmond, WA 98052 INSURER D : INSURER E INSURER F : GUVtKAbt, 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 A TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR ADDL UBR POLICY NUMBER 4030507381 POLICY EFF MM/DD/YYYY 05/01/2014 POLICY EXP MM/DD/YYYY 05/01/2015 LIMITS EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 1000 000 $ MED EXP (Any one person) $ 5'� PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ EXCLUDED B 4029265138 05/01/2014 05/01/2015 GEN'L AGGREGATE LIMIT APPLIES PER X POLICY PRO- LOC AUTOMOBILE LIABILITY EOMaBcINEnDtsINGLELIMIT $ 11000,000 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 $ COMP / COLL DED. $ 1,000 UMBRELLA LiAB OCCUR EACH OCCURRENCE $ EXCESS LIAB AGGREGATE $ HCLAIMS-MADE OTH- X vVCSTATULIMJ- I ER A A N / A 4030507378 (ADS) () 4030507364 CA U01/2014 05/01/2014 05/01/2015 05/0112015 DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) tl yes, describe under DESCRIPTION OF OPERATIONS below E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEd $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) A P 11C i1�CM Re: Monroe County Board Of Commissioners B ��_�{(_. Additional Insured Status Applies Only If It Is Reflected In Your Written Contract. W A -tCU- " Monroe County Board of Commissioners is included as Additional Insured under General Liability and Auto Liability as required by written contract. �'/1,1� e b 'AiNI103 308NOW Monroe County Board of County Commissioners 1100 Simonton Street Key West, FL 33050 10 0 Nd 6 — AN 1[ b104 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. Cheryl Bermudez ..........n ^^12nAnA1rlf%U All w..M1c -—&A ACORD 25 (2010106) The ACORD name and logo are registered marks of ACORD A�ORO CERTIFICATE OF LIABILITY INSURANCE D r 091920/DDYWY) 1914 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. 1301 5th Avenue, Suite 1900 _ A/cC No xt : ac No): Seattle, WA 98101 Attn: Seattle.CertRequest@marsh.com I F: 212-948-4326 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # 184424-STND-GAWUp-14-15 INSURER A : Continental Casualty Company 20443 INSUREDPhysio-Control INSURERS: National Fire Insurance of Hartford 20478 International, Inc. INSURER C : NIA N/A Physio-Control, Inc. 11811 Willows Road NE Redmond, WA 98052 INSURER D : INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: SEA-002496329-01 REVISION NUMBER:2 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 VVITH 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. INTSR R TYPE OF INSURANCE DL UBR POLICY NUMBER MM DIDY /YYYY MMDDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR 4030507381 05/01/2014 05/01/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X I POLICY 7 PRO LOC PRODUCTS - COMP/OP AGG $ EXCLUDED $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS 4029265138 05/01/2014 05/01/2015 EO aBINED .d.,SINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY Per accident ( ) $ PROPERTY DAMAGE Per accident $ COMP / COLL DED. $ 1,000 UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? M (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4030507378 (ADS) 4030507364 (CA) 05/01/2014 05/01/2014 05/01/2015 05/01/2015 X WC STATU- 0TH- E. L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE- EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Additional Insured status (except workers' compensation) applies only if it is reflected in your written contract. CERTIFICATE HOLDER CANCELLATION Monroe County Fire Rescue Attn: Holly Pfiester 49063rd Street Ocean, Suite 140 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Marathon, FL 33050 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Cheryl Bermudez @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AC40R �® CERTIFICATE OF LIABILITY INSURANCE DATE (MMDDMlYY) 0411312015 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. NE FAX 1301 5th Avenue, Suite 1900 AIC. No. Ext : A/C No): E-MAIL ADDRESS: Seattle, WA 98101 Attn: Seattle.CertRequest@marsh.com / F: 212-948-4326 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Continental Casualty Company 20443 184424-STND-GAWUp-15-16 INSURED INSURER B: National Fire Insurance of Hartford 20478 Physio-Control International, Inc. INSURER C : N/A N/A Physio-Control, Inc. INSURER D : 11811 Willows Road NE Redmond, WA 98052 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: SEA-002343415-13 REVISION NUMBER:24 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 EFF MM/DDNYYY MM DDPOLICY Y EXP /YYYY LIMITS A GENERAL LIABILITY 4030507381 05/01/2015 05/01/2016 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 CLAIMS -MADE 1XI 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 $ EXCLUDED $ T POLICY PRO LOG B AUTOMOBILE LIABILITY 4029265138 05/01/2015 05/01/2016 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE Per accident $ NON --OWNED HIREDAUTOS AUTOS COMP / COLL DED. $ 1,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DED I I RETENTION $ $ A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 4030507378 (AOS) 4030507364 (CA) 05/01/2015 05/01/2015 05/01/20 66 05/01/2016 X WCSTATU- OT H- T RY LIMITS E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is require Re: Monroe County Board Of Commissioners PPROVE B fi(V�ENTI Additional Insured Status Applies Only If It Is Reflected In Your Written Contract. Monroe County Board of Commissioners is included as Additional Insured under General Liability and Auto Liability as required by written contra�A1VE N/ S _ ��f`'II►�'' �cv Rotf" r Monroe County Board of County Commissioners 1100 Simonton Street Key West, FL 33050 VANLICLLA I lum 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. Cheryl Bermudez 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD MARSH - CERTIFICATE OF INSURANCE CERTIFICATE NUMBER CHI-000298179-15 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Marsh USA Inc. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE 333 South 71h Street, Suite 1600 _._.___—.... _ POLICY. THIS CERTIFICATE{DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE Minneapolis, MN 55402-2400 AFFQRQED Y THE POLICIES DESCRIBED HEREIN. S COMPANIES AFFORDING COVERAGE COMPANY 3840 -EMERS-GAW-07/08 X I -AA , E AMERICAN INSURANCE COMPANY MFCT INSURED COMPANY MEDTRONIC EMERGENCY RESPONSE SYSTEM INC B MEDTRONIC, INC. L~F 710 MEDTRONIC PARKWAY f'Ca CANvt M.S. LC310 'T MINNEAPOLIS, MN 55432 COMPANY D COVERAGES 8 THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE POLICYEXPIRATION LTR LIMITS DATE IMMIDDIYYI DATE(MM/DDIYY) A GENERAL LIABILITY HDCG 23724236 ,05/01/07 05/01/08 GENERAL AGGREGATE $ 10,000,000 X COMMERCIAL GENERAL LIABILITY - ---- 7 X�OWNER'SB 1 PRODUCTS COMP/OPAGG� 1O,000,000 CLAIMS MADE OCCUR PERSONAL&ADO INJURY $ iAOQ000 EACH OCCURRENCE $ 10,000,000 CONTRACTC)R'S PROT --- FIRE DAMAGE (Any one (ire) $ 1,000,000 MED EXP (Any one eDion) $ 10,000 A 1 AUTOMOBILE LIABILITY ISAH 08229065 05/01/07 05/01/08 — X COMBINED SINGLE LIMIT $ 1,000,000 _. ... ANY AUTO ALL OWNED AUTOS BODILY INJURY $ _ SCHEDULED AUTOS (Per Person) HIRED AUTOS NON -OWNED AUTOS BODILY INJURY 1 $ IPer acciAanQ i I PROPERTY DAMAGE $ GARAGE LIABILITY �I AUTO ONLY EA ACCIDENT $ OTHER THAN AUTO ONLY ANY AUTO -- --- --- �/ / ( ^� EACHACCIDENT $ AGGREGATE $ EX CESS LIABILITY 1�/ _E..A_C_H OCCURR-E-NCE $ UMBRELLA FORM _— Iy/I/I AGGREGATE $ OTHER THAN UMBRELLA FORM $ A I WORKERS COMPENSATION AND WLR C4 4460853 (AOS) 105/01/07 05/01/08 ''X u- H- W. EMPLOYERS'LIABILMY I TORV UMITT� ER A SCF C44460877 (WI) 05/01/07 05/01/08 EL EACH ACCIDENT $ 100Q000 _ '.X INCL THE NER5i XECI A WLR C44460865 (MO,NC,NE,OK) 105/01/07 05/01/08 EL DISEASE -POLICY LIMIT $ 1 000,000 P r---- __. OFFICERS A OFFICERS ARE ExcL SCF C44468542 (NJ) 05/01/07 05/01/08 EL DISEASE -EACH EMPLovEE1$ 1,000,000 O 1 DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESISPECIAL ITEMS THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, ITS EMPLOYEES & OFFICIALS IS NAMED AS ADDITIONAL INSURED UNDER GENERAL AND A TO LIABILITY AS REQUIRED BY WRITTEN CONTRACT. GC ; Pn 6Ln if e_ CERTIFICATE' HOLDER CANCELLATION SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 'I DAYS WRITTEN NOTICE TO THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CERTIFICATE HOLDER NAMED HEREIN. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR RISK MANAGEMENT DEPT. HABIL?Y OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES. OR THE 1100 SIMONTON STREET KEY WEST, FL 33040 wIssueR or rs cERnFlcnre. MARSH USA INC. BY: Kevin M. Brogan MM'I(3/02) VALID AS OF: 05/02/07 _-._.... ,..... ,A-.... .. .......,_�.. �... .,..;�x..oxv.. timx seats.: a,:...7 a ` 4 '" " x'- x fi '`''� CERTIFICATE NUMBER - NE .,, "' .'".. +.�,"4'F`.'a tw .i CHI-000298179-18 x.&. .§- *( .�, ,.�kg x L': .. e x, .. _ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS PRODUCER NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE Marsh USA Inc. 333 South 7th Street, Suite 1600 POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE Minneapolis, MN 55402-2400 AFFORDED BY THE POLICIES DESCRIBED HEREIN. "---- ` CO PANIES AFFORDING COVERAGE T - ` 3840 -EMERS-GAW-08-09 X A ACE ERI N INSURANCE COMPANY INSURED 1 / �O�PAfIx,..n MEDTRONIC, INC. Ma _..;1°J 710 MEDTRONIC PARKWAY M.S. LC310 COMPANY I MINNEAPOLIS, MN 55432 11 x THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. c0 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/OD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS LTR A GENERAL LIABILITY HDCG 23740850 05/01/08 05/01/09 GENERAL AGGREGATE $ 10,000,000 PRODUCTS - COMP/OP AGO $ 10,000,000 X COMMERCIAL GENERALLIABILITY PERSONAL B ADV INJURY $ 1,000,000 IRK] CLAIMSMADE ❑OCCUR EACH OCCURRENCE $ 10,000,000 OWNER'S A CONTRACTOR'S PROT FIRE DAMAGE (Any one tire) $ 1,000,000 MED EXP An one person)$ 10,000 A AUTOMOBILE LIABILITY ISAH 08242008 05/01/08 05/01/09 COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS .- BODILY (Perer ILLY INJURY $ NON-OWNED AUTOS -/ C PROPERTY DAMAGE $ GARAGE UABILITY I / I ( ' AUTO ONLY - EA ACCIDENT $ � ��i�Jl / ANY AUTO If /. OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE Is EXCESS UASILITY EACH OCCURRENCE Is AGGREGATE Is UMBRELLA FORM Is OTHER THAN UMBRELLA FORM A WORKERS COMPENSATION AND WLRC 44347064(AOS) OS/01/OB 05/01/09 X TUI5TAIU- ER EL EACH ACCIDENT Is 1,000,000 A EMPLOYERS'LIABIUTY WI 46849 SCF C443() 05/01/08 05/01/09 EL DISEASE-POLICVLIMIT $ 1,000-000 A THE PROPRIETOR/ FV7 INCL WLRC44346990 (MO,NC,NE,OK05/01/08 05/01/09 EL DISEASE -EACH EMPLOYEE$ 1,000,000 PARTNERS/EXECUTIVE F1 SCF C44346801(NJ) 05/01/08 05/01/09 A OFFICERS ARE: EXCL OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS WAIVER OF SUBROGATION AND/OR ADDITIONAL INSURED STATUS APPLIES ONLY IF IT IS IN YOUR WRITTEN CONTRACT. MEDTRONIC INCLUDES BUT IS NOT LIMITED TO THE FOLLOWING ENTITIES: MEDTRONIC EMERGENCY RESPONSE SYSTEMS, INC., MEDTRONIC SOFAMOR DANEK, INC., MEDTRONIC SPINE, LLC AND MINIMED DISTRIBUTION CORPORATION. 1 IN SHOULD MY OF THE POLICIES DESCRIBED HEREIN BE CANCELLEDBEFORE THE E%PIRATION DATE THEREOF, CC' � \ \ V`CA/VL C.�_ 719SUER THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL �O DAYS WRITTEN NOTICE TO THE MONROE COUNTY BOARD CERTIFICATE HOLDER NAMED HEREIN. BUT FAILURE TO MAIL SUCH NOTICE SHALLIMPOSE NO OBLIGATION OR OF COUNTY COMMISSIONERS RISK MANAGEMENT DEPT. LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES. OR THE 1100 SIMONTON STREET OF THIS CERTIFICATE. KEY WEST, FL 33040 AUTHORIZED REPRESENTATIVE Manh USA I.. -�^`'�e ,. BY: Mary Radaszewski'V .ti � VALID AS OF O5/15/08 AC40R CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) 03128/201, 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 C IMPORTANT: If the certificate holder is an AD TIONAL I y(ies) m t be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain p licies may require an endorsement. statement on this certificate does not confer rights to the certificate holder in lieu of such end orsement(s). PRODUCER TACT Marsh USA Inc. APR 2 E: 333 South 7th Street, Suite 1600 R FAX Minneapolis, MN 55402-2400 F_1i1e1 - A/C No MONROE 43840-MEDTR-GAWP-10/11 INSURED Medtronic, Inc. and all its subsidiaries 710 Medtronic Parkway M.S.LC310 Minneapolis, MN 55432 - w—c I NAIC # INSURER A: ACE American Insurance Company 22667 c: D: ;.OVERAGES CERTIFICATE NUMBER: CHI-003457047-05 REVISION NUMBER: 3 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. ISR ADDL UBR TR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP MM/D02= MM/DD/YYYY LIMITS A GENERAL LIABILITY SPLG 24561288001 05101/2010 05/01/2012 EACH OCCURRENCE $ 15,000,000 Y DAMA E T RENTED MERCIAL GENERAL LIABILITY 1,000,000 PREMISES Ea occurrence $ CLAIMS -MADE OCCUR MED EXP (Any one person) 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE PRODUCTS - COMP/OPAGG GEN'L AGGREGATE LIMIT APPLIES PER $ 15,000,000 15M0.000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ISA H08634671 - 05/01/2011 ( / {I I 05/01/2012 I$ X COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ OCCUR CLAIMS -MADE J '� "(/YGJ EACH OCCURRENCE $ - ECOMPENSATION AGGREGATE $ --- $ — A A A A WOR AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WLR U46478307 (AOS) WLR C46478277 (MO�, NC, NE 8, OK) SCF C46478289 (NJ) SCF C46478290 WI ( ) 05/01/2011 05/01/2011 05/01/2011 05/01/2011 05/01/2012 05/01/2012 05/01/2012 05/01/2012 $ X tn/C STATU- OTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE -POLICY LIMIT $ 1,000,0001 2:06,OZO'�'.6.00-0060 A I Professional HealthIOCVVl 11`" SPLG 24561288001 05/01/2010 05/Ot/2012 Each Claim 2 ( DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Waiver of Subrogation and/or Additional Insured status applies only if it is reflected in your written contract. For hospital credentialing purposes, Medtronic employees are covered under Professional Health Care Liability noted above. Medtronic includes but is not limited to the following entities: Physio-Control, Inc., Medtronic Sofamor Danek, In Medtronic Spine, LLC (including Osteotech, Inc.), Minimed Distribution Corporation and Medtronic ATS Medical, Inc. CC-- ` -\ 0.h CJ? _ 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: MONIQUE DIAZ 1100 SIMONTON STREET KEY WEST, FL 33040 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Katey E. Jones V1_ ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD ADDITIONAL INFORMATION PRODUCER - Marsh USA Inc. 333 South 7th Street, Suite 1600 Minneapolis, MN 55402-2400 43840-MEDTR-GAWP-10/11 INSURED Medtronic, Inc. and all its subsidiaries 710 Medtronic Parkway M.S. LC310 Minneapolis, MN 55432 CHI-003457047-05 I DATE(MM/DDJYY) I 03/28/2011 INSURERS AFFORDING COVERAGE I NAIC # INSURER G: INSURER H: INSURER I: INSURER J: TEXT Other - - - Policy Covers Care Liability Limits Aggregate : 15,000,000 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS IS INCLUDED AS ADDITIONAL INSURED UNDER GENERAL LIABILITY AS REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER MONROE COUNTY BOARD OF COUNTY COMMISSIONERS ATTN: MONIQUE DIAZ 1100 SIMONTON STREET KEY WEST, FL 33040 of Marsh USA Inc. Katey E. Jones V,4.— Isa, � CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) o312a/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 T IMPORTANT: If the certificate hold�]7 .y(ies) mu t be endorsed. If SUBROGATION ISWAIVED, subject to the terms and conditions of the polirequire an endorsement. statement on this certificate does not confer rights to the certificate holder in lieu of such endPRODUCER TACT Marsh USA Inc. PR NE 333 South 7th Street, Suite 1600 FAX Minneapolis, MN 55402-2400 E-MAILNQ' Exth_— 'C. 0 Not- MONROE 43840-MEDTR-GAWP-10/11 INSURED Medtronic, Inc. and all its subsidiaries 710 Medtronic Parkway M.S.LC310 Minneapolis, MN 55432 A: ACE American Insurance Company C: COV FRAG FA 1r`cor101^ w rr 22667 _--------- --- .__- --•-• -VV. 1-1-vv KGVIJIUNNUMOLK:3 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 ADDL SUBR LTR TYPE OF INSURANCE POLICY NUMBER FOLIC YYYY MM/DDY/YYYY LIMITS A GENERAL LIABILITY SPLG 24561288001 05/01/2010 05/01/2012 EACH OCCURRENCE $ 15,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 1 X PREMISES Ea occurrence $ CLAIMS -MADE OCCUR MED EXP (Any one person) $ 10,000 -- PERSONAL & ADV INJURY $ 1,000,000 - --- -- - GENT AGGREGATE LIMIT APPLIES PER JFrT X POLICY PRO LOC GENERAL AGGREGATE $ PRODUCTS -COMP/OP AGG $ 15,000,000 15,000,000 A AUTOMOBILE LIABILITY ANY AUTO ISA H08634671___--'� 05/01/2011 05/01/2012 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS - BODILY INJURY (Per accident) $ SCHEDULED AUTOS a*� HIRED AUTOS" PROPERTY DAMAGE (Per accident) $ NON -OWNED AUTOS $ iA UMBRELLA LIAB EXCESS LIAB% OCCUR CLAIMS-MADEmx� 7 EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ -- ---- A A A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WLR C46478307 (AOS) WLR C46478277 (MO, NC, NE & OK) SCF C46478289 (NJ) SCF C46478290 (WI) 05J01/2011 05/01/2011 05/01/2011 0510112011 05/01/2012 05/01/2012 05/01/2012 05/0112012 X WC LIMIT orH- $ E.L. EACH ACCIDENT $ 1.000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Professional Health SPLG 24661288001 05/01/2010 05/01/20 12 Each Claim 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Waiver of Subrogation and/or Additional Insured status applies only if it is reflected in your written contract. For hospital credentialing purposes, Medtronic employees are covered under Professional Health Care Liability noted above. Medtronic includes but is not limited to the following entities: Physio-Control, Inc., Medtronic Sofamor Danek, In Medtronic Spine, LLC (including Osteotech, Inc.), Minimed Distribution Corporation and Medtronic ATS Medical, Inc. TE HOLDER CANCELLATION 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: MONIQUE DIAZ 1100 SIMONTON STREET KEY WEST, FL 33040 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Katey E. Jones��_ ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD ADDITIONAL INFORMATION CHI-003457047-05 DATE(MM/DD/YY) PRODUCER __ _ __ 03/28/2011 Marsh USA Inc. 333 South 7th Street, Suite 1600 Minneapolis, MN 55402-2400 43840-MEDTR-GAWP-10/11 INSURED Medtronic, Inc. and all its subsidiaries 710 Medtronic Parkway M.S.LC310 Minneapolis, MN 55432 INSURERS AFFORDING COVERAGE INSURER G: INSURER H: INSURER I: INSURERJ: TEXT Other _ Policy Covers Care Liability Limits Aggregate : 15,000,000 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS IS INCLUDED AS ADDITIONAL INSURED UNDER GENERAL LIABILITY AS REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER MONROE COUNTY BOARD OF COUNTY COMMISSIONERS ATTN: MONIQUE DIAZ 1100 SIMONTON STREET KEY WEST, FL 33040 AU IMORIZED REPRESENTATIVE of Marsh USA Inc. Katey E. Jones NAIC #