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Item C05 C5 BOARD OF COUNTY COMMISSIONERS COUNTY of MONROE Mayor Craig Cates,District 1 The Florida Keys Mayor Pro Tern Holly Merrill Raschein,District 5 Michelle Lincoln,District 2 James K.Scholl,District 3 m' David Rice,District 4 Board of County Commissioners Meeting September 20, 2023 Agenda Item Number: C5 2023-1381 BULK ITEM: Yes DEPARTMENT: Fire Rescue TIME APPROXIMATE: STAFF CONTACT: James K. Callahan NA AGENDA ITEM WORDING: Renewal of Class B Certificate of Public Convenience and Necessity (COPCN) to National Health Transport Inc., for the operation of a non-emergency medical transportation service in all geographical locations in Monroe County for the period October 19, 2023, through October 18, 2025. National Health Transport Inc., is not permitted to perform 911 emergency response work in Monroe County. ITEM BACKGROUND: In October of 2015, a Class B COPCN was issued to National Health Transportation to operate a non- emergency medical transportation service in all geographical locations of Monroe County, Florida. National Health Transportation's current Class B COPCN will expire on October 18, 2023. In view of the foregoing,National Health Transport Inc. is applying for renewal of its Class B COPCN to commence on October 19, 2023 and expire on October 18, 2025. PREVIOUS RELEVANT BOCC ACTION: 10/21/15: MCBOCC approved the issuance of National Health's Class B COPCN certificate for the period October 19, 2015 through October 18, 2017. 10/18/17: MCBOCC approved renewal of National Health's Class B COPCN certificate for the period October 19, 2017 through October 18, 2019. 10/16/19: MCBOCC approved renewal of National Health's Class B COPCN certificate for the period October 19, 2019 through October 18, 2021. 328 09/15/21: MCBOCC approved the issuance of National Health's Class B COPCN certificate for the period October 19, 2021 through October 18, 2023. CONTRACT/AGREEMENT CHANGES: NA STAFF RECOMMENDATION: Approval. DOCUMENTATION: National Health Transport Inc. - Class B Certification 10.19.2023 through 10.18.2025.pdf National Health Transport Class B COPCN Application 2023—Redacted.pdf 2023 08 COI National Health signed exp 6 1 2024.pdf FINANCIAL IMPACT: Effective Date: 10/19/23 Expiration Date: 10/18/25 Total Dollar Value of Contract: N/A Total Cost to County: N/A Current Year Portion: N/A Budgeted: N/A Source of Funds: N/A CPI: N/A Indirect Costs: N/A Estimated Ongoing Costs Not Included in above dollar amounts: N/A Revenue Producing: N/A If yes, amount: N/A Grant: N/A County Match: N/A Insurance Required: N/A 329 0 M M t ( o t = z / •2 ° ƒ / w « Co / ƒ \ \ / 0u Co � QL) Co IL) @ 2 / � \ ) \ \ @ zt Q / 0 2 \ .o e / \ } 2 0 2 °« Z\ � o o m u / Co Q � ƒ o o » z % � 2 w/ / / \ � °ƒ � { 7 ® ( \ z / @ \ / o •� ƒ / § Q Iz O ƒ 2 w / ƒ \ \ o Q � » � W C0 / \ / Co \ •\ 2 04 ( / \ \ ( \ /� U 7 \ o § 6 o U § ° Co / U \ \ � \ k o « w 2 / % \ / \ � \ $ \ = G » k 2 / C0 0 E � � f � \ o t 2 \ / } 0 6 ƒ m \ 2 % \ 2 } % _ \ / 2 k Co / ° m t / ° / Cd / \ ° / / �/ ( [ / % % / % § \ / ) \ ) \ 6 0 \ 2 \ % U a / = k U MONROE COUNTY,FLORIDA APPLICATION FOR CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY (COPCN) CLASS B NON-EMERGENCY MEDICAL TRANSPORTATION SERVICE mu uwuuwwwuwwimvuwwwwwwwwwwwwwuwwwwwwwwiwuwuuuuwwwuwuwwiuuwwwwuwu (PRINT OR TYPE) ❑ INITIAL APPLICATION-$950.00 I,0 141N1�W AL APPLICATION-$475.00 �r•� IF RENEWAL,PLEASE LIST NUMBER OF PREVIOUS CERTIFICATE:# I. NAME OF SERVICE NATIONAL HEALTH TRANSPORT INC. BUSINESS MAILING ADDRESS....2290 NW.....1.1..0TH...AVE.N..U.E. S ..........................�_. � FI EETWAT FL ER, 33172 305-636-5509 ................................305-479-347.1 BUSINESS PHONE NUMBER EMERGENCY PHONE NUMBER 2. TYPE OF OWNERSHIP(i.e.,Sole Proprietor,Partnership,Corporation,etc.) S-CORP DATE OF INCORPORATION OR FORMATION OF THE BUSINESS ASSOCIATION 01/15/2010 3. LIST ALL OFFICERS,DIRECTORS,AND SHAREHOLDERS(Use separate sheet if necessary): �..._w NAME AGE ADDRESS TELEPHONE# POSITION/TITLE RAUL RODRIGUEZ 44 215 SW 125TH AVENUE,MIAMI,FL 33184 305-479-3471 CEO 4. DESCRIBE THE GEOGRAPHIC AREA(S)THAT YOUR SERVICE DESIRES TO SERVE(Use separate sheet if necessary): ALL GEOGRAPHICAL AREAS WITHIN MONROE COUNTY 5. LIST THE ADDRESS AND/OR DESCRIBE THE LOCATION OF YOUR BASE STATION AND ALL SUB- STATIONS(Use separate sheet if necessary): BASE STATION 19970 OVERSEAS HIGHWAY, SUGARLOAF KEY, FL 33040 SUB-STATION Page 1 of 3 331 6. DESCRIBE YOUR COMMUNICATION SYSTEM(Attach copy of all FCC licenses): _. ..n .. ... __.. .. FREJUENCIES CALL NUMBERS #OF MOBILES #OF PORTABLES SEE ATTACHED W� 7. LIST THE NAMES AND ADDRESSES OF THREE(3)U.S.CITIZENS WHO WILL ACT AS REFERENCES FOR YOUR SERVICE: NAME ADDRESS TERESITA FERNANDEZ 481 W 40TH PLACE, HIALEAH FL 33012 ALEXIS MANTECON 3267 RIVIERA DR, CORAL GABLES, FL 33143 DANIEL ESPIN i S. ATTACH A SCHEDULE OF RATES WHICH YOUR SERVICE WILL CHARGE DURING THE COPCN PERIOD. 9. PROVIDE VERIFICATION OF ADEQUATE INSURANCE COVERAGE DURING THE COPCN PERIOD. 10. ATTACH A STATEMENT INDICATING THE METHOD OF SCREENING THAT WILL BE USED TO ASSURE THAT ALL CALLS RESPONDED TO REQUIRE ONLY TRANSPORTATION AS MAY BE PROVIDED BY A NON-EMERGENCY MEDICAL TRANSPORTATION SERVICE AND VEHICLE. 11. ATTACH A CHECK OR MONEY ORDER IN THE APPROPRIATE AMOUNT,MADE PAYABLE TO THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS. 12. ATTACH A COPY OF AUDIT REPORT AS REQUIRED BY THE MONROE COUNTY NON-EMERGENCY MEDICAL SERVICES ORDINANCES. I,THE UNDERSIGNED REPRESENTATIVE OF THE ABOVE NAMED SERVICE,DO HEREBY ATTEST MY SERVICE MEETS ALL OF THE REQUIREMENTS FOR OPERATION OF A NON-EMERGENCY MEDICAL TRANSPORTATION SERVICE IN MONROE COUNTY AND THE STATE OF FLORIDA. I FURTHER ATTEST THAT ALL THE INFORMATION CONTAINED IN THIS APPLICATION,TO THE BEST OF MY KNOWLEDGE,IS TRUE AND CORRECT. ( *1"RESENTATIVE SIGNATURE OF APPLICAN %AUTHO1�1Zd�D 1,. � NOTARY SEAL""'P4tF: ALISSA D. ' Cbq MY COMMISSION#HH 151116 z+,Fo�P EXPIRES:July 10,2p25 Pijhfl OTBonded ru _SJ('NATURE';1 DATE Page 2 of 3 332 NArIONAL HEALM rRANSPORr Schedule of Rates for Monroe County Ambulatory patients will be$30.00 flat rate(within15 mile radius)each additional mile$2.00 Wheelchair bound patients will be$75.00 flat rate(within 15 mile radius)each additional mile$3.00 Non-Medical Stretcher patients will be$150.00 flat rate(within 15 mile radius)each additional at$4.00 19970 Overseas Highway,Sugarloaf Key FL 33040 1 OFFICE:305-636-5555 1 FAX:305-636-5503 WWW.NATIONALHEALTHTRANSPORT.COM 333 ,a►coR CERTIFICATE OF LIABILITY INSURANCE DA/30120/DD/YYYY) 05/30/2023 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 NAME: MARSH USA,LLC. 1221 Brickell Avenue,Suite 1550 WCNNv.9M (AAiCC„No): Miami,FL 33131 E-MAIL - ADDRESS: INSURERS)AFFORDING COVERAGE NAIC# CN 11 0033400-WAGP-23-24 INSURER A:Old Republic Insurance Co 24147 INSURED National Health Transport,Inc. INSURER s:Coven's Specialty,Insurance Company 15686 2290 NW 110TH Ave INSURER C: Sweetwater,FL 33172-1923 INSURER D INSURER E: ......... INSURER F: ......... ..... COVERAGES CERTIFICATE NUMBER: ATL-005439277-06 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 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 .ADDLISUBR .--- POLICY EFF I POLICY EXP j ......... ...... LTR TYPE OF INSURANCE GN'."3r� rrr POLICY NUMBER flMM/DD/YYYY MMIDD/YYYY LIMITS B _------___ _ _-- X..�COMMERCIAL GENERAL LIABILITY 005FLDO0036286 06123l2022 :0612312023 EACH OCCURRENCE $ 1,000,000'.. DAMAGL'TO RENTED .., CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ 50,000 _._ MED EXP(Any one person) $ 5006 .. ...... PERSONAL&ADV INJURY $ ... 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY❑JECT LOC j PRODUCTS-COMPlOPAGG $ 3,000,000 ,-T..,—,,OTHER: ...-....„... ._ .. _. $ A AUTOMOBILE LIABILITY _.... -...... w I MWTB 313612 23 O6l0112023 101 �IT $ 1 - ��.._......_.. COMBINED SINGLELITWWWWWW� � .....�. 06101/2024 (Ea accident _ 000,000 X^ANY AUTO ""Auto Physical Damage" BODILY INJURY Per person) $ '. OWNED SCHEDULED "'Comprehensive Ded:$1,000" AUTOS ONLY „AUTOS p BODILY INJURY(Per accident) $ X HIRED X NON-OWNED '.. "Collision Ded:$1,000', PROPERTY DAMAGE '$ AUTOS ONLY _ AUTOS ONLY i IPer accidenty I $ .__. _ __ .. „� �.......... ................'....._.................,-..wm,i ......................._..._...... ,.�........ UMBRELLA LIAB OCCUR EACH OCCURRENCE _ $ i EXCESS LIAB ) CLAIMS-MADE, A, d GGREGATE $ _ 'DED RETENTION$ _ , $ A WORKERS COMPENSATION MWC31361123� -� ��- .,'.'�)f1i�� ' 06/0112024 X PER OTH AND EMPLOYERS'LIABILITY STATUTE ER ANYPROPRIETORIPARTNER/EXECUTIVE YIN N I E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBEREXCLUE � NIA -- -- - - - ;(MandatorylnNH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Professional Liability 005FL000036286 06/2312022 06/23/2023 Limit Per Claim 1,000,000 Aggregate 3,000,000' DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD 101,Additional Remarks Schedule,may be attached if more space is re �Y��.��ed) CERTIFICATE HOLDER CANCELLATION Monroe County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Key West,FL 33040 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 334 rRANsPoRr #10 National Health Transport dispatch center has comprehensive protocols that carefully screen all requests for service for non emergency ambulance transportation. All acute conditions and requests for service from the general public are referred to the local 911 provider. National Health Transport provides transportation services to healthcare facilities and insurance companies and is not generally available to private callers. 19970 Overseas Highway, Sugarloaf Key FL 33040 1 OFFICE: 305-636-5555 1 FAX: 305-636-5503 WWW.NATIONALH EALTHTRANSPORT.COM 335 NATI'OIVAL TRANSPORT #12. There were no non-medical transports during the previous licensed period. 19970 Overseas Highway,Sugarloaf Key FL 33040 I OFFICE: 305-636-5555 I FAX:305-636-5503 WWW.NATIONALHEALTHTRANSPORT.COM 336 0'=Qk""�4 pOMM(/ �„ Federal Communications Commission 90 + Public Safety and Homeland Security Bureau „_ • . RADIO STATION AUTHORIZATION Is LICENSEE:NATIONAL HEALTH TRANSPORT INC Call Sign File Number WQYV762 0007636306 Radio Service ATTN:RAUL RODRIGUEZ PW-Public Safety Pool,Conventional NATIONAL HEALTH TRANSPORT INCH 2950 NW 7TH AVE MIAMI,FL 33127 Regulatory Status PMRS Frequency Coordination Number FCC Registration Number(FRN): 0026157818 PS20170200029 Grant Date Effective Date Expiration Date Print Date 02-06-2017 02-0\6-2017 02-06-2027 02-07-2017 STATION TECHNICAL SPECIFICATIONS Fixed Location Address or Mobile Area of Operation, Loc.1 Area of operation Countywide:MONROE,FL Antennas Loc Ant Frequencies Sta. No. No. Emission "Output ERP Ant. Ant. Construct No. No. (MHz) Cis. Units Pagers Designator Power (watts) Ht./Tp AAT Deadline (watts) meters meters Date 1 1 000463.11250000 MO 20 11K2F3E 100.600 100.000 02-06-2018 1 1 000468.11250000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000463.13750000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000468.13750000 MO 20 11K2F3E 100,000 100.000 02-06-2018 1 1 000463.16250000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000468.16250000 MO 20 11K2F3E 100.000. 100.006 02-06-2018 Conditions: Pursuant to§309(h)of the Communications Act of 1934,as amended,47 U.S.C. §309(h),this license is subject to the following conditions: This license shall not vest in the licensee any right to operate the station nor any right in the use of the frequencies designated in the license beyond the term thereof nor in any other manner than authorized herein. Neither the license not the right granted thereunder shall be assigned or otherwise transferred in violation of the Communications Act of 1934,as amended. See 47 U.S.C.§310(d). This license is subject in terms to the right of use or control conferred by§706 of the Communications Act of 1934,as amended. See 47 U.S.C. §606. FCC 601-ULSHSI Page 1 of 4 August zoo? 337 Licensee Name: NATIONAL HEALTH TRANSPORT INC Call Sign:WQYV762 File Number: 0007636306 Print Date: 02-07-2017 Antennas Loc Ant Frequencies Sta. No. No. Emission Output ERP Ant. Ant. Construct No. No. (MHz) Cls. Units Pagers Designator Power (watts) Ht./Tp AAT Deadline (watts) meters meters Date 1 1 000462.95000000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000467.95000000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000462.96250000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000467.96250000 N40 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000462.97500000 Mo 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000463.02500000 MQ' 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000468.02500000 MO, 2o 11K2F3E 100.000 100.000 02-06-2018 1 1 000463.05000000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000463.00000000 MO 2b 11K2F3E 100.000 100.000 02-06-2018 1 1 000468.00000000 MO 20 11MIME 100.000 100.000 02-06-2018 1 1 000468.17500000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000463.18750000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000468.18750000 MO 20 11K2M 100.000 100.000 02-06-2418 1 1 000463.01250000 MO 20 11K2F3E 100.0,00 100.000 02-06-2018 1 1 000468.01250000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000463.03750000 MO 20 11K2F3E 100.000' 100.000 02-06-2018 1 1 000468.03750000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000463.06250000 MO 20 11K2F3E V00.000 1,00A00 02-06-2018 1 1 000468.06250000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000463.08750000 MO 20 11K2F3E 100.000 100.000 02-06-2018 FCC 601-ULSHSl Page 2 of 4 August 2007 338 Licensee Name: NATIONAL HEALTH TRANSPORT INC Call Sign:WQYV762 File Number: 0007636306 Print Date: 02-07-2017 Antennas Loc Ant Frequencies Sta. No. No. Emission Output EPP Ant. Ant. Construct No. No. (MHz) Cls. Units Pagers Designator Power (watts) Ht./Tp AAT Deadline (watts) meters meters Date 1 1 000468.08750000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000462.98750000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000467.987500W MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000467.97500000 KO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000468.05000000 MO '20 11K2F3E 100.000 100.000 02-06-2018 1 1 000463.07500000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000468.07500000 MO 211 11 ME 100.000 100.000 02-06-2018 1 1 000463.10000000 P,10 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000468.10000000 MO 20y 11K2F3E 100.000 100.000 02-06-2018 1 1 000463.12500000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000468.12500000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000463.15000000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000468.15000000 MO 20 11K2F3E 100.000 100.000 02-06-2018 1 1 000463.17500000 MO 20 11K2F3E 100.000 100.000 02-06-2018 Control Points Control Pt.No.1 Address:2950 NW 7th Ave City:Miami County: MIAMI-DADE State:FL Telephone Number:(305)636-5510 Associated Call Signs <NA> FCC 601-ULSHSI Page 3 of 4 August zoo? 339 Licensee Name: NATIONAL HEALTH TRANSPORT INC Call Sign:WQYV762 File Number: 0007636306 Print Date: 02-07-2017 Waivers/Conditions: NONE FCC 601-ULSHSI Page 4 of 4 August 2007 340 ......................_____ ........ ...... -- ------- ___ - M w 0 CO W a v CD cn Z C7 pwq U) a a � Z } Z m. 0 N a Z U v U � N �_ _..._. ... . .... ........_............ x w � aH i U .a Cc p7 W U x vO 3 x � .........-.......... CN w W CV 4° � W O w > CV �u. C w co pro A > v O CU14 V 0 a 14 V a w �a L U - W � > U W N O CU W � F � — -- .. . W. .m �... .. m. . . . �� H 4. o A � w CrA O w a41 a n .....Zro n Q � F O a U Q+ a � x � w A A a � x w a _.. Q Z F-+ O-D w t 1 A a J-- -- _. ,,.1j. ,.r.. J 1 ... ...... .._ _.....m. o N o V �o --� r w ee C.l E� V 41 a rJ p A N aw A U ....... 342 �� BOARD OF COUNTY COMMISSIONERS County of Monroe ' 'IP t Mayor Craig Cates,District 1 The Florida Keys 1 Mayor Pro Tem Holly Merrill Raschein,District 5 f Michelle Lincoln,District 2 James K.Scholl,District 3 - ��.�'' David Rice,District 4 Monroe County Fire Rescue 490 63Td Street Ocean Marathon,FL 33050 Phone(305)289-6004 �" MEMORANDUM TO: Nicole Lyons FROM: Cara Johnson SUBJECT: Check for Deposit- COPCN DATE: June 14, 2023 ...................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... Attached please find Check_ and_ dated June 12, 2023 in the amount of$475.00 per check to be deposited in revenue account 141-342000-RC 00345.These checks have been issued for the renewal application of a Class A and Class B Certificate of Public Convenience for National Health Transport Inc. Thank you, Ca4r, ;'6� Cara Johnson 343 • 81-275/829 I�. NATIONALHEALTHR TRANSPORT INC. DAB FLORIDA 3312 7 PAYTOTBn ORDER OF& N i�Wi W . rtN e �rc -.Ih. _:_. , p� me.Mr.mm p .{ a s 0 " y •E ww ,m 1006enkcom Np MEMO.. 0 +r a a. . .,.;,.,<," ,,,.s ..��d 4xy..f -w„�„,� �i,1� '�"�.�'n�G_.�"w1Y',;� ,fE'l t I� i e t d �e e e d 344 (MMID A�® CERTIFICATE OF LIABILITY INSURANCE D06/21/2023DIYYYY) 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 CONTACT MARSH USA,LLC. NAME: PHONE FAX 1221 Brickell Avenue,Suite 1550 A/C,No Ext: AIC,No): Miami,FL 33131 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# CN110033400--WAGP-23-24 INSURER A:Old Republic Insurance Cc 24147 INSURED National Health Transport,Inc. INSURER B:Covery'S Specialty Insurance Company 15686 2290 NW 110TH Ave INSURER C Sweetwater,FL 33172-1923 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-005439277-07 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 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR IN SD WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY B X COMMERCIAL GENERAL LIABILITY 005FL000036286 06/23/2023 06/23/2024 EACH OCCURRENCE $ 1,000,000 DAMAGE T CLAIMS-MADE 1XI OCCUR PREM SESOEa occurrDence $ 50,000 APPROVED BY RISK MANAGEMENT MED EXP(Any one person) $ 5000 BY :' PERSONAL&ADV INJURY $ 1,000,000 . .I1�y -..�.. GEN'L AGGREGATE LIMIT APPLIES PER: DATE 8/28/202.3 GENERAL AGGREGATE $ 3,000,000 X POLICY❑ PRO JECT ❑ LOC WAIVER N/A_YES_ PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER 1 1 $ A AUTOMOBILE LIABILITY MWT13 313612 23 06/01/2023 06/01/2024 COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO "Auto Physical Damage" BODILY INJURY(Per person) $ OWNED SCHEDULED "Comprehensive Ded:$1,0001, BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED L NON-OWNED "Collision Ded:$1,0001, PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION MWC 313611 23 06/01/2023 06/01/2024 X PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N❑ NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Professional Liability 005FL000036286 06/23/2023 06/23/2024 Limit Per Claim 1,000,000 Aggregate 3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Monroe County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Key West,FL 33040 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 345