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Certificates of Insurance ACORDTM CERTIFICA TF OF LIABILITYINSURAtJCE PRODUCER SCPIE INSURANCE SERVICES, INC. 2255 GLADES ROAD, SUITE 324A BOCA RATON, FLORIDA 33431 INSURED LOWER FLORIDA KEYS HEALTH SYSTEM, INC, 5900 JUNIOR COLLEGE ROAD KEY WEST, FLORIDA 33040 tI ,. d..? ,] DATE (MMlDD/YY) 8f24/98 THIS CERTIFICATE I~ ...SUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR A TER THE C VERA AFFOR D THE W. COMPANIES AFFORDING COVERAGE COMPANY A ROYAL INSURANCE COMPANY OF AMERICA COMPANY B RELIANCE INSURANCE COMPANY OF ILLINOIS COMPANY C COMPANY D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED B Y 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. co i POLICY EffECTIVE POLICY EXPIRATION LTIt TYPE OF INSURANCE POLICY NUMBER DATE (MMlDDIYY) DATE (MMIDDIYY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL liABILITY PRODUCTS - COMPIOP AGG $ I CLAIMS MADE 0 OCCUR I PERSONAL & ADV INJURY I $ OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE .$ L-..J FIRE DAMAGE (Anyone fire) I $ MED EXP (Anyone person) $ AUTOMOBILE LIABILITY PST 314828 10/01/97 10/01/98 I COMBINED SINGLE LIMIT $ 500,000 A X ANY AUTO ALL OWNED AUTOS BODilY INJURY $ SCHEDULED AUTOS (per person) X HIRED AUTOS BODilY INJURY $ X I NON-OWNED AUTOS (Per accident) i PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONl Yi EACH ACCIDENT i $ AGGREGATE $ EXCESS LIABILITY i NPB141205913190 10/01/97 10/01/98 i EACH OCCURRENCE $ 1 500 000 Bi UMBRELLA FORM AGGREGATE $ X OTHER THAN UMBRELLA FORM $ O~ WOIlKEIl'S COMPEItSATION AIIID ER I!MI"LOYEIlS' LIABILITY El EACH ACCIDENT i$ lHE PROPRIETOR! r--1 HINCl El DISEASE - POLICY LIMIT $ PARlNERSlEXECI.JTIVE OFFICERS ARE: ! EXCl i El DISEASE - EA EMPLOYEE $ OTHER MONROE COUNTY AND MONROE COUNTY SCHOOL BOARD IS AN ADDITIONAL INSURED WITH COVERAGE LIMITED TO THEIR LEGAL LIABILITY ARISING OUT OF THE ACTS OR OMMISSIONS OF THE NAMED INSURED, AS RESPECTS TO HURRICANE EVACUATION TRANSPORTATION AGREEMENT - HOSPITAL MONROE COUNTY AND MONROE COUNTY SCHOOL BOARD MONROE COUNTY SOCIAL SERVICES PUBLIC SERVICE BLDG., WING" 5100 COLLEGE ROAD KEY WEST, FLORIDA 33040 SHOULD AIIIY OP THE A80VE ~IlI8ED POLICIES BE CANCELLED aEfOllE THE EXPIltATION DATE THEREOf', THE I88UINO COMPAIIIY WILL ENDEAVOIt TO MAIL ~ DAYS WIlmEN NOTICE TO THE CERT'I'ICATE HOLDEIl NAMED TO THE LEPT, BUT I'AILUIlE TO MAIL SUCH NOTICE SHALL IIIIJOO8E NO OBLIGATION Oil LIABILITY 01' AIIIY KIND UPON THE COMPAIIIY ITS AGEIIITS Oil IlEPIlESENTATlVES. AUTHORIZ~PRE~" ,., ro /:tJ. // 7 ~~ C'- ~l/~ .A aORDTM ~ER"'f'IF=le.l"1L . '.........-------.--...""""........,..,...-.... ".- , "C).t=.......I..IA.81..I..I'"I"~.......I.ra.S.I.J..J.1f~....,...~...~.IE.......f~IE~.l... DA;~ 7;~;~~ ..'. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE PRODUCER Head Beckham Insurance Agency 3050 Biscayne Blvd. Ste 412 Miami FL 33137 William E. Beckham PhonoNo, 305-571-8000 Fax No, 305-573-5074 INSURED COMPANY A Reliance Insurance Co LOWER FLORIDA KEYS PHYSICIANS HOSPITAL ORGANIZATION INC. 5900 COLLEGE ROAD KEY WEST FL 33040 j COMPANY B Royal Ins Co/SCPIE Ins Serv COMPANY C Pinnacle Assurance Corporation COMPANY D ---- ','" . ' "., " THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MM/DD/YY) DATE (MM/DDIYY) LIMITS GENERAl LIABILITY - A X COMMERCIAL GENERAL LIABILITY NPB14l2l44/ 4260 X I CLAIMS MADE D OCCUR OWNER'S & CONTRACTOR'S PROT 10/01/97 GENERAL AGGREGATE $ 5, 000, 000 . 10/01/98 PRODUCTS - COM PlOP AGG $ 5,000,000. PERSONAL & ADV INJURY $ 5,000,000. EACH OCCURRENCE $ 5 , 000, 000 . FIRE DAMAGE (Anyone fire) $ 5 , 000 , 000 . MED EXP (Anyone person) $ 10 , 000 . - A ...!. PROFESSIONAL LIABILITY AUTOMOBilE LIABILITY - B ...!. ANY AUTO ALL OWNED AUTOS >--- SCHEDULED AUTOS f-- B ~ HIRED AUTOS B ~ NON-OWNED AUTOS >--- GARAGE liABILITY >--- ANY AUTO >--- P ST 31428 10/01/97 10/01/98 COMBINED SINGLE LIMIT $500,000. BODilY INJURY $ (Per person) BODilY INJURY $ (Per accident) PROPERTY DAMAGE $ AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: 1< << / EACH ACCIDENT $ AGGREGATE $ EACH OCCURRENCE $ AGGREGATE $ EXCESS liABILITY RUMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 'mD :cJ;OJh:~ ,; 'e ,.,y -...... -,' CAil ~l (Q H'i ill,>' ~_Vf'<; r' ota'. (Vo.llh - ; rJ 0 .n {C ...f ~ " IA OLJ. 1\ _ c;;.~ fJ,I, -- (J II 7/J ~..-I-.... V I'UliVER: C THE PROPRIETORI PARTNERS/EXECUTIVE OFFICERS ARE: OTHER nlNCl IX1 EXCL 407692301 06/30/98 06/30/99 $ X I ~OCR~Tl1~~TS I IOJ~- '..,.,...>< El EACH ACCIDENT $ 100, 000 . EL DISEASE - POLICY LIMIT $ 500, 000 . EL DISEASE - EA EMPLOYEE $ 100, 000 . DESCRIPTION OF OPERATIONS/LOCATIONSNEHIClES/SPECIAllTEMS -~ , ", ., ",.., MONRO-1 ~........./.........'..,..< SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO MAll 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. COUNTY OF MONROE RISK MANAGEMENT DEPT. ATT: MARIA DEL RIO 5100 COLLEGE ROAD KEY WEST, FL 33040 1110C' ' DA'Il! {11m rNm:t ~ , ' ~z BUT FAILURE TO MAlL SUCH NOTICE SHAlL IMPOSE NO OBLIGATION OR liABILITY KIND UPON THE COMPANY;ITSjAGENTS OR REPRESENTATIVES, \ ~R~~~p~~~l'IVE r:\yjtL/u:r'~' ~il1i~~-E~6;ckham < ACORDTM CERTIFICA TF OF LIABILITY INSURA~r:E DATE (MMIDDIYY) 12/02/98 THIS CERTIFICATE IS ,..SUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER TH COY RAG 0 E Y THE PO COMPANIES AFFORDING COVERAGE PRODUCER SCPIE COMPANIES 2255 GLADES ROAD, SUITE 221A BOCA RATON, FLORIDA 33431 COMPANY A ROYAL INSURANCE COMPANY OF AMERICA INSURED LOWER FLORIDA KEYS HEALTH SYSTEM, INC, 5900 JUNIOR COLLEGE ROAD KEY WEST, FLORIDA 33040 COMPANY B AMERICAN HEAL THCARE INDEMNTIY COMPANY i COMPANY C COMPANY D ~; THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, co POLICY EFFECTIVE POLICY EXPIRATION LTft TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDIYY) DATE (MMIDDIYY) LIMITS i GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $ i CLAIMS MADE n OCCUR PERSONAL & ADV INJURY $ OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ FIRE DAMAGE (Anyone fire) $ MED EXP (Anyone person) $ AUTOMOBILE LIABILITY PST 314828 10101/98 10101/99 I COMBINED SINGLE LIMIT $ A X ANY AUTO ! ALL OWNED AUTOS ! BODilY INJURY $ r--J SCHEDULED AUTOS (per person) . X, HIRED AUTOS I BODilY INJURY $ ~ NON-oWNED AUTOS uY (Per accident) PROPERTY DAMAGE $ pARAGE LIABILITY ..LYF~__._ ! AUTO ONLY - EA ACCIDENT $ iANYAUTO W.~IV[R: 1\1,; OTHER THAN AUTO ONLY: I EACH ACCIDENT $ f---j I AGGREGATE ! $ EXCESS LIABILITY TO BE ASSIGNED 10101/99 EACH OCCURRENCE $ B UMBRELLA FORM BINDER NO. 0014 AGGREGATE $ X OTHER THAN UMBRElLA FORM $ ee' O"IH- WOftKEJI:'S COMPENSATION AND ! ER EMPLOYEJl:S' LIABILITY &V' $ , 1HE PROPRIETORl RINCl El DISEASE - POLICY LIMIT $ I PAR1NERSlEXECUT1VE OFFICERS ARE: EXCl I El DISEASE - EA EMPLOYEE $ OTHER 1,000,000 1,000,000 MONROE COUNTY AND MONROE COUNTY SCHOOL BOARD IS AN ADDITIONAL INSURED WITH COVERAGE LIMITED TO THEIR LEGAL LIABILITY ARISING OUT OF THE ACTS OR OM MISSIONS OF THE NAMED INSURED, AS RESPECTS TO HURRICANE EVACUATION TRANSPORTATION AGREEMENT - HOSPITAL MONROE COUNTY AND MONROE COUNTY SCHOOL BOARD MONROE COUNTY SOCIAL SERVICES PUBLIC SERVICE BLDG" WING II 5100 COLLEGE ROAD KEY WEST, FLORIDA 33040 SHOULD ANY 01' THE ABOVE DESCftlBED POLICIES BE CANCELLED BEI'OftE THE EXPIItATION DATE THEftEOl', THE ISSUING COMPANY WILL ENDEAVOK TO MAIL ~ DAYS WftITTEN NOTICE TO THE CEftTlI'lCATE HOLDEft NAMED TO THE LEI'T, BUT I'AlLUftE TO MAIL SUCH NOTICE SHALL IlllPOSE NO OBLIGATION Oft LIABILITY 01' ANY KIND UPON THE COMPANY ITS AGENTS Oft ftEPftESENTATIVES. .. ~CORf)N CERTIFICATr 0F LIABILITY INSURp. -CEolci~~~2 DATE (MMlDOIYY) I 10/29/99 ; PRODUCER' THIS CERTIFICATE IS IS~_ .) AS A MATTER OF INFORMATION I ~ Ins'uranc~, ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR , ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, IWilliam COMPANIES AFFORDING COVERAGE E. Beckham COMPANY A st Paul Fire & Marine Ins Co Phone No. Fax No. INSURED COMPANY LOWER FL KEYS PHYSICIAN B HOSPITAL ORGANIZATAION, INC. D/B/A KEYS PHYSICIAN HOSPITAL COMPANY ALLIANCE C 5900 College Rd COMPANY Key West FL 33040 D COVERAGES 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, CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS lTR DATE (MMJDDIYY) DATE (MMJDDIYY) GENERAL LIABILITY GENERAL AGGREGATE $$2,000,000. - A X COMMERCIAL GENERAL LIABILITY DK06619905 05/01/99 05/01/00 PRODUCTS - COMPJOP AGG $$1,000,000. I CLAIMS MADE ~ OCCUR PERSONAL & ADV INJURY $$1,000,000. OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ $1,000,000. - $$1,000,000. A X EMPLOYEEE BENEFIT FIRE DAMAGE (Anyone fire) - MED EXP (Anyone person) $$ 5,000 AUTOMOBilE LIABilITY $ $1,000,000. f-..- COMBINED SINGLE LIMIT ANY AUTO - All OWNED AUTOS BODilY INJURY f- $ SCHEDULED AUTOS (Per person) - 05/01/00 A ~ HIRED AUTOS DK06619905 05/01/99 BODilY INJURY (Per accident) $ ~ NON-OWNED AUTOS PROPERTY DAMAGE $ .- ,- '.lliJV GARAGE LIABILITY ,/'\f:( . (l()t~: · AUTO ONLY - EA ACCIOEl-IT $ f-..- Ov? I"........,.",' ANY AUTO OlHER lHAN AUTO ONLY, I-- L' ' \/ I, OJ'1 jZ dia EACH ACCIDENT $ I-- J -;~ 7-(:2) c (~ rr7'r [C],LUJ-:YJ AGGREGATE $ EXCESS LIABilITY l P C:lc Ei:lcH OCCURRENCE $ ~P"\.TQ: ~;. ;-. ,_/_ YFS_ I...- R UMBREllA FORM :...-- AGGREGATE $ OTHER lHAN UMBRELLA FORM $ WORKERS COMPENSATION AND IWCSTATU-T 10TH. ..' , TORY LIMITS ER EMPLOYERS liABilITY El EACH ACCIDENT $ THE PROPRIETORl R INCl El DISEASE - POLICY LIMIT $ PARTNER~ECUTlVE OFFICERS ARE: EXCl El DISEASE - EA EMPLOYEE $ OTHER A CRIME COVERAGE DK06619905 05/01/99 05/01/00 EMPL DIS $10,000. A PROFESSIONAL LIAB DM06630472 05/01/99 05/01/00 PROF LIAB $5,000,000. DESCRIPTION OF OPERATIONSIlOCATIONSNEHIClESlSPECIAl ITEMS THE MONROE COUNTY BOARD OF COUNTY COMMISSIONER~ ITS EMPLOYEES AND OFFICIALS ARE INCLUDED ON THE ABOVE POLICIES AS ADDITION INSUREDS. CERTIFICATE HOLDER >CANCELLA TlON ."..<> .<< MONRO-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO MAil MONROE COUNTY BOARD OF COUNTY 2SL- DAYS WRITTEN NOTICE TO lHE CERTIFICATE HOLDER NAMED TO THE lEFT, COMMISSIONERS BUT FAilURE TO MAil SUCH NOTICE SHAll IMPOSE NO OBLIGATION OR LIABILITY ATT: STEPHEN KRATHEN, D.O. r;! jlNY KIND UPON THE COM.3Af1Y, ITS e,GENTS OR REPRESENTATIVES, 5100 COLLEGE RD. KEY WEST FL 33040 ~1?PRESENTZ~., in 11 1 O~ n[ /-4"1 ACORD 25-S (1/95) /---;;7 ", .c-., ,'ACORD CORPORATION 1988 7 " ((""A"""',....,'c'...,"""'o""""..ifjj"""""fWfi?S.:::::::::::;t:.:::il:I::::jji:i:M&::::::'I::::::::::~~iii~fiI~'I:::t*fl:::::::::~:.::::iiI:I::::_'::::::::::::::::r:::ttl\ii~:I:::::::\imji::I:::::::::::::*:::ilI:':li:iit~:tti~:tj:tttmmtt~:~f:t~fmt~m:~~~:~~~~fr""""~~;~..;;;~;~~;"" '" ~:~::::,:,:,:,:,:,:,:,:,:,:,:,:,:,:,:,:,:,:,:,:,:,:,:,:,:,:,:,:,:,:)~:,:,::::::::e:Ii::::jt:;::::":::::)!lt:::..:::"::::Ii:::!::~::::::::::::ElI::it::m::::::::::;::::::9:::::::::::::~:::\::::~:::IL::'"L,;::::;;M::::j::::n;!.:M:Il:I:t::::::::::::::::J::::::::::::::::I::I:::::I:::::::tt::::::::I 2 01 00 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE Aon Risk Services, Inc of GA One Piedmont Center, Bldg. 1 3565 Piedmont Road NB,~STB 700 Atlanta, GA 30305 404-264-3115 COMPANY A INSURED Health Management Inc. 5811 Pelican Bay Naples, FL 34108 Associates, COMPANY B Blvd #500 COMPANY C COMPANY D Em 10 era Insurance of Wausau ::9g_qg:~:j:::j:j:::j:j:::j:::::j:::::::I::::::::::::::::t:::::::::j:~:~:~:~:~:j:~:::::::j:::::::::::::::~:::::~:::::~:::~:~:~:~:~:~:~:~:~l:j:~:~:~:~:I~:~:::~:I~:~:::~:~:::~:~:j:j:~:::j:~:::::::::::::~:~:~:~:~:~:::~:~:j:~:~:~:~:~:j:~:~:~:::::::::::::t:It:::::::::::i:::::::::::::~:::::~I:::::::::~:::::n~:::::~:II~:t:~:~l:~:::::~:::::~:::~:~:::~:~:::~:~:::~:~:::~:~~~:~:::::::::~:I::::::::::~:::::~:~:~:~:~:~:~:~:::::::::~:~~~~~:::::::::::::::::I~:~:::~~~:::::~:~~~~~:::::::::::::j:::~:~:~:::~:::::: 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. EXCESS LIABilITY UMBRElLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABilITY POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE (MMIDDIYYI DATE CMMIDDIYYI GENERAL AGGREGATE PRODUCTS - COMP/OP AGG PERSONAL &. ADV INJURY EACH OCCURRENCE . FIRE DAMAGE (Anyone fire) . MED EXP (Anyone person) COMBINED SINGLE liMIT BODilY INJURY (Per person) BODilY INJURY (Per accident) PROPERTY DAMAGE AUTO ONLY - EA ACCIDENT . OTHER THAN AUTO ONLY: EACH ACCIDENT . AGGREGATE . EACH OCCURRENCE . AGGREGATE 10/01/99 10/01/00 1000000 El DISEASE - POLICY liMIT 1000000 El DISEASE - EA EMPLOYEE 1000000 CO TYPE OF INSURANCE POLICY NUMBER lTR GENERAL LIABILITY COMMERCIAL GENERAL LIABilITY CLAIMS MADE D OCCUR OWNER'S &. CONTRACTOR'S PROT AUTOMOBilE LIABilITY ANY AUTD All OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS ''), GARAGE lIABIlITY ANY AUTO D 48000151 THE PROPRIETOR/ INCl PARTNERS/EXECUTIVE OFFICERS ARE: EXCl OTHER DESCRIPTION OF OPERATIONS/LOCATlONSNEHICLESISPEClAllTEMS Lower Keys Medical Center is included as an insured location, 5900 College Rd. Key West, FL 33040. ::lm.tn'mAn#a.glttfff:{::::::~f:lff:{~ffff:{~f:::::::f:~ff:@:{~ffff:{{~:~:jfm@ff~j:jf:j:::::::n::::::::n@m@mjt11w.lgitAnlllntf:Ilff:n{~:~:~fffff:{n~:~:j:~~~:~:~:n~:~m~:~:::~:j:n~:n@ff:::::~::f:::~ffff:InIn::n@mn:::mj:::~:{~~n:fm~:~~~~~:~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Monroe County Board of County Commissions 5100 College Road Key West,FL 33040 INITIAL EXPIRATION DATE THEREOF. THE ISSUING COMPANY Will ENDEAVOR TO MAil ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABiliTY OR REPRESENTATIVES, PRo'DUCEii..'................, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE Aon Risk Services, Inc of GA One Piedmont Center, Bldg. 1 3565 Piedmont Road NE, STE 700 Atlanta, GA 30305 404-264-3115 CDMPANY A Reliance Insurance Company INSURED COMPANY B Health Management Associates Inc. 5811 Pelican Bay Blvd #500 Naples, FL 34108 COMPANY I D :@Q.Al.ii~:'~::"::~:':,~':~~~'~~~,~~!~:{:::::~~:!~:~!:~::~:::::::::::::::':':'::::t!'t!~::!:!:::!:!::::::::~:::~:':::':::':':"'~'~~!{{{:!~::~:!{{:!:!:'~:'!,!':{:~:t!:!:!:!:::::!::~::!:::::":::':~:,:,~:t!:!::!:!{:!::~:!:t!::{I{:::~~:~!~::!:!:!:!'!:!'t"~I~::t!II:!:!::~!:::::!'!'::!I~t!:!I:~::~::!:::!::::'tt!:!:!:::!:!:::!:!:::!:!'::':"~,!:!:~~!~~:~~!:!:!~!:!:!,!:':"'~:~~:!:!~~:!:!:!:!!:::!~~~t!~~~!I'!!~t!:!~"~:~~!~!~!:!:!~::~~~,".. 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. COMPANY C CO lTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MM/DDNYI DATE (MM/DDNYI LIMITS GENERAL LIABiliTY - GENERAL AGGREGATE COMMERCIAL GENERAL LIABILITY i< I CLAIMS MADE 0 OCCUR OWNER'S & CONTRACTOR'S PROT - PRODUCTS COMP/OP AGG $ PERSONAL & ADV INJURY $ EACH OCCURRENCE $ - FIRE DAMAGE (Anyone fire) $ MED EXP (Anyone person) $ AUTOMOBilE LIABILITY - A ...!.... ANY AUTD All OWNED AUTOS THE PROPRIETOR/ PARTNERS/EXECUTIVE OFFICERS ARE: OTHER RINCl EXCl 11/15/99 11/15/00 COMBINED SINGLE liMIT $ VQ8484854 1000000 BODilY INJURY $ (Per person) "'l ''07 1ft"\'. BODILY INJURY $ =-r DR' I, .," (Per accident) ,~~ -, ^- Vj 'f\iJS PROPERTY DAMAGE $ LrY r ;:-v"\ .ca' J -LJ-" - AUTO ONLY EA ACCIDENT $ D~TE l\!,"?~- YES DTHER THAN AUTO ONLY: >< W\lVER: EACH ACCIDENT $ j,\ ^ AGGREGATE $ ~: C1bA.JV EACH OCCURRENCE $ J. 00 AGGREGATE $ rf' VI" , $ .............. . -" - I T,,;!;~.;I~Ns I IOJ~-: .'.'.>> ...'.....:., SlY~ . EL EACH ACCIDENT $ El DISEASE POLICY LIMIT $ El DISEASE EA EMPlDYEE $ - SCHEDULED AUTOS - _ HIRED AUTOS - NON-OWNED AUTOS - GARAGE LIABILITY - r-- ANY AUTO r-- EXCESS LIABilITY RUMBRElLA FORM OTHER THAN UMBREllA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABilITY DESCRIPTION OF OPERATlONS/lOCATIONSNEHIClES/SPECIAlITEMS Monroe County is named Additional Insured as respects the Named Insured's use of County School buses for evacuation of patients if there is a mandatory evacuation due to a Hurricane. Location: Lower Keys Medical Center :qUlt{'@ltl!:'IIM>,g,j:t':!"::rmm::::r:!:!:!:!:!:i!':'ttmm::m:[t:m:mt::t::::::::'m:'::mm::::::':tttmmt!:!m::~::r':m!mt!:::!:!:!:!:tmmttqINlbtltl#Nlt:m:m::ltmm::t::::::'rm:r:!rr:':!::'::"::I!:!:tti:rt:::::::::::::':'::::::'!~::!'!'!:::::It!:I!r:::'!':''':I:!::r:::!: : .... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE County of Monroe EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO MAil Monroe County Risk Management ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT. Attn: Maria del Rio BUT);AILURE TO MAil SUCH N~TICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 5100 College Road OF/4NY KIND WON THE d'oMPANY, ITS "GENTS OR REPRESENTATIVES, Key West, FL 33040 AU"7fYZ:::'Ej1:fATr:J' ) t J I 106026000 1"",:6... l!i*"=~",,i;jlil:Js" ~':i~~"ii&'tt~:: ,,:,,:,: ::',:::,,:,:"::',::: '::":::",:,:"::,::::::::,:":,::,,,:,,,:,:,,::,',:::,,::,:,::::::::,:::::,,:::,::,,:,,:,,:,:::::,,:: :;::::::,::,:'::':::::;:;:",:',::,:,::"",::: ,:",'::}:: ':,..,::"',,::',,'~,~,',',:,::,,,:,':,:,::',:,X,:',,:,:,::',':",:','~:',:,::'::,,"~,::,!;~'::,,:,~,',':,:,'":":,,,:::,':::,::',-:,',:,::',':':,::',':::,,',,,::,,~::,::~,:::,::','::,",',':',':',:~::,,61,::,:,,:::,'::,':',::,,::,,1::~,~::,:::,::::,,':::,,'::::,:::::,"::,:::,:::,'::,':~,::',':','::,':',:::,::',':':,:: ---:':::":',:::,:::,::':,'::,::"::':,::,,:::':,:::,',,":,:,:,:,:",,:,',:,:,:,, ,,", ":~~,",",',:',',,li,i:il:i:,' .."bio>",''''', 'lii::":~,t, ..=.:.., ',',', ~," :~""'" r~~uf.JI~ ~V: *:, f.~7: ...:....::;. ;';:;:;':.::;'::::::':::'::::: :.:::': :::::.:.:::.;.;.;::.;::.:.::;.;:::::;....:.:.; :';.: ::..; ;'.::::.:.r:::::.-:.:: :::::. ."::::':.:. ..:::.::.:......:.: : .: ..' .'''''. nlof. Sf;\:l:nf.:.Sf.~::\::\W:J:' :~ ~o:O: PROOUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE Aon Risk Services, Inc of GA One piedmont Center, Bldg. 1 3565 Piedmont Road NE, STE 700 Atlanta, GA 30305 404-264-3115 Health Management Inc. 5811 Pelican Bay Naples, FL 34108 Associates ?J~d- COMPANY A Reliance Insurance Com an COMPANY B INSURED Blvd #500 COMPANY C COMPANY D ii9PEAq'Ii:::::i::::::::::::/:i:}:::::/:::::i:::i::///::/:::::::::}:/:::::::::::i/:i::/:i:iiiiiiiiiiii::i:}i:::::i/:i:::::::::}::}::::}}}t}}t}::}:::/ii/i::i/ii:i/:i:i:i:i:i:i:i/:::::::}}}::::::::::::}l:::}::::::t::::::::::::://::/:::t::tt::::::::l//::::ltt:::/::::/:::::::::ttttttttttttt://:i:::::i:i:i:i::::::~~::~:/::/::::::::::::::~i~i} THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE IMM/DDIYY) DATE (MM/DDIYY) LIMITS GENERAL LIABilITY COMMERCIAL GENERAL liABiliTY CLAIMS MADE D OCCUR OWNER'S & CONTRACTOR'S PROT GENERAL AGGREGATE PRODUCTS - COMP/OP AGG . PERSONAl & ADV INJURY . EACH OCCURRENCE . FIRE DAMAGE (Anyone fire) MED EXP (Anyone person) AUTOMO.BllE LIABilITY A X ANY AUTO All OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS VQ8484854 11/15/99 11/15/00 COMBINED SINGLE LIMIT 1000000 BODilY INJURY (Per person) BODilY INJURY (Per sccldent) PROPERTY DAMAGE \A,,".'\,TP: i~1 .' AUTO ONLY - EA ACCIDENT . OTHER THAN AUTO ONLY: EACH ACCIDENT . AGGREGATE . EACH OCCURRENCE AGGREGATE GARAGE LIABilITY ANY AUTO .,Y EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY D~ THE PROPRIETOR! PARTNERSIEXECUTIVE OFFICERS ARE: OTHER INCl EXCl El DISEASE - POLICY liMIT El DISEASE - EA EMPLOYEE DESCRIPTION 6'F OPERATIONS/lOCATlONSNEHIClES/SPECIAlITEMS Monroe County is named Additional Insured as respects the Named Insured's use of County School buses for evacuation of patients if there is a mandatory evacuation due to a Hurricane. Location: Lower Ke s Medical Center i:lmr.m@itlmlJIt.III:t:f:::::i:::::f:tmf::imii:ii:fff:i:ffffff::ff:::~::f:t:}:r::ft:ff:ti:ff:t::i:::::::::::f/J~I.NIm;,*tll&fff:it:::::::::::::ffffffff:::::mff:tii::::::::::::::::t::::::::t::::::::::::::::::::::::':'::f::::::f:ti::im:m:titi:::i:i:~~:t:i: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAil .1L DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAilURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF OR REPRESENTATIVES. 106026000 ':l~l\Fijb.iijb.MftQfitji.f: ACORDTM PRODUCER Aon Risk Services, Inc. of Georgia 3565 Piedmont Rd NE,Blgl,#700 Atlanta GA 30305 USA nnSCERTIFICATEIS ISSUED ASA MAITEROF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERfIFlCATE HOLDER. lHlS CERTIFlCA TE DOES NOT AMEND, EXTEND OR ALTER THE COVERAG E AWORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED Health Management Associates, Inc. 5811 Pelican Bay Blvd #500 Naples FL 341080000 USA INSURER A: Liberty Mutual Insurance Co. INSURERB: INSURER C: INSURER D: INSURER E: THE POLICIES CF 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 OTIlER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, TIlE 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 REDlX:ED BY PAID CLAIMS, POLICYEFFECTIVE POLICY EXPIRATION DATF.(MM'OD\YV) DA TF.(MM'ODIYV) lYPE OF INSURANCE POLICYNUMBDl LIMITS L1ll GENERAL LIABILITY COMMERCIAL GENERAL LIABll.IlY CLAIMS MADED OCCUR EACH OCCURRENCE FIRE DAMAGE(Any one fire) MED EXP (Anyone person) PERSONAL & ADV INJURY GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: D PRO- 0 POLICY JECT LOC PRODUCTS - COMP/OP AGG AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS V l' . COMBINED SINGLE LIMIT (Ea accident) SCHEDULED AUTOS HlRED AUTOS BODILY INJURY ( Per p....on) NON OWNED AUTOS BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABIUTY AUTO ONLY - EA ACCIDENT ANY AUTO OTHER THAN AUTO ONLY : EA ACC AGG OCCUR D CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION $ A WORKERS COMPEi'fiATION AND EMPLOYERS'LIAIIILrrY WA265D004245010 Workers Compensation 10/1/00 10/1/01 x E.L, DISEASE-POLICY LIMIT E.L, DISEASE-EA EMPLOYEE $1,000,000 $1,000,000 $1,000,000 OTHER Lower Keys Medical Center is included as an insured location: 5900 College Rd, Key West, FL 33040 Certificate No : SHOULD ANY OF THE ABOVE IESCRlBED POCICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANYWll.L ENDEAVOR TO MAll. 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAll.URE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABll.ITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REPRESENTATIVE Monroe County Bd of County Commissioners 5100 College Road Key West FL 33040 USA ACORDTM PRODUCER Aon Risk Services, Inc. of Georgia 3565 Piedmont Rd NE,Blgl,*700 Atlanta GA 30305 USA THIS CERTIFICATE IS ISSUEDASA MATI'EROF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TIlE CERrU1CATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER TIlE COVERAGE AFFORDED BY TIlE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED Health Management Associates, Inc. 5811 Pelican Bay Blvd *500 Naples FL 341080000 USA INSURER A: Safeco Ins Co Of America INSURER B: INSURER C: INSURER D: INSURER E: THE POLICIES CF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED . NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDmON OF ANY CONTRACT OR OlHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. niE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF S urn POLICIES, AGGREGATE LIMITS SHOWN MA Y HAVE BEEN REDU:::ED BY PAID CLAIMS, POLICY EFFECTIVE POLICY EXPIKATKl N DATE(MM'IID\YV) DATE(MM'IIDlYY) TYPE OF INSURANCE POLICY NUMBER LIMITS LlX GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADED OCCUR EACH OCCURRENCE FIRE DAMAGE(Any one fire) MED EXP (Anyone penon) PERSONAL '" AnV INJURY GENERAL AGGREGATE A GEN'L AGGREGATE LIMIT APPLIES PER: D PRO- D POLICY JEer LOC PRODUCTS - COMPIOP AGG AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS BA2406248 Business Auto Policy-FL 11/15/00 11/15/01 COMBINED SINCi.E LIMIT (Eo accident) $1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) GARAGE LIABILITY C' PROPERTY DAMAGE (Per accident) X Non Emergency Autos AUTO ONLY - EA ACCIDENT ANY AUTO OTHER THAN AUTO ONLY : EA ACC AGG OCCUR D CLAIMS MADE AGGREGATE DEDUCTIELE RETENTION $ WORKFJIS COMPENSATION AND EMPLOYERS'LIABlLITY E,L, DISEASE-POLICY LIMIT E,L. DISEASE-EA EMPLOYEE OTHER Monroe County is named Additional Insured as respects the Named Insured's use of county school buses for evacuation of patients if there is a mandatory evacuation due to a hurricane. Location: Lower Keys Medical Center County of Monroe Monroe County Risk Management Attn: Maria del Rio 5100 College Road Key West FL 33040 USA SHOULD ANY OF TIlE ABOVE IESCRIBED PCLICIES BE CANCELLED BEFORE TIlE EXPIRATION DATE THEREOF, TIlE ISSUING COMPANYWILL ENDEAVOR TO MAIL 30 DAYS WRITIEN NOTICE TO TIlE CERTIFICATE HOLDER NAMED TO TIlE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TIlE COMPANY, ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REPRESENTATIVE Certificate No : ACORDTM DA TE(MM/DDNY)i; 10/02/02 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE PRODUCER Aon Risk Services, Inc, of Georgia 3565 Piedmont Rd NE,Blg1 ,#700 Atlanta GA 30305 PHONE - (404) 261-3400 FAX - (404) 264-3002 INSURED Health Management Associates, Inc, 5811 Pelican Bay Blvd #500 Naples FL 341080000 USA COMPANY A Liberty Mutual Insurance Co, COMPANY B COMPANY C THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, TYPE OF INSURA;,>/CE POLICY Nl'MBER POLICY EFFECTIVE POLICY EXPIRA T10, DATE (MMlDDI\'Y) DATE (MMIDDI\'Y) LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS MADE D OCCUR OWNER'S & CONTRACTOR'S PROT GENERAL AGGREGATE PRODUCTS. COMP/OP AGG PERSONAL & ADV INJURY EACH OCCURRENCE FIRE DAMAGE(Anv one fire) MED EXP (Anv one person) A AS651 004245022 Business Auto Coverage 10/01/02 10/01/03 COMBINED SINGLE LIMIT $2,000,000 BODilY INJURY ( Per person) WORKER'S COMPENSATION AND EMPLOYERS' liABILITY THE PROPRIETOR! PARTNERS/EXECUTIVE OFFICERS ARE: INCl BODILY INJURY (Per accident) PROPERTY DAMAGE GARAGE liABiliTY ANY AUTO AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT EXCESS liABiliTY UMBRELLA FORM AGGREGA T EACH OCCURRENCE GREGATE OTHER THAN UMBRELLA FORM EXCl DESCRIPTION OF OPERA TIONS/lOCA TIONSNEHIClESlSPECIAllTEMS Monroe County is named Additional Insured as respects the Named Insured's use of county school buses for evacuation of patients if there is a mandatory evacuation due to a hurricane. Location: Lower Keys Medical Center County of Monroe Monroe County Risk Management Attn: Maria del Rio 1100 Simonton Street Key West FL 33040 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO MAil 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE 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. AUTHORIZED REPRESENTATIVE ~--t.i? ~ , -"SS~f ACORDTM PRODUCER Aon Risk Services, Inc, of Georgia 3565 Piedmont Rd NE,Blg1,#700 Atlanta GA 30305 DATE(MM/DDNY) .. 09/27/02 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE PHONE. (404) 261-3400 FAX - (404) 264-3002 INSURED Health Management Associates, Inc, 5811 Pelican Bay Blvd #500 Naples FL 341080000 USA COMPANY A Liberty Mutual Insurance Co. COMPANY B COMPANY C COMPANY D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, CO LTR POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRA no DATE (MMIDD/yy) DATE (MMIDD/YY) TYPE OF INSURANCE GENERAL liABiliTY COMMERCIAL GENERAL LIABILITY CLAIMS MADE D OCCUR OWNER'S & CONTRACTOR'S PROT EXCESS liABiliTY UMBRELLA FORM All OWNED AUTOS ~~:w: DAT':; - OTHER THAN UMBRELLA FORM A W A265D004245012 Workers Compensation WORKER'S COMPENSATION AND EMPLOYERS' liABilITY THE PROPRIETOR! PARTNERSlEXECUTIVE OFFICERS ARE: 10/01/02 10/01/03 X INCl EXCl DESCRIPTION OF OPERATIONSllOCATIONSlVEHIClESlSPECIAllTEMS Lower Keys Medical Center is included as an insured location: 5900 College Rd, Key West, FL 33040 LIMITS GENERAl AGGREGATE PRODUCTS - COMP/OP AGG PERSONAL & ADV INJURY EACH OCCURRENCE FIRE DAMAGE(Anv one firel MED EXP (Anv one person) COMBINED SINGLE LIMIT BODilY INJURY ( Per person) BODilY INJURY (Per accident) PROPERTY DAMAGE AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGAT EACH OCCURRENCE AGGREGATE El EACH ACCIDENT El DISEASE-POLICY LIMIT El DISEASE-EA EMPLOYEE $1,000,000 $1,000,000 $1,000,000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO MAil 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE 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, AUTHORIZED REPRESENTATIVE <fJ----tf;? ~ ~t,.. . Monroe County Bd of County Commissioners 5100 College Road Key West FL 33040 USA 570003962443 Lower Keys 3Y1y Holder Identifier: ACORDTM DATE (MM/DD/VV) 09 30/03 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE VI > <Ii ~ 1... <Ii ~ ...J PRODUCER Aon Risk services, Inc. of Georgia 3565 piedmont Rd NE,Blg1,#700 Atlanta GA 30305 PHONE - (404) 261-3400 FAX - (404) 264-3002 INSURED Health Management Associates, Inc. 5811 Pelican Bay Blvd #500 Naples FL 341080000 USA COMPANY A Liberty Mutual Insurance Co. ;.: ~ :5 - c ~ 'Q - 1-0 ~ 'Q '0 = COMPANY B COMPANY C THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPlRA TION DA TE (MM/DDIYY) DATE (MMffiDIVY) LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS MADE 0 OCCUR OWNER'S & CONTRACTOR'S PROT GENERAL AGGREGATE PRODUCTS. COM PlOP AGG PERSONAl & ADV INJURY EACH OCCURRENCE ,." lJ"l o N 0"> '<l' I'- o o o I'- lJ"l A AUTOMOBilE LIABiliTY X ANY AUTO All OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS AS2651004245023 Business Auto FIRE DAMAGECAnv one fire) MED EXP (Anv one person) o z ~ - ~ $2,000,000 5 - 1-0 ~ U 10/01/03 10/01/04 COMBINED SINGLE LIMIT BODilY INJURY ( Per person) ANY AUTO BODilY INJURY (Per accident) PROPERTY DAMAGE EXCESS LIABILITY UMBRELLA FORM AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGAT OTHER THAN UMBRELLA FORM EACH OCCURRENCE AGGREGATE WORKER'S COMPENSATION AND EMPLOYERS' liABILITY THE PROPRIETOR! PARTNERs/EXECUTIVE OFFICERS ARE: INCl EXCl El DISEASE-POLICY LIMIT El DISEASE.EA EMPLOYEE DESCRIPTIO.N OF OPERATJONSllOCATlQNS/VEHIClESlSPECIAlITEMS Monroe county 1S named Add1t1onal Insured as respects the Named Insured's use of county school buses for of patients if there is a mandatory evacuation due to a hurricane. Location: Lower Keys Medical Center County of Monroe Monroe County Risk Management Attn: Maria Slavik 1100 Simonton Street Key West FL 33040 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO MAil 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE 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, AUTHORIZED REPRESENTATIVE <()----ti;? ~ .c:--.. ) c.c.. '~~..A.._ PRODUCER Aon Risk services, Inc. of Georgia 3565 piedmont Rd NE,Blg1,#700 Atlanta GA 30305 OATE(MM(OO(YY) 04(02(04 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE PHONE - (404) 261-3400 FAX - (404) 264-3002 INSURED Health Management Associates, Inc. 5811 pelican Bay Blvd #500 Naples FL 341080000 USA COMPANY A Liberty Mutual Insurance Co. COMPANY B COMPANY C ~ . ::. . Q l;: <: ~ Q 't .. . Q 't C : 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, - ~ ~ ~ i:i ~ ~ ~ ===-- BUT FAILURE TO MAil SUCH NOTICE SHAll IMPOSE NO OBLIGATION OR LIABiliTY :l:! OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES, ~ AUTHORIZED REPRESENTATIVE <P~ ~ ~~ _ ~ TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION DATE (MM/DDIYY) DATE (MM/DDIYY) POLICY NUMBER COMMERCIAL GENERAL LIABILITY CLAIMS MADE 0 OCCUR OWNER'S & CONTRACTOR'S PROT AUTOMOBilE liABiliTY ANY AUTO All OWNED AUTOS EXCESS LIABiliTY UMBRElLA FORM OTHER THAN UMBRELLA FORM A WA265D004245013 workers compensation 10/01/03 WORKER'S COMPENSATION AND EMPLOYERS' LIABiliTY THE PROPRIETOR! PARTNERSIEXECUTIVE OFFICERS ARE: 10/01/04 X INCl EXCl DESCRIPTION OF OPERATIOtlSllQCATlONSNEHIClESlSPECIAllTEMS Re: Lower Keys MeOlcal Center LIMITS GENERAL AGGREGATE PRODUCTS-COM~OPAGG PERSONAL & ADV INJURY EACH OCCURRENCE rt' CIC a CIC a " a c c c ,..,. lJ' FIRE DAMAGE(Anv one fire) MED EXP (Anv one person) c ;Z '" ... '" .. I; :;: .. '" ~ COMBINED SINGLE LIMIT BODilY INJURY ( Per person) BODilY INJURY (Per accident) PROPERTY DAMAGE AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGAT EACH OCCURRENCE AGGREGATE El DISEASE-POLICY LIMIT El DISEASE-EA EMPLOYEE $1,000,000 $1,000,000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE Monroe County Board of County commissioners Attn: Monroe County Risk Management 1100 simonton Street Key West Fl 33040 USA EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO MAil 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT, . ACORDTM DATE (MM/OD/VV) 09/30/04 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE III > QJ ~ PRODUCER Aon Risk services, Inc. of Georgia 3565 piedmont Rd NE,Blg1,#700 Atlanta GA 30305 L.. QJ ;: o -J PHONE - (866) 283-7124 FAX - (866) 430-1035 INSURED Health Management Associates, Inc. 5811 pelican Bay Blvd #500 Naples FL 341080000 USA COMPANY A Liberty Mutual Insurance Co. ~ ~ !E c ~ == .. ~ 'l:l '0 ::c COMPANY B COMPANY C 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 SUC_H POLICIES, L1MIT~ SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLlCY EXPIRA TIO DA TE (MM/DDIYY) DATE (MMlDDIYY) LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS MADE 0 OCCUR OWNER'S & CONTRACTOR'S PROT GENERAL AGGREGATE PRODUCTS - COMP/OP AGG PERSONAL & ADV INJURY EACH OCCURRENCE FIRE DAMAGE(Any one fire) en <Xl .-I ..... In .-I .-I .-I o o ..... In MED EXP (Anyone person) = Z A As2-651-004245-024 Business Auto 10/01/04 10/01/05 COMBINED SINGLE LIMIT $2,000,000 ~ ~ ... I:: ; .. ~ U BODilY INJURY ( Per person) BODilY INJURY (Per accident) APPiil BY ___,. DATE __" PROPERTY DAMAGE EXCESS liABiliTY UMBRELLA FORM AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGAT EACH OCCURRENCE AGGREGATE OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS' liABiliTY THE PROPRIETORI PARTNERS/EXECUTIVE OFFICERS ARE INCl EXCl El DISEASE-POLICY LIMIT El DISEASE-EA EMPLOYEE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE - ~ ~ ~ ~ ~ ~ --= ~- --.:I ~ ~ ---- ~ ~ ~ .:!..I r:- 2! ~ ~ - DESCRIPTIO~ OF OPERA TIONSILOCA TlQNSlVEHIClES/SPECIAllTEMS Monroe county 1S named Add1t10nal Insured as respects the Named Insured's use of county school buses for evacuatio of patients if there is a mandatory evacuation due to a hurricane. Location: Lower Keys Medical Center CER1'IFI county of Monroe Monroe county Risk Management Attn: Maria Slavik 1100 Simonton Street Key West FL 33040 USA EXPIRATION DATE THEREOF, THE ISSUING COMPANY WIll ENDEAVOR TO MAil 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE 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, AUTHORIZED REPRESENTATIVE <()--t:f? ~ ~t.... _ PRODUCER Aon Risk services, Inc. of Georgia 3565 piedmont Rd NE,Blg1,#700 Atlanta GA 30305 DATE (MM/DD/VY) 09/30/04 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE VI > QJ ~ '- QJ 3: o ....J PHONE - (866) 283-7124 FAX - (866) 430-1035 INSURED Health Management Associates, Inc. 5811 pelican Bay Blvd #500 Naples FL 341080000 USA COMPANY A Liberty Mutual Insurance Co. i.: ... l: :.: c ... ::! .. ... '0 = :: COMPANY B COMPANY C COMPANY D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TE~M 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, E.XCLUSIONS ,A,ND CONDITIONS OF SUCH PQUCIF.S LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, TYPE OF INSURANCE POLICY NUI\1BER POLICY EFFECTIVE POLICY EXPlRA TlO DATE (1\11\1/DD/YV) DA TE (l\1l\11DDNV) LlI\1ITS COMMERCIAL GENERAL LIABILITY CLAIMS MADE D OCCUR OWNER'S & CONTRACTOR'S PROT GENERAL AGGREGATE PRODUCTS - COMP/OP AGG PERSONAL & ADV INJURY EACH OCCURRENCE .-I "- N "- Ln .-I .-I .-I o o "- Ln FIRE DAMAGE(Any one fire) MED EXP (Anyone person) Q Z BODilY INJURY ( Per person) ~ ~ '" ~ .. ... U COMBINED SINGLE LIMIT WAiVER BODilY INJURY (Per accident) PROPERTY DAMAGE AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGAT EXCESS LIABILITY UMBREllA FORM EACH OCCURRENCE AGGREGATE OTHER THAN uMBRELLA fORM A WORKER'S COMPENSATION AND EMPLOYERS' liABiliTY THE PROPRIETOR! PARTNERS/EXECUTIVE OFFICERS ARE WA765D004245014 workers Compensation 10/01/04 10/01/05 INCl EXCl El DISEASE-POLICY LIMIT El DISEASE-EA EMPLOYEE $1,000,000 $1,000,000 _ DESCRIPTION OF OPERA TIOfllS/lOCA TIONSNEHIClES/SPECIAllTEMS Re: Lower Keys Medlcal Center c:. 0 \-::> ~ . ~ \ 'I'-(l 'l\.."t <L-- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE Monroe County Board of County commissioners Attn: Monroe County Risk Management 1100 simonton Street Key west FL 33040 USA EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO MAil 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE 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 AUTHORIZED REPRESENTATIVE <fJ--tJ;? ~ ~~.. _ ,. :! I ACORDm DATE (MM/OO/VV) 09 30 04 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE III > ev ~ PRODUCER Aon Risk services, Inc. of Georgia 3565 piedmont Rd NE,Blg1,#700 Atlanta GA 30305 L- ev 3: o ..J PHONE - (866) 283-7124 FAX _ (866) 430-1035 INSURED Health Management Associates, Inc. 5811 pelican Bay Blvd #500 Naples FL 341080000 USA COMPANY A Liberty Mutual Insurance Co. i.: IV !5 - = IV 'C .... 100 IV 'C "S =: COMPANY B COMPANY C THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MMJDDIYY) DATE (MMJDDIYY) LIMITS AUTOMOBilE liABilITY ANY AUTO All OWNED AUTOS AS2-6S1-00424S-024 Business Auto GENERAl AGGREGATE PRODUCTS - COMP/OP AGG PERSONAl & ADV INJURY EACH OCCURRENCE FIRE DAMAGE(Any one fire) MED EXP (Anyone person) a'I 00 .-t "'- VI .-t .-t .-t o o "'- VI COMMERCiAl GENERAl LIABILITY CLAIMS MADE 0 OCCUR OWNER'S & CONTRACTOR'S PROT 10/01/04 10/01/05 COMBINED SINGLE LIMIT ~ IV - = $2,000,000 ~ 1: IV U AP'V"f\ BY ~ 0' 01\' T BODilY INJURY ( Per person) BODilY INJURY (Per accident) YES PROPERTY DAMAGE :\PP~OVED B AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE EACH OCCURRENCE AGGREGATE dY OTHER THAN UMBRELLA FORM :~) t\1 E WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOR! PARTNERs/EXECUTIVE OFFICERS ARE: INCl EXCl El DISEASE-POLICY LIMIT El DISEASE-EA EMPLOYEE DESCRIPTION OF OPERATIONSIlOCATIONSlVEHIClEs/SPECIAL ITEMS Monroe County is named Additional Insured as respects the Named Insured's use of county school buses for of patients if there is a mandatory evacuation due to a hurricane. Location: Lower Keys Medical Center county of Monroe Monroe county Risk Management Attn: Maria slavik 1100 simonton Street Key West FL 33040 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO MAil 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT. BUT FAILURE TO MAIL SUCH NOTICE SHAll IMPOSE NO OBLIGATION OR LIABILITY ~1":X:!i1'%0~0:/;;!"'~~ ~~~~1~7""S>rp{~~~~I~""J~~'E~" 'Wf "'-, ""'F''t--~-=*",I0'Mm~0'';\~,W-''''~~H''F ~ , I" "'iJ1IP" ;.' I'" I~ 1,'~~II,jl'p,,\V"I; ;1'>' j "" I II- , l ~l l ~ I"~ j ;'J p ~ 1 %t' .l! 4 ~ A riD ~ '" ill ,," i ' ' j; I k t %C, ^ '-.! ". 1 I"" ~";,.w0 " "Wfc)J!f1I'M~ i^ - lr1 1" "'" ~ 1 >>&. '" _bJ;;""'~"J/lli;.&~~~ J4 % 'd"~~,^~"I/.2.~~~:IM*.~~!~rLzJrG~I.\Ii:\: ""J"~,Afh""",, ~ "," w"'~ PRODUCER Aon Risk services, Inc. of Georgia 3565 piedmont Rd NE,Blg1,#700 Atlanta GA 30305 DATE (MM/DD/YV) 09 30 04 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE III > Ql ::.: L. Ql ~ ...J PHONE. (866) 283-7124 FAX - (866) 430-1035 INSURED Health Management Associates, Inc. 5811 Pelican Bay Blvd #500 Naples FL 341080000 USA COMPANY A Liberty Mutual Insurance Co. i.: ~ $; - = ~ '0 .... "" ~ '0 '0 = COMPANY B COMPANY C THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRA nON DATE(MMlDDIYY) DATE(MMlDDIYY) LIMITS COMMERCIAL GENERAl LIABILITY CLAIMS MADE D OCCUR OWNER'S & CONTRACTOR'S PROT GENERAl AGGREGATE PRODUCTS - COMP/OP AGG PERSONAl & ADV INJURY EACH OCCURRENCE ...... ...... N ...... '" ...... ...... ...... o o ...... '" FIRE DAMAGE(Anv one fire) MED EXP (Anv one person) 15 Z ~ - <II Col It: 1: ~ u AUTOMOBilE liABILITY ANY AUTO All OWNED AUTOS COMBINED SINGLE LIMIT AP 8V BODilY INJURY ( Per person) BODilY INJURY (Per accident) DI\T[ WAiVER PROPERTY DAMAGE AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE EACH OCCURRENCE AGGREGATE OTHER THAN UMBRELLA FORM A WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOR! PARTNERs/EXECUTIVE OFFICERS ARE: WA765D004245014 Workers compensation 10/01/04 10/01/05 INCl EXCl El DISEASE. POLICY LIMIT El DISEASE-EA EMPLOYEE $1,000,000 $1,000,000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE - ~ ~ M ~ ~ ~ ~ ===-- ~ ~ ~ - DESCRIPTION OF OPERATIONSllOCATIONSlVEHICLESlSPECIAL ITEMS Re: Lower Keys Medical Center Monroe County Board of County commissioners Attn: Monroe County Risk Management 1100 simonton Street Key west FL 33040 USA EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO MAil 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE 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, AUTHORIZED REPRESENTATIVE <P~ ~ ~ ;) ACORDTM DATE (MM/DD/VV) 08 11/05 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE Vl > ClI :..: L.. ClI ;: o ..J PRODUCER Aon Risk Services, Inc. of Georgia 3565 piedmont Rd NE,Blg1,#700 Atlanta GA 30305 PHONE - (866) 283-7124 FAX - (866) 430-1035 INSURED Health Management Associates, Inc. 5811 Pelican Bay Blvd #500 Naples FL 341080000 USA COMPANY A Liberty Mutual Insurance Co. '-= Q,l !6 .... c Q,l "C:l - I. Q,l "C:l '0 == COMPANY B COMPANY C THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, " TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MMlDDIYY) DATE (MMlDDIYY) LIMITS COMMERCiAl GENERAL LIABILITY CLAIMS MADE D OCCUR OWNER'S & CONTRACTOR'S PROT GENERAl AGGREGATE PRODUCTS - COMP/OP AGG PERSONAl & ADV INJURY EACH OCCURRENCE '<I' co '<I' Ln en Ln '<I' M o o r-... Ln FIRE DAMAGE(Any one fire) MED EXP (Anyone person) BODilY INJURY ( Per person) o z Q,l .... ..s $2,000,000 ~ t: Q,l u A AUTOMOBilE liABILITY X ANY AUTO All OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON.OWNED AUTOS As2-651-004245-024 Business Auto 10/01/04 10/01/05 COMBINED SINGLE LIMIT BODilY INJURY (Per accident) ANY AUTO PROPERTY DAMAGE ~.) /\l L ~~10 ::D.:=J... '~ ,.\l., "/;::-~: AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE EACH OCCURRENCE AGGREGATE '1/./ f~\ I \11:: ;~' OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS' LIABiliTY THE PROPRIETOR! PARTNERs/EXECUTIVE OFFICERS ARE: INCl EXCl El DISEASE-POLICY LIMIT El DISEASE.EA EMPLOYEE DESCRIPTION OF OPERATIONSllOCATIONSlVEHIClESlSPECIAllTEMS Monroe county is named Additional Insured as respects the Named Insured's use of county school buses for of patients if there is a mandatory evacuation due to a hurricane. Location: Lower Keys Medical Center Y?t:.e.. County of Monroe Monroe county Risk Management Attn: Maria Slavik 1100 Simonton Street Key West FL 33040 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO MAil 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE 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, AUTHORIZED REPRESENTATIVE <()~~ ~~_ ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY) 1/10/2006 PRODUCER (678)539-4800 FAX (678) 539-4890 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Beecher Carlson - Atlanta HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2002 Summit Boulevard ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 900 Atlanta GA 30319 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Liberty Mutual Ins. Co. Health Management Associates, Inc. INSURER B: 5811 Pelican Bay Blvd INSURER C: Ste 500 INSURER D: Naples FL 34108-2710 INSURER E: COVERAGES 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, INSR ADD'l POLICY EFFECTIVE POLICY EXPIRATION lTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MM/DDNY) DATE (MM/DDNY) LIMITS GENERAL liABILITY EACH OCCURRENCE $ - ~~~~U?E~~~~~nce) COMMERCIAL GENERAL LIABILITY $ I CLAIMS MADE D OCCUR MED EXP (Anyone person) $ - PERSONAL & ADV INJURY $ - GENERAL AGGREGATE $ ~'l AGGREAE LIMIT AnES PER: PRODUCTS - COMP/OP AGG $ PRO- POLICY JECT lOC AUTOMOBilE LIABILITY COMBINED SINGLE LIMIT - $ 2,000,000 ~ ANY AUTO (Ea accident) A - All OWNED AUTOS AS2651004245025 10/1/2005 10/1/2006 BODilY INJURY $ SCHEDULED AUTOS (Per person) - ~ HIRED AUTOS BODilY INJURY $ X NON-OWNED AUTOS (Per accident) - ~ $1,000 comp ded PROPERTY DAMAGE $ X $1,000 coll ded (Per accident) GARAGE liABiliTY AUTO ONLY - EA ACCIDENT $ =J ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY AP~' t;!(7~ { .h\i" i\"~' EACH OCCURRENCE $ tJ OCCUR D CLAIMS MADE 1;~'f'1L AGGREGATE $ [;'f-- - ",I~ . ----~_.'" $ R DEDUCTIBLE o i\T L: ....r {2r".".,. $ . ._.~N_". '-~ RETENTION $ "" ,. $ WORKERS COMPENSATION AND WAI\fFP "jlA . I.L....:.~ .,.. I we STATU., I 10TH. TORY LIMITS ER EMPLOYERS' LIABILITY ( ANY PROPRIETOR/PARTNER/EXECUTIVE ~. Uk E.l. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? . '-J II yes, describe under C ( ,<:j E.l. DISEASE - EA EMPLOYEE $ SPECIAL PROVISIONS below E,l. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERA TlONS/lOCA TlONSNEHIClES/EXClUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The Certificate Holder is listed as an Additional Insured as required per written contract. C. c- . h n a... 11 C e.- CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE Monroe County Board of County Commission EXPIRATION DATE THEREOF, THE ISSUING INSURER WIll ENDEAVOR TO MAIL Attn: Risk Management Administrator ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT, BUT P. O. Box 1026 Key West, FL 33041-1026 FAilURE TO DO SO SHAll IMPOSE NO OBLIGATION OR liABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ~JJJ "~. ': ' , Robert HessellRANDNO :~,..) ') ACORD 25 (2001/08) INS025 (010B)06 AMS VMP Mortgage Solutions, Inc, (BOO)327 -0545 @ ACORD CORPORATION 1988 Page 1 012 ~'l.~ ACORD'M CERTIFICATE OF LIABtL!TY INSURANCE DATE(M~1/ OD/YY) 10/05/05 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE Vl > Q) "" PRODUCER Aon Risk services, Inc. of Georgia 3565 piedmont Rd NE,Blg1,#700 Atlanta GA 30305 L Q) ~ o -' PHONE- (866) 283-7124 FAX- (866) 430-1035 INSURED Health Management Associates, Inc. 5811 pelican Bay Blvd #500 Naples FL 341080000 USA COMPANY A Liberty Mutual Insurance Co. i.: "" !5 ...- c "" '0 - ... "" '0 '0 = COMPANY B COMPANY C 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 POLICY NUMBER I POLICY EFFECTIVE POLICY EXPIRA nONI TYPE OF INSURANCE DATE (MMIDD/YYl DATE (MMIDDNY) LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS MADE 0 OCCUR OWNER'S & CONTRACTOR'S PROT GENERAL AGGREGATE PRODUCTS. COMP/OP AGG PERSONAl & ADV INJURY EACH OCCURRENCE a; N N '<t N lJ'l .-I o o ,..., lJ'l A As2-651-004245-025 Business Auto 10/01/05 10/01/06 COMBINED SINGLE LIMIT $2,000,000 o z ~ e !5 ...- ... "" U FIRE DAMAGE(Anv one fire) MED EXP (Anv one person) BODilY INJURY ( Per person) BODilY INJURY (Per accident) GARAGE LIABiliTY ANY AUTO PROPERTY DAMAGE EXCESS LIABILITY UMBRELLA FORM AUTO ONLY. EA ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE EACH OCCURRENCE AGGREGATE OTHER THAN UMBReLLA f'ORM WORKER'S COMPENSATION AND EMPLOYERS' LIABilITY THE PROPRIETORI PARTNERs/EXECUTIVE OFFICERS ARE, INCl EXCl El DISEASE-POLICY LIMIT El DISEASE-EA EMPLOYEE DESCRIPTION OF OPERATIONSllOCATIONSlVEHIClESlSPECIAllTEMS Monroe County is named Additional Insured as respects the Named Insured's use of county school buses for evacuatio of patients if there is a mandatory evacuation due to a hurricane. Location: Lower Keys Medical Center - ~ ~ ~ ~ .:.... '-.=-a ;:-po --- ~ ""--- :Si ""'- - . ~ .::!..:: r:.. 2:J l!J;' ~ - County of Monroe Monroe county R;sk Management Attn: Maria slavik 1100 simonton Street Key west FL 33040 USA /' c-c-:~~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO MAil 3U DAYS WRITTEN ~OTICE TO THE CEHilrilAiE "OLDER NAMED TO THE lEFT, BUT FAILURE TO MAil SUCH NOTICE SHAll IMPOSE NO OBLIGATION OR LIABILITY Of' AN' KII'<D UPON THE COMPANY, I IS AGEN I S uti REPHE"ioNTATIVES, AUTHORIZED REPRESENTATIVE <{?~ ~ .c....,~~ _ ACORDTM CERTIFICA TEOF lIABILIT'i'~INSURANCE DATt:.l"MM/DD/VV) 10/05/05 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE Vl > Q) ~ PRODUCER Aon Risk Services, Inc, of Georgia 3565 piedmont Rd NE,Blg1,#700 Atlanta GA 30305 L. Q) :;; o .J PHONE _ (866) 283-7124 FAX - (866) 430-1035 INSURED Health Management Associates, Inc. 5811 pelican Bay Blvd #500 Naples FL 341080000 USA COMPANY A Liberty Mutual Insurance Co. i.: "" 5 -= "" "0 - ... ;; "0 '0 ::t COMPANY B COMPANY C 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, co I EO SURANCE POLICY NUMBER POLICY EFFECTlVE\POLlCY EXPIRATION LIMITS L TRI TYP FIN DATE (MMIDDNY) DATE (MMIDDfYY) COMMERCiAl GENERAL LIABILITY CLAIMS MADE 0 OCCUR OWNER'S & CONTRACTOR'S PROT GENERAL AGGREGATE PRODUCTS - COMP/OP AGG PERSONAl & ADV INJURY EACH OCCURRENCE 00 V'> N N "" N V'> rl o o "- V'> GENERAL LIABILITY FIRE DAMAGE(Anv one fire) APPhfIW ij Y -..-L!.f~ BODilY INJURY ( Per person) o Z "" - ~ u 5 - ... "" U MED EXP (Anv one person) AUTOMOBilE LIABILITY ANY AUTO All OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON.OWNED AUTOS COMBINED SINGLE LIMIT BODilY INJURY (Per accident) PROPERTY DAMAGE ANY AUTO AUTO ONLY. EA ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE EACH OCCURRENCE AGGREGATE EXCESS LIABiliTY UMBREllA FORM OTHF-R TH"'N UMBRf:II.I\ I'()RM A WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETORI PARTNERs/EXECUTIVE OFFICERS ARE: WA765D004245015 workers Compensation 10/01/05 10/01/06 INCl EXCl El DISEASE. POLICY LIMIT El DISEASE-EA EMPLOYEE $1,000,000 $1,000,000 DESCRIPTION OF OPERATIONS/lOCATIONSlVEHIClES/SPECIAlITEMS Re: Lower Keys Medical Center .eER'1'IFI<M SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE Monroe county Board of county commissioners Attn: Monroe County Risk Management 1100 Simonton Street Key wesl F~ 33040 USA cc...:~~ EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE L..tHflFICATE HOLDER NAMED TO THE lEFT, BUT FAilURE TO MAil SUCH NOTICE SHAll IMPOSE NO OBLIGATION OR LIABILITY Of ANy KIND UPON THE COMPANY, If::; AGb"';, OR HEoPRESENTATIVES, AUTHORIZED REPRESENTATIVE </J-..t.J;? ~ ~~ . A CORQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY) 1/3/2006 PRODUCER (678)539-4800 FAX (678) 539-4890 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Beecher Carlson - Atlanta ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2002 Summit Boulevard ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 900 Atlanta GA 30319 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Columbia Casual tv Company 31127 Health Management Associates, Inc. INSURER B: Libertv Mutual Insurance 23043 5811 Pelican Bay Blvd, Ste 500 INSURER c: INSURER D: Naples FL 34108-2710 INSURER E: COVERAGES 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, INSR ADD'l POLICY EFFECTIVE POLICY EXPIRATION lTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MM/DDNY) DATE (MM/DDNY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 - X COMMERCIAL GENERAL LIABILITY ~~~~H?E~~~J';'~nce) $ A I CLAIMS MADE ~ OCCUR HAZ10644106693 10/1/2005 10/1/2006 MED EXP (Anyone person) $ - PERSONAL & ADV INJURY $ - GENERAL AGGREGATE $ 10,000,000 GEN'l AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ ~ nPRO- n X POLICY JECT lOC AUTOMOBilE liABiliTY COMBINED SINGLE LIMIT - (Ea accident) $ - ANY AUTO .,... ,^, ""['("'" C - All OWNED AUTOS ,WP ~OlJrn r~ I~Dll Y INJURY ~i7~JA U-';:::i\'L . r person) $ SCHEDULED AUTOS - {"j --- --- - :-j HIRED AUTOS ,j ,,_ ~:Q'--'-'---'" - 'trODll Y INJURY DAn ---__._..J.=-_ (Per accident) $ - NON-OWNED AUTOS ---,J)?---------. - WAi\ ER N/A_~ ,... (;:~:; ,-r.. ,..,'"" PROPERTY DAMAGE $ ..~Per accident) GARAGE liABILITY ~ ,AUTO ONLY - EA ACCIDENT $ =1 ANY AUTO OTHER THAN EA ACC $ (j-,'~'a AUTO ONLY: AGG $ EXCESS/UMBRELLA liABILITY ~ Yh{' ~ EACH OCCURRENCE $ tJ OCCUR D CLAIMS MADE uti U10 AGGREGATE $ '\.l&.- .-/ ~ $ ~ DEDUCTIBLE -.::::7 $ RETENTION $ $ B WORKERS COMPENSATION AND I we STATU-; r 10TH- EMPLOYERS' liABiliTY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E,L EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? WA765DOO4245015 10/1/2005 10/1/2006 E,L DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under SPECIAL PROVISIONS below E:L DISEASE - POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS/lOCATIONSNEHIClES/EXClUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE Monroe County Board of County Commissione EXPIRATION DATE THEREOF, THE ISSUING INSURER Will ENDEAVOR TO MAil Attn: Risk Management Administrator ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT, BUT P. O. Box 1026 Key West, FL 33041-1026 FAilURE TO DO SO SHAll IMPOSE NO OBLIGATION OR LIABiliTY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REPRESENTATIVE ~lk-J .i. Robert Hessel/RANDNO ACORD 25 2001/08 Go c:.;~ c ( INS025 (010B)06 ) AMS @ACORDCORPORATION 1988 VMP Mortgage Solutions, Inc. (BOO)327 -0545 Page 1012 J') "!J ACORD~ CERTIFICATE OF LIABILITY INSURANCE PROOUCER (503) 219-3227 FAX: (503) 914-5427 Beecher Carlson - New York 220 N W 2nd Ave., Suite 800 Suite 2102 Portland OR 97209-1 31 I DATE (MMfDOIYYYY) 9/28/2006 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ~--__n_.._._ 0 "-HelElER~'I"-HIS CERTIFICATE DOES NOT AMEND, EXTEND OR 'I .. f'.lL TER THE ,COVERAGE AFFORDED BY THE POLICIES BELOW. ...1:'""....., I INSURSRS AFFORDING COVERAGE INSURER A: Li~rty Mutual/Northwest INSURERB ~.." . -.,. '.~'___', '_.'_.'.'_' .INSURERC: _Ai_)?:t,,}:t;/::()W.l~~~URER 0: i ..~.:':;;"",~......! F -'0 INSURED NAIC# Health Management Associates, I c 5811 Pelican Bay Blvd. Ste 500 Naples ()I....'T V,-, I FL 34108 :: 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. An, REGATE LIMITS ~HOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I I~;: ~~~,L TYPE OF INSURANCE POLICY NUMBER PJl1-t~~:~f88ME Pg~lfll~':.t~N LIMITS GENERAL LIABILITY r-- A ~ r-- GEN'L AGGRE~E LIMIT APPLIES PER 'I POLICY J I ~fR;: n LOC AUTOMOBILE LIABILITY e- p ANY AUTO e- x SCHEDULED AUTOS - ~ HIRED AUTOS ~ NON-OWNED AUTOS X $1,000 ded comp x $1 000 ded collision ALL OWNED AUTOS AS2651004245026 EACH CCURR"'NCE $ ~~~~~~J9F~;~~~nce\ $ MED EXP IAn ana Darsonl $ PERSONAL & ADV INJ RY , GENERAL AGGREGATE , PRODUCTS - COMP/OP AGG , COMBINED SINGLE LIMIT , 2,000,000 {Eaaccidanl) 10/1/2006 10/1/2007 BODILY INJURY (Per person) , BODILY INJURY , {Per accident) PROPERTY DAMAGE , (Peraccidenl) AUTO ONLY - EAACCIDENT $ COMMERCIAL GENERAL LIABILITY I CLAIMS MADE 0 OCCUR GARAGE LIABILITY R ANY AUTO EXCESSfUMBRELLA LIABILITY P OCCUR 0 CLAIMS MADE ROEOUCTIBLE RETENTION !I: WORKERS COMPENSATION AND EMPLOYER!i'LLI\BIL.ITY ANY PROPRIETORfPARTNERfEXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER OTHER THAN EAACC , AUTO ONLY; AGG , m ,\Doo;.J_ (jJ ,"000""0 , AGGREGATE $ , \D ~3'( ~ , , '" r'l ".1 I. ~Cf5,"ST~U;!c; f IO,!,\" ~-, ~ E.L. EACH ACCIDENT , Ie C) EL DISEASE - EA EMPLOYEE $ /-...L E.L. DISEASE - POLICY LIMIT $ - DESCRIPTION OF OPERA TrONS/LOCATIONSNEHICLESlEXClUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The Certificate Holder is listed as an Additional Insured as required per written contract. C.[, .c:'r;~~ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Monroe County Board of County Commission EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Attn: Risk Management Administrator 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT P. O. Box 1026 - FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE Key West, FL 33041-1026 INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ~t;J Robert Hessel/RANDNO ACORD 25 (2001/08) INS025 (0108)_08 AMS (~l TM Wolters Kluwer Financial Services @ACORD CORPORATION 1988 Page 1 of2 A CORD~ CERTIFICA TE OF LIABILITY INSURANCE DATE (MM/DDlYYYY) 9/28/2006 PRODUCER (646) 358 8500 FAX: (646)358 8590 THIS CERTIFICATE IS ISSUED AS A MATTER DF INFDRMA TION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Beecher Carlson - New York HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 7 Times Square ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 2102 r ---- New York NY 10036 : '. tNIl1iERSAFFO~DING COVERAGE NAIC# . '- INSURED ., . ..tu.l&.~Co1 um:l>ia Casualty Company 31127 [ Health Management Associates, Ino : r INSURER 8 5811 Pelican Bay Blvd, Ste 500 OCT INSURER C ! INSURER 0 I , Naples FL 34108-271 ,_. ". ~~~URER E I i ~ 'E THE POLICIES OF INSURANCE LISTED BELOW HAVE BE USSUED TO ~fi:~ ED ABOVE OR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTH 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. MGREG TE L1MITS~OWN MAY HAVE BeEN REDUCED BY PAID CLAIMS IIN-i': I~~~~ P~.k+~~~~~~8tW\E POLICY EXPJRA nON TYPE OF INSURANCE POLICY NUMBER DATE-IMM/DDlVYI LIMITS GENERAL LIABILITY i=ACH orrl RRENCE $ 1,000,000 '-'" ~~~~~~J9E~~~J~~enc& .x CO:...~Mt:RC~!.L. C::::NER:,L. LiAC:UTY , A I CLAIMS MADE ~ OCCUR HAZ10644106694 10/1/2006 10/1/2007 MED EXP An one erson $ C- PERsnNAL & AnV INJURY $ C- ADS except PA GENERAL AGGREGATE $ 11,000,000 GEN'L AGGilllMIT nES PER: PRODUCTS - COMP/OP AGG $ ~ PRO- X POLICY :,F:r.r LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - (E~,accident) $ - ANY AUTO m~ '5'& " ^'- "" ALL OWNED AUTOS i,ln III, ,UJlt ~m;;L Y INJURY - (Per person) $ - SCHEDULED AUTOS -' - HIRED AUTOS ..........To BODILY INJURY (Per accident) $ NON-OWNED AUTOS l - "A-,-{:! V'.'i i I PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY D1f] , \ \r - AUTO ONLY - EA ACCIDENT $ RANY AUTO ''";7 0 OTHER THAN EA ACC $ "J.- L~ ~ AUTO ONLY AGG $ EXCESS/UMBRELLA LIABILITY '''00' $ P OCCUR D CLAIMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION !t $ WORKER:) COMPENSATION AND l,"/..f S[rJHs I I OJ~- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E_L. DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIDNS below EL DISEASE - POLICY LIMIT $ A OTHER Hospi tal HAZI0644106694 10/1/2006 10/1/2007 Each Medical $1,000,000 Professional Claims Made Incident Annual Aaaregate $11,000,000 DESCRIPTION OF OPERATlONSILOCATlONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The Certificate Holder is listed as an Additional Insured as required by written contract regarding Lower Keys Medical Center, 5900 College Road, Key West, FL 33040. 3?'? CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Monroe County Board of Commissioners EXPIRATJON DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 0/0 Monroe County Risk Management ~ DAYS WRITTEN NOTICE-TO THE CERTIFICATE HOLDER NAMED TO THE lEFT, BUT Attn: Maria Slavik 1100 Simonton Street FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE Key West, FL 33040 INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ~ik.J! Robert Hessel/RANDNO ACORD 25 (2001/08) INS02S (0108)08 AMS o JII! Wolters Kluwer Financial Services @ACORD CORPORA TION 1988 Page1of2 COMMENTS/REMARKS Madison Regional Medical Center Canton, MS retro date 01/03 Medical Center of Mesquite Mesquite, TX retro date 01/02 Medical Center of SE Oklahoma Durant, OK retro date 05/87 Mesquite Community Hospital Mesquite, TX retro date 05/02 Midwest Regional Medical Center Midwest City, OK retro date 06/96 Mountainview Regional Medical Center Norton, VA retro date 02/05 Natchez Community Hospital Natchez, MS retro date 09/93 NW Mississippi Regional Medical Cntr Clarksdale, MS retro date 01/96 Pasco Regional Medical Center Dade City, FL retro date 09/00 Paul B. Hall Regional Medical Center paintsville, KY retro date 01/79 Peace River Regional Medical Center Port Charlotte, FL retro date 02/05 Physicians' Regional Medical Center Naples, FL retro date 05/06 Poplar Bluff Regional Medlcal Center IN) Poplar Bluff, MO retro date 11/03 Poplar Bluff Regional Medical Center (S) Poplar Bluff, MO retro date 11/03 Rankin Medical Center Brandon, MS retro date 01/97 Riley Hospital Meridian, MS retro date 01/98 River Oaks Hospital Flowood, MS retro date 01/98 Riverview Regional Medical Center Gadsden, AL retro date 07/91 Sandhi lIs Reoional Medical Center Hamlet, NC retro ~ate 08/87 Sandy Pines Tequesta, FL retro date 01/90 Santa Rosa Medical Center Milton, FL retro date 01/02 Sebastian River Medical Center Sebastian, FL retro date 09/93 Seven Rivers Regional Medical Center Crystal River, FL retro date 11/03 Southwest Regional Medical Center Little Rock, AR retro date 11/97 Spring Hill Regional Hospital Spring Hill, FL retro date 06/98 St. Cloud Regional Medical Center St. Cloud, FL retro date 02/06 Stringfellow Memorial Hospital Anniston, AL retro date 01/97 Summitt Medical Center (formerly Crawford Memorial) Van Buren, AR 05/87 Toppenish Hospital Toppenish, WA retro date 08/03 Twin Rivers Regional Medical Center Kennett, MO retro date 11/03 University Behavioral Center Orlando, FL retro date 01/89 University Medical Center Lebanon, TN retro date 11/03 Upstate Carolina Medical Center Gaffney, SC retro date 03/88 Venice Regional Medical Center Venice, FL retro date 02/05 Walton Regional Medical Center Monroe, GA retro date 09/03 Williamson Memorial Hospital Williamson, WV retro date 06/79 Woman's Hospital at River Oaks Flowood, MS retro date 01/98 Yakima Medical Center Yakima, WA retro date 08/03 OFREMARK COPYRIGHT 2000, AMS SERVICES INC. COMMENTS/REMARKS Health Management Associates, Inc. 5811 Pelican Bay Blvd, Ste 500 Naples, FL 34108 Addendum to Certificate of Insurance: Health Care Policy - including Hospital Professional Liability - Claims Made and Health Care Provider General Liability - Occurrence HAZI064410669-3 10/1/06-10/1/07 Each Person Limit/Each Occurrence Limit/Each Medical Incident - $1,000,000 Total Limit/General Aggregate (Combined GL/PL) - $10,000,000 shared by all coverages DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS The $10,000,000 Total Limit/General Aggregate Limit (Combined GL/PL) ("aggregate limit") for policy HAXI064410669-3 as specified on this Certificate is the total limit available for all covered claims under the policy, is shared by all insureds covered under the policy, including all HMA Hospitals, all employed physicians, and any and all other healthcare provide~s insured uncer the policy, and is tne most that the in~urer will pay under the policy. The aggregate limit is also shared by all of the coverages afforded under the policy, including Hospital Professional Liability and Health Care Provider General Liability coverages. The Additional Benefits, as defined in and provided under the policy, including all costs of defending a suit are also included within the aggregate limit. Any and all payments of indemnity amounts and/or defense costs made on behalf of any insured under the policy shall reduce and exhaust the $10,000,000 aggregate limits of the policy, as such limit is shared by all insureds. If you should have any questions concerning the amount of available insurance, please contact HMA Risk Management The following classes of medical employees of a Named Insured hospital facility, while acting within the course and scope of their employment by such facility, shall be protected parties, under this policy (shared limits basis): Certified Nurse Midwife Certified Registered Nurse Anesthetist Nurse Practitioners Physician Assistants Residents Interns Registered Nurses Nurses Assistants HOSPITALS, CLINICS OR AFFILIATES are covered under the following subsidiaries per written contract: Barrow Regional Medical Center Winder, GA retro date 01/06 Bartow Regional Medical Center Bartow, FL retro date 04/05 Biloxi Regional Medical Center Biloxi, MS retro date 09/86 Brooksville Regional Hospital Brooksville, FL retro date 06/98 Carolina Pines Regional Medical CenterHartsville, SC retro date 09/95 Central Mississippi Medical Center Jackson, MS retro date 04/99 Charlotte Regional Medical Center Punta Gorda, FL retro date12/94 Chester Regional Medical Center Chester, SC retro date 10/04 Davis Regional Medical Center Statesville, NC retro date 10/00 East Georgia Regional Medical Center Statesboro, GA retro date 10/95 Fishermen's Hospital Marathon, FL retro date 08/86 Franklin Regional Medical Center Louisburg, NC retro date 08/86 Gilmore Memorial Reg Medical Center Amory, MS retro date 12/05 Gulf Coast Medical Center Biloxi, MS retro date 06/06 Harton Regional Medical Center Tullahoma, TN retro date 11/03 Heart of Florida Regional Med Center Haines City, FL retro date 08/93 Highlands Regional Medical Center Sebring, FL retro date 08/85 Jamestown Regional Medical Center Jamestown, TN retro date 01/02 Lake Norman Regional Medical Center Mooresville, NC retro date 01/86 Lee Regional Medical Center Pennington Gap, VA retro date 09/01 Lehigh Regional Medical Center Lehigh Acres, FL retro date 12/01 Lower Keys Medical Center Key West, FL retro date 05/99 OFREMARK COPYRIGHT 2000, AMS SERVICES INC. ACORDN CERTIFICATE OF LIABILITY INSURANCE I DA~ (MMlDDIYYYY) 12/11/2006 PRODUCER (503)219-3227 FAX: (503)914-5427 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Beecher Carlson - New York ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 220 N W 2nd Ave. , Suite 800 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 2102 Portland OR 97209 FFORDlNG COVERAGE NAIC# INSURED ~t~;trVt INSURER A: L . oertv Mutual/Northwest Health Management Associates, Inc INSUR B 5811 Pelican Bay :Blvd. LO~rRE c. Ste 500 FEB 1 2 L SURE D. Naples FL 34108 INSURE E. THE POLICIES OF INSURANCE LISTED BELOW HA BEE ~NAMED AB VE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CO TRACT OJ=Rn aT ITH RE8PEC TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSU~:~~;T~F:.5'~~~I~A:~ I THE POLICIES ESCRIBE E TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AT T N ~.6.V~ j:::II=1= YP I INSR ADO'L ~l-{i~:~~&w~ Pg~~/~~~N LIMITS TYPE OF INSURANCE POL.ICY NUMBER ~NERAL LIABIL.ITY EACH ocr.! IRRENC" $ COMMERCiAl GE:NERAllIABILlTY ~~~~~J?E~~~~~nce I I CLAIMS MADE o OCCUR MED EXP Ar, one erson $ PERSONAL & MJV INJURY $ GEN!:RAl AGGREGATE I n'l AGG~En LIMIT Ar~.!~t,PER PRODUCTS COMplOP AGG $ PRO- POLICY I::OCT lOC ~TOMOBILE L.IABILlTY COMBINED SINGLE LIMIT $ 2,000,000 ~ ANY AUTO {Ea accident} A f- ALL OWNED AUTOS AS2651004245026 10/1/2006 10/1/2007 BODilY INJURY (Per person} $ ~ SCHEDULED AUTOS ~ HIRED AUTOS BODILY INJURY (Peraccidenl) $ ~ NON-OWNED AUTOS ~ $1,000 ded camp PROPERTY DAMAGE Sl 000 ded (Per accident} $ X collision ~RAGE WABIL'TY AUTO ONLY EA ACCIDENT $ ANY AUTO OTHER THAN c, .rr $ /" AUTO ONLY: AnG $ ::=JESS/UMBRELLA I~IABILITY \ \{)n. ,_~.i .-,. \ .r. $ OCCUR [J CLAIMS MADE -~-- - AGGREGATE $ $ 1 ~EDUCTlBlE I {}.' ;)..01 '-"-"- $ RETE"-ITION Of; I. WORKERS COMPENSATION AND 14: .- /1 I~~C Sif"JI~!::: I OJ~- EMPLOYERS' LIABILITY ~/Kl. ANY PROPRIETOR/PARTNEFUEXECUTIVE EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDI,:D? C EL DISEASE - EA EMPLOYEE $ ~~~~I~S~~~~~~~~s beklw ' . "" ~. ') '. EL DISEASE - POLICY LIMIT I OTHER ''"- C .' -<.- DESCRIPTION OF OPERATIONSlLOCATIONSlVEHICLESlEXCL.USlONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS MOnroe County is listed as an Additional Insured as respects the Named Insureds use of county school buses for evacuation of patients if there is a mandatory evacuation due to a hurricane. Location: Lower Keys Medical Center. I't:: r:n a, Yl C~ CERTIFICATE HOLDER CANCELLATION County of Mclnroe 1100 Simontcln Street Key West, Fl. 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING ....SURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Robert Hessel/INASHP ~lJJ 0.".." 1 n/? ACORD 25 (2001108) IJJCln')~"'"""\"Q AUC::: @ACORDCORPORATION 1988 l.I ThO \^,,,,,<,,~ 1<"1"""" !:;nanrko' c:",.."....... ACORON CERTIFICATE OF LIABILITY INSURANCE DATE (l!tMJDDJYYYYl 5/2/2001 PRODUCER (305)114-4400 rAX: (305) f-U01 THIS CERlIFI(;~TE IS ISSUED AS A MATTER OF INFORMAlION O~U AND C' NFERS NO RIGHTS UPON THE CER'TIFICATE HBA INSUlIANa: GIIOUP. INC. " J 'Il DER. THIS' CER'TIFlCATE DOES NOT AMEND!: EXTEND OR 2500 Nl'I 19th AveDtle Al. R THE COVERAGE AFFORDED BY THE POllCI S BELOW. suite' 101 , MAY MiaIIl:i !'L 33122 , : -, INStillERS AFFORDING COVERAGE NAIC# INSURED i INsuUR6:< A. Hartford :J:n8u:r:ance GroUD 00914 LONZll !'L tal\YS PHO, INC. I .. INSURER B ODe Beaccm .amezica P. O. BoX '9101 " " , INSURER C , ililstiRER D My West !'L 33041 INSURER E THE POLICIES OF INSURANCE LISTED BELOW H'WE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO """CH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSUR~CErr~FFORDED BY THE POLICI;:",~;~~~':'';~,,~~~;:::,'S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. E IMIT S Y ROY P 10 S. INSRIADD'\. TYPE OF INSURANCE POL-ICY NUMBER ~+i"':~~ ~~ ~>:.6Rf,mN LIMITS ~ERAL llABLITV 1,000,000 ~ 5'MERCIAL GENERAl "ABILITY ~~&~9g~~~encel . 300,000 A X - CLAIMS M;,DE [!] OCCUR 21SBldlQ812"7 5/1/2007 5/1/2008 MED E.XP AA" one arson' . 1.0,000 PER~NAl & /JDV IN IIRY . 1,000,000 I- GENERAL AGGREGATE $ 2,000,000 ~'l AGG~EnE LIMIT -ns PER' _,-,^Up""'o Af''''- $ 2,000,000 X 1 on, ,'-v ~;>~,Q,:- v' ~UTO"OBILE LIABI'UTY COMBINED SINGLE LIMIT $ 1,000,000 - JlNYAUTO {Eaacddent) A - .ALL O'M'lED JlJ.JTOS 21SBMllQ8121 5/1/2007 5/1/2008 BODILY INJJRY . - SCHEDULED AUTOS (Per person) ~ HIRED AUTOS BODILY IN..lIRY ~ NON-OW'lED Il"UTOS (PeracdclentJ I - PROPERTY [)/IMAGE I (PeraCddent) ~~OE LIABlLrN AUTO ONLY EAACCIDENT . JlNYAUTO OTHER THI>N 'AI'ce ^ " - -. ' ' AUTO ONLY />GO $ OSSAJMBRELI.A L1AEnLlTY P\.'\V, v.. / ,.cu $ OCCUR 0 CLAIMS MADE AGGREGATE $ 5:<6-V] ~'"m&.- ~ ~EDUCT'BLE \:. ,n,,_.' C I RETENTION , " WORKERS COMPENSATION AND ':f ,O~ -1 WO STN~o, I IOJ~- EMPL.OYERS' UABILlTY CC '. ANY PROPRIETORfPARTNERJEXECUT1VE E.L. EACH ACCDENT $ OFFICER/MEMBER EXCLUDED? NY,,;. 1--' ~=r:s~b~~I~~~<:> "'J'-' ELDISEASE-EAEMPlOYE E.l. DISEASE POLICY LIMIT I..: B OTHER Managed Care E'O HCP1'1940'1 5/1/2007 5/1/2008 Bach Cl.1m $1,000,000. Claims-Made aetro Date 0./01/99 AtillilIAVate $1,000,000. DESCRIPTION OF OftERAll0rt8A.OCATIOHBNEHICL.Es.Exa..USI0NB ADDED BY ENDORSEMENTISPEClAL PROVISIONS certifieate Holder' is included a. Additional Insured with respects to General Liabili ty. c:c:Hn~I1C~ /(fu< SHOll..O Atrt OF THE ABOVE DESCRBED POL.ICIES BE CANCELLED BEFORE Tl-lE MONROE COU1'l'1'r BOAlID or C=1C EXf'RAll0N DAle THEREOf, nE ISSUING INSURER WILL ENDEAVOR TO MAIL CCH(ISSIO_ .!L.. CAYS VtftTTEN NOllCE TO Tl-lE CERTlFICATE HOLDER NAMED TO THE LEFT, BUT Arr: MNIIA lIIoAVIK. tuSK _. 1100 sDdlm'rCIN ST. FAILURE TO DO so SHAL.L IMPOSE NO OBLlGAll0N OR UABLITY OF At('( KIND UPON 1l-E J(ZY MEST, !'L 33040 INSURER. ITS AGENTS OR REPAESENTAllVES. AUTHORIZED REPRESENTAllVE CJ? - -- HBA INSURANCE CERlIFICATE HOLDER CANCELLA liON ACORD 25 (2001108) INS025 (01(J8),08a "ACORD CORpORA'TION 19811 Pe\1l1of2 ACORD~ CERTIFICA TE OF LIABILITY INSURANCE I DATE (MMlDDfYYYY) 3/14/2007 PRODUCER (503)219-3227 FAX: (503)914-5427 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Beecher Carlson - New York o~fDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 220 N W 2nd Ave., Suite 800 1 MAY 7 TERTHE COVERAGE AFFORDED BY THE POLICIES BELOW. , Suite 2102 97209-1eb1 __v, Portland OR INSURERS AFFORDING COVERAGE NAIC# I .. -...-< " . fNSURERA: Liber.!:y Mutual Insurance 23043 INSURED Health Management Associates, In';:. ' . INS.UReR B: 5811 Pelican Bay Blvd. INSURER C Ste 500 INSURER D: Naples FL 34108 INSURER E: 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 ) RV PAin r.1 AI"" INSR AOO'L POLICY EFFECTIVE ~i'~%~~!gN LIMITS UR INSRO TYPE OF INSURANCE POLICY NUMBER OATE MM/OOIYY GENERAL LIABILITY EACIi.QCCURRENCE . - ~~~~~~JO RENTED eel COMMERCIAL GENERAL LIABILITY $ J CLAIMS MADE 0 OCCUR MED EXeJAny o~person . EEHSONAU~ I RV . lGeNERA!.AGGBmAT . 4'LAGG~En LIMIT :0 PER: PR()ntt("~p AM . POUCY I ~ LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - (Eeaccident) . ANY AUTO - .~ - ALL O'MIIED AUTOS "d'\~~ · BOOIL Y INJURY (Per person) . - SCHEDULED AUTOS r HIRED AUTOS BODILY INJURY :) (Per accident) . r NON-O'MIIED AUTOS ~r_ ~ .'0 .... r- PROPERTY DAMAGE . (Par accident) GARAGE LIABILITY O)b'}' DM)!. AUTO ONLY. EAACCIDENT . ~ ANY AUTO OTHER THAN EA ACC . AUTO ONLY: AGG . EXCESS/UMBRELLA LIABILITY C \ .~ YJI $ ~ OCCUR o CLAIMS MADE r' , AGGREGATE ~~l. . f . q ~EDUCTIBLE . RETENTION S rU- . A WORKERS COMPENSATION AND X we STATU. IOJ~' EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT . 1,000,000 OFFICERIMEMBER EXCLUDED? WA7GSDOO4245016 lC/1/200G 10/1/2007 EL DISEASE - EA EMPlOYEE . 1,000,000 ~~~6:s~~~~~;~s be~ E,l. DISEASE - POLICY LIMIT . 1,000,000 OTHER DESCRIPTION OF OPERA TJONSlLOCA TIONSNEHICLES/EXCLUSlONS ADDEO BY ENDORSEMENTISPECIAL PROVISIONS The Certificate Holder is listed as an Additional Insured. Re: Lower Florida Keys Physician Hospital Organization, Inc. CC' h~tL+'1~ . CERTIFICATE HOLDER Monroe County Board of Commissioners c/o Monroe County Risk Management Attn: Monique Diaz 1100 Simonton Street Key West, FL 33040 ACORD 25 (2001/08) II\JCl;n?.II;",."o,,,o 4UCl; ---.---..- -----..---.-.- Ill... \AInI""'.I(I,".....~"on,.i..tc::_,".....c P"",..1 nf? CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTlFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 so SHALL IMPOSE NO OBLlGA TlON OR LIABILITY OF ANY KINO UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Robert Hessel/RANDNO ~/kJ @ACORDCORPORATlON 1988 it kQR[)~ CERTIFICATE OF LIABILITY INSURANCE DATE (MMIODIYYYY) 9/21/2007 PRODUCER (646)358-8500 FAX: (646)358-8590 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Beecher Carlson - New York ._-----,-._- THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 7 Times Square RECEIVED ALTER HE COVERAGE AFFORDED 8Y THE POLICIES BELOW. Suite 2102 .--.'.. .. _.~-_..~... -."'1 New York NY 10036 INS RER AFFORDING COVERAGE NAIC# INSURED SEP 27 i;'n INS ERA: ibertv Mutual Insurance 23043 ,:,\JI",. Health Management Associates, Inc INSU ER B 5811 Pelican Bay Blvd, INSl ERe: Ste 500 l -----.---. .,~. MOi,;r-i2E COUNTY INSURER D' Naples FL 34108 2710Ri'~'.~'i..~\G~M[i!T lI>IS~.' 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. o IIM,T<SHnWN'MAY HAVF BFFN R'F~Dlir'EO By PAID CI AIM~. rl~:: ADD'L P~l-+~~ri~~g,wlE Pg~!fJ ~~~C~\gN LIMITS IiNSRD TYPE OF INSURANCE POLICY NUMBER ~NERALlIABllITY EACH' $ COMMERCIAL GENERAL LIABILITY ~~~FE TO RENT~~ncel $ J CLAIMS MADE 0 OCCUR MED EXP (An" one parson) $ "- p<oon, l & ADV N.H JRY $ GENERAL AGGREGATE $ -~~r~ AGGREGATE LIMIT APPLIES PER PR()DllrT'l. _ r()lAp/()P AC~r.. $ .1'1' PRO. n', POLICY '1';'''r:T LOC ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Eaaccidant) f-- ANY AUTO I- ALL OWNED AUTOS BODILY INJURY (0\ \i (Per person) $ - SCHEDULED AUTOS diJ1 - HIRED AUTOS BODILY INJURY (Peraccidenl) $ NON-OWNED AUTOS ''C "- ~~b) - PROPERTY DAMAGE $ (Peraccidant) ~R~GE LIABILITY 7' AUTO ONLY - EA ACCIDENT $ ANY AUTO , (()/l,( 1 OTHER THAN EAr.rr $ f\\ / AUTO ONLY AGG $ pESS/UMBRELLA LIABILITY VI' :" ~. V' FAN $ OCCUR 0 CLAIMS MADE ,) ,~~ AGGREGATE $ 0 $ R DEDUCTIBLE $ RJ:;:TENTl()lj <I; , A WORKERS COMPENSATION AND I WC STATU__ J /OJi," EMPLOYERS' LIABILITY ANY PROPRIETORlPARTNERIEXECUTIVE EL. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? WA765DOO424S017 10/1/2007 10/1/2008 EL. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under ,<:;PFrIAL PR()VI~IONS bel w EL. DISEASE POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLESfEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS The Certificate Holder is listed as an Additional Insured. Re, Lower Florida Keys Physician Hospital Organization, Inc. Q..e " c= ~ V\..CUL.4..L- CERTIFICATE HOLDER Monroe County Board of c/o Monroe County Risk Attn: Monique Diaz 1100 Simonton Street Key West, FL 33040 Commissioners Management -- --- ---- --- , - ACORD 25 (2001/08) INS025 (01081.08a CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIl. ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Robert Hessel/STESTO ~~ @ACORDCORPORATlON1988 A CJ)RD CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DOfYYYV) ----"--- .-..---...... 9/21/2007 PRODUCER (646)358-8500 FAX: (646)358-8590 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Beecher Carlson - New York ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ---"-- R. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 7 Times Square r-f)f'~-J'~ L \ It f' ALTEF THE COVERAGE AFFORDED 8Y THE POLICIES 8ELOW. Suite 2102 I 'r! ! ' - ,J 1,_ ,.., < . 1 r- . . New York NY 1003 6 INSURE S AFFORDING COVERAGE NAIC# INSURED ! INSURER A: Liberty Mutual/Northwest Health Management Associatesr Incj:. .- INSURER B: 5811 Pelican Bay Blvd. 34101 INSURER C Ste 500 , ;-" INSURER D' Naples FL . .INSU~R-E:.J . 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 DESCRIBE~I~~~IN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES jlAlTc:. c:.H y I-IllVI= RI=I= R BY PAl 1M'<=:' INSR ADD'L PJ>;+i~~~~68~~IE Pg~lflf~~~~N LIMITS TYPE OF INSURANCE POLICY NUMBER ~NERAL L1AB1LlTY EA RO' '0 . COMMERCIAL GENERAL LIABILITY ~~~~~.J?F~ENT~~n"..\ . ! CLAIMS MADE: D OCCUR MED EXP An one erson\ . PER<::nNAl R. Am/INIII~Y . GENERAL AGGREGATE . n'L AGG~nE LIMIT AAES PER: oRnn"o' "np '00 . POLICY ffRi LOC ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT . 2,000,000 f2'- ANY AUTO (Eaaccident) A r- ALL OWNED AUTOS AS2651004245027 10/1/2007 10/1/2008 BODilY INJURY (Per person) . ~ SCHEDULED AUTOS ~ HIRED AUTOS BODilY INJURY (Per accident) . ~ NON-OWNED AUTOS X $1,000 ded camp PROPERTY DAMAGE $1 000 ded (Per accident) . X collision RRAGE LIAB'LITY AUTO ONLY - EA ACCIDENT . ANY AUTO OTHER THAN EAACC . /' AUTO ONLY: AGG . pESSIUMBRELLA LIABILITY \,')\\ ", \ ; . OCCUR D CLAIMS MADE AGGREGATE . ~'~ ~J. 5-0) . R DEDUCTISLE . RETENTION $ \.1 !, WORKERS COMPENSATION AND (( 00 Q....,:' I T,;>;~m..W" I IO,T.\' EMPLOYERS' LIABILITY U't(J ANY PROPRIETOR/PARTNER/EXECUTIVE El. EACH ACCIDENT . OFFICER/MEMBER EXCLUDED? - IU~ If yes, describe under . El. DISEASE _ EA EMPLOYEE $ SPECIAL PRoVIsioNS bel w E.l. DISEASE - POLICY LIMIT $ OTHER \-.--\. , DESCRIPTION OF OPERATIONSfLOCATIONSfVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The Certificate Holder i.s listed as an Additional Insured as required per written contract. c...c.. '. \= \ "'-Q..v\,C,L. CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commission Attn: Risk Management Administrator P. O. Box 1026 Key West, FL 33041-1026 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLlGAT10N OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ~ ~ /'r' ~ I. /) Robert Hessel/STESTO ~~ ACORD 25 (2001/08) INS025 (0108).08a @ACORDCORPORATION1988 AC08D~ CERTIFICA TE OF LIABILITY INSURANCE DATE (MMJDDfYYYV) 9/18/2007 PRODUCER (646)358-8500 FAX: (646)358-8590 THIS CERTIFICATE IS ISSUED AS A MAHER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Beecher Carlson - New York HOLDER. - THI~ CERTIFICATE DOES NOT AMEND, EXTEND OR 7 Times Square ALTER THE C - VERAGE AFFORDED BY THE POLICIES BELOW. Suite 2102 New York NY 10036 INSURERS AFFORDING COVERAGE NAIC# INSUReD INSURER A: Col umbia Casua1tv Company Health Management Associates, Inc. INSURER B 5B11 Pelican Bay Blvd. . INSURER C Ste 500 3410B-271l [:iIC~~;WE G ~RER D: I Naples FL HlSK r,.:ri~.'f\G :1., J ,- - -,- 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. TFI iMIT< <HOWN'MAY HAVF BY PAID CLAIMS I~:: A~~'~ TYPE OF INSURANCE POLICY NUMBER PJ'..t+i~.i~~~8~IE Pg~lfJf~~~~~~N LIMITS ~NERAL LIABILITY I EACH nee, ,0R""e" $ 1,000,000 X COMMERCIAL GENERAL LIABILITY ~~*~.J?F~ENT~~mcel $ A I CLAIMS MADE [i] OCCUR HAZl0644l06695 10/1/2007 10/1/2008 MED EXP IAnll one ersol!} $ - AOS Except PA PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ 11,000,000 ~'L AGG:Er LIMIT APPLIES PER: PRnDuCTS ' cnMp/np ACC $ f~T n- X POLICY T LOC ~TOMOBtLE LIABILITY COMBINED SINGLE LIMIT $ (Eaaccident) I-- ANY AUTO I- ALL OWNED AUTOS BODILY INJURY (Per person} $ I- SCHEDULED AUTOS "- HIRED AUTOS )n BODilY INJURY $ NON-OWNED AUTOS 111. \i DIe n~') (Per accident) I-- - ~.Y:s . ~~RTY DAMAGE $ ':..<A. aCCident) ==rAGE LIABILITY Kdl -u !) AUTO ONLY - EA ACCIDENT $ ANY AUTO '" OTHER THAN EAAr:r: $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY cai 'J I EACh $ W OCCUR 0 CLAIMS MADE C {L 3--~ AGGREGATE $ i)' , '-v-' $ R DEDUCTIBLE . , I 11 'f. 'p -- $ 1/, - - RFTENTlON 1 " WORKERS COMPENSATION AND I WC STATU- IO'!,\" EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.l. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.l. DISEASE. EA EMPLOYEE $ If yes. describe under SPECJAL PROVISIONS below E.l. DISEASE - POLICY LIMIT $ A OTHER Hospi tal HAZl0644l06695 10/1/2007 10/1/2008 Each Medical $1,000,000 Professional Claims Made Incident Annual Aaareaate $11,000,000 DESCRIPTION OF OPERA TIONS/LOCA TlONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The Certificate Holder is listed as an Additional Insured as required by written contract regarding Lower Keys Medical Center, 5900 College Road, Key West, FL 33040. Q c.; f; "'-o..Vl C. -L. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2001/08) @ACORD CORPORATION 1988 INS02S (0108}.08a Page 1 of 2 - -. __ __. _._u__._ _ _ ____ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE r'17 ~ /t - _,. /J. Robert Hessel/STESTO ~~ Monroe County Board of Commissioners c/o Monroe County Risk Management Attn: Maria Slavik 1100 Simonton Street Key West, FL 33040 COMMENTS/REMARKS Health Management Associates, Inc. 5811 Pelican Bay Blvd, Ste 500 Naples, FL 34108 Addendum to Certificate of Insurance: Health Care Policy - including Hospital Professional Liability - Claims Made and Health Care Provider General Liability _ Occurrence HAZ10644106695 10/1/07-10/1/08 Each Person Limit/Each Occurrence Limit/Each Medical Incident _ $1,000,000 Total Limit/General Aggregate (Combined GL/PLj - $11,000,000 shared by all coverages DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS The $11,000,000 Total Limit/General Aggregate Limit (Combined GL/PL) ("aggregate limit") tor policy HAXI0644106695 as specified on this Certificate is the total limit available for all covered claims under the policy, is shared by all insureds covered under the policy, including all HMA Hospitals, all employed physicidns, and any and all other healthcare providers insured under the policy, and is the most that the insurer will pay under the polic~(. The aggregate limit is also shared by all of the coverages afforded under the policy, including Hospital Professional Liability and Health Care Provider General Liability coverages. The Additional Benefits, as defined in and provided under the policy, including all costs of defending a suit are also included within the aggregate limit. Any and all payments of indemnity amounts and/or defense costs made on behalf of any insured under the policy shall reduce and exhaust the $11,000,000 aggregate limits of the policy, as such limit is shared by all insureds. If you should have any questions concerning the amount of available insurance, please contact HMA Risk Management The following classes of medical employees of a Named Insured hospital facility, while acting within the Course and scope of their employment by such facility, shall be protected parties, under this policy (shared limits basis): Certified Nurse Midwife Certified Registered Nurse Anesthetist Nurse Practitioners Physician Assistants Residents Interns Registered Nurses Nurses Assistants OFREMARK COPYRIGHT 2000, AMS SERVICES INC. A co CERTIFICATE OF LIABILITY INSURANCE `� DATE ,0/0,/20„ (MM /DD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOR ` 1 • • • ■ Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIV LY AME `11 - - - • . HE COVERAGE AFFORDED BY THE POLICIES t BELOW. THIS CERTIFICATE OF INSURANCE DOES N • CONSTI * _ f, T B " - - THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICA ' HOLDER. �" - Ali/ IMPORTANT: If the certificate holder is an ADDITIONAL SURED, the policy(ies) must be endo =d. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies m- require agppdorsement. A statement n this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). V(,1 4 NM • PRODUCER CONTACT Marsh USA, Inc. NAME PHONE FAX 1801 West End Avenue, Suite 1500 , . (A/C, No): • Nashville, TN 37203 r AsIIRER( AFFORDING COVERAGE NAIC # 072392 - ALL- ALIWC -11 -12 KeyWes INSURER A: Liberty Insurance •rporation 42404 INSURED INSURER B : Liberty Mutual Fire Insurance Compan 23035 Health Management Associates, Inc. 5811 Pelican Bay Boulevard, Suite 500 INSURER C : Naples, FL 34108 -2710 INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: ATL 002932464 - 11 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE A SR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MM /DD/YYYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ ■ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES (Ea occurrence) $ ■■ CLAIMS -MADE OCCUR MED EXP (Any one person) $ ■ PERSONAL 8 ADV INJURY $ ■ GENERAL AGGREGATE $ ` GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ _ POLICY ,IF LOC $ B AUTOMOBILE LIABILITY AS2 651 - 004245 - 021 10/01/2011 10/01/2012 COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ © ANY AUTO BODILY INJURY (Per person) $ . ■ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON -OWNED PROPERTY DAMAGE $ © HIRED AUTOS X AUTOS (Per accident) $ UMBREL A LIAR OCCUR EACH OCCURRENCE $ ■ EXCESS LIAB ■ CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION WA7 - 65D - 004245 - 011 10/01/2011 10/01/2012 X WC STATU - OTH- AND EMPLOYERS' LIABILITY y/ N TORY LIMITS ER 1,000,000 ANY PROPRIETOR /PARTNER /EXECUTIVE E.L. EACH ACCIDENT $ OFFICER /MEMBER EXCLUDED? N N / A (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 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) . Re: Lower Florida Keys Physician Hospital Organization, Inc. , Monroe County Board of County Commissioners is named as additional insured as respects Automobile Liability as required by wirtten contract. 4 CERTIFICATE HOLDER CANCELLATION Monroe County Board of Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE c/o Monroe County Risk Management THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Monique Diaz ACCORDANCE WITH THE POLICY PROVISIONS. e 1100 Simonton Street Key West, FL 33040 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. / • Marjorie L. Rippy 1+•r.�e..a_ aS . �i•py i G C. © 1988 -2010 ACORD CORPORATION. 1 rig reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD C n a, lf22 , I ACORD ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4....■--- 10/03/2012 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 (`coTUarATF unl r1FR IMPORTANT: If the certificate holder is an At DITIONAL icy(ies) mlist be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may re u rsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(: ). PRODUCER CONTACT Marsh USA, Inc. NT 1 r ' , � HON 1801 West End Avenue, Suite 1500 1,A /C. No. Est): (A/C, No): Nashville, TN 37203 E - MAIL ADDRESS: MONROE COUNTT INSURER(S) AFFORDING COVERAGE NAIC # 072392 - ALL- ALANC -12 -13 KeyWes RISK Mt>,NA(;FME19 A : L l erty Insurance Corporation _ 42404 INSURED INSURER B : c�erty Mutual Fire Insurance Company 23035 Health Management Associates, Inc. 5811 Pelican Bay Boulevard, Suite 500 INSURER C : Naples, FL 34108 -2710 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: ATL 002932464 - 13 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR W NCR VD POLICY NUMBER (MM /DD/YYYY) (MM /DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ • CLAIMS -MADE OCCUR B P i - M MED EXP (Any one person) $ W N PERSONAL 8 ADV INJURY $ — GENERAL AGGREGATE $ r GEN'L AGGREGATE LIMIT APPLIES PER: �;' City^�� PRODUCTS - COMP/OP AGG $ — I POLICY PRO- LOC -' .. ' $ .IFfIT B AUTOMOBILE LIABILITY AS2 651 004245 - 022 10/01/2012 10/01/2013 COMBINED SINGLE LIMIT 1,000,000 (Ea accident)_ -- _ _.$ —. -- X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS X x NON -OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) PIP $ STATUTORY UMBRELLA LIAB OCCUR EACH OCCURRENCE _ $ EXCESS UAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION WA7 - 65D - 004245 10/01/2012 10/01/2013 X WC STATU OTH- AND EMPLOYERS' LIABILITY Y / N TORY LIMITS ER _ ANY PROPRIETOR /PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N I N / A — - (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 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Re: Lower Florida Keys Physician Hospital Organization, Inc. Monroe County Board of County Commissioners is named as additional insured as respects Automobile Liability as required by wirtten contract. cc . (.7a..2,-.0 CERTIFICATE HOLDER CANCELLATION Monroe County Board of Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE c/o Monroe County Risk Management THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Monique Diaz ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West, FL 33040 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Marjorie L. Rippy T+r.•}}w:d rS . s4 i py.. © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD