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<br />..:0-5 0tO~ ,Ll c.. 6-( bf~ L-(PrSSrc.. Ck4Ecr-~ <br />~w No: l\-O~-O\ <br />3<{ <br /> <br />ACORD'M CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDfYYYY) <br />4/14/2011 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />THE PHYSICIANS ADVOCATE. LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />630 J NW 5TH WAY. SUITE 1800 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />FORT LAUDERDALE. 1'1. 3330<) Al TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> INSURERS AFFORDING COVERAGE NAIC # <br />INSURED INSURER A' ADMIRAL INSURANCE CO <br />INDEPENDENT LIVING SYSTEMS, LLC INSURER B CHARTIS <br />5201 BLUE LAGOON DR, SUITE 270 INSURER C SCOTTSDALE INSURANCE COMPANY <br />MIAMI, FL 33126 INSURER D DARWIN SELECT INSURANCE CO, <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHST ANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF <br />SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS <br />IN$R DD' POLICY EFFECTIVE POLICY EXPIRATION <br />LTR TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDIYY DATE MMIDDNYl LIMITS <br />A ~NERAL LIABILITY EACH OCCURRENCE 1 000 000 <br /> ~ COMMERCIAL GENERAL LIABlITY ~~~~~~~~E~E~~~~RENCE))l 100,000 <br /> - :=]CLAIMS MADE 00CCUR CAOOO014193-01 06/06/2010 06/01/2011 MED EXP (Anyone person) 50 000 <br /> PERSONAL S. AOV INJURY 1 000 000 <br /> GENERAL AGGREGATE 3,000000 <br /> ~;L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG 2,000000 <br /> nPRO. n <br /> POLICY JEeT lOC <br /> ~TOMOBllE LIABILITY COMBINED SINGLE LIMIT <br /> (Ea accident) <br /> - ANY AUTO <br /> - ALL OV\INEO AUTOS BODIL Y INJURY <br /> (Per person) <br /> - SCHEDULED AUTOS <br /> HIRED AUTOS BODIL Y INJURY <br /> - (Per accident) <br /> - N ON-OWN ED AUTOS <br /> PROPERTY DAMAGE <br /> (pet accident) <br /> r=rGE LIABILITY AUTO ONL Y - EA ACCIDENT <br /> ANY AUTO OTHEH THAN EA ACC <br /> AUTO ONL Y AGG <br /> EXCESSfUMBRELLA LIABILITY EACH OCCURRENCE <br /> DOCCUR DCLAIMS MADE AGGREGATE <br /> R;DUCTIBLE <br /> ETENT10N <br /> WORKERS COMPENSATION AND I WC STATU. I 10TH. <br /> EMPLOYERS' LIABILITY X TORY LIMITS ER <br />B ANY PROPRIETOR/PARTNERfEXECUTIVE E,L. EACH ACCIDENT 500,000 <br /> OFFICER/MEMBER EXCLUDED? WC 007158687 01/14/2011 01/14/2012 <br /> E,L. DISEASE - EA EMPLOYEE 500,000 <br /> If yes, descnbe under <br /> SPECIAL PROVISIONS below E.L. DISEASE - POliCY LIMIT 500,000 <br />C $500,000 EACH CLAIM <br />CRIME EKS3020265 06/12/2010 06/12/2011 $500,000 AGGREGATE <br /> $10,000 RETENTION <br /> MANAGED CARE 1,000,000 EACH CLAIM <br />0 ERRORS & OMISSIONS 0305-2453 01/01/2011 01/01/2012 1,000,000 AGGREGA TE <br /> COVERAGE 20,0000 DEDUCTIBLE EACH CLAIM <br />DESCRIPTION OF OPERATlONS/LOCATlONSIVEHICLES/EXCLUSIONS ADDEO BY ENDORSEMENT/SPECIAL PROVISIONS <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCEllATION <br /> <br />OFFICE OF THE CITY CLERK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />CITY OF SUNNY ISLES BEACH DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _..1..!L DAYS WRITTEN <br />18070 COLLINS AVENUE NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL <br />SUNNY ISLES BEACH, FL, 33160 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE INSURER, ITS AGENTS OR <br />R EPRESENTA TIVES. <br /> AUTHORIZED REPRESENT ATlVE <br /> , <br /> <br />ACORD 25 (2001/08) <br /> <br />@ACORD CORPORATION 1988 <br />