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<br />A CORDr.. CERTIFICATE OF LIABILITY INSURANCE I DATE (MIWOOIYYYY) <br />04/03/2012 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />~HE PHYSICIANS ADVOCATE, LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />6301 NW 5111 WAY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />SUITE 2800 AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />FT. LAUDERDALE. FL 33309 <br />954-491 -8052 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED INSURER A: ADMIRAL INSURANCE COMPANY <br />INDEPENDENT LIVING SYSTEMS, LLC INSURER B: SCOTTSDALE INSURANCE COMPANY <br />5201 BLUE LAGOON DRIVE, SUITE 270 INSURER C: DARWIN SELECT INSURANCE COMPANY <br />MIAMI, FL 33309 INSURER D: <br /> INSURER E: <br /> <br />COVERAGES <br /> <br /> THE POLICIES OF INSURANCE LISTED BELON HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,N01WrTHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 />INSR DD'L POLICY EFFECTIVE POLICY EXP I RATION <br />LTR NSRD TYPE OF INSURANCE POLICY NUMBER DATE MMIDDIYYI DATE IMMIDD/yy) LIMITS <br />A X .J!ENERAL LIABILITY EACH OCCURRENCE 1 000 000 <br /> DAMAGE TO RENTED <br /> X COMMERCIAL GENERAL LIABLlTY PREMISES lEA OCCURENCEm 50 000 <br /> - ~ [KJOCCUR <br /> CAOOO014193-03 06/01/2011 06/01/2012 MEO EXP (Anyone person) 50 000 <br /> - <br /> PERSONAL & ADV INJURY 1,000,000 <br /> GENERAL AGGREGATE 3 000 000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COM PlOP AGG 2 000 000 <br /> --, ,--, ,--, <br /> ~UTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> (fa accident) <br /> - ANY AUTO <br /> ALL CWVNED AUTOS BODILY INJURY <br /> - (Per person) <br /> - SCHEDULED AUTOS <br /> HIRED AUTOS BODILY INJURY <br /> - (Per accident) <br /> - NON,CWVNED AUTOS <br /> PROPERTY DAMAGE <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY- EAACCIDENT <br /> ~ANY AUTO OlliER lliAN EA ACC <br /> AUTO ONLY: <br /> AGG <br />A EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE 5,000,000 <br /> ~OCCUR DCLAIMS MADE EXOOO012006-02 06/01/2011 06/01/2012 AGGR EGI\ TE 5 000 000 <br /> R~DUCTIBLE <br /> ETENTION <br /> WORKERS COMPENSATION AND I WC STATU, I lOlli, <br /> EMPLOYERS' LIABILITY X TORY LIMITS X ER <br /> ANY PROPRIETORlPARTNERlEXECUTIVE E,L EACH ACCIDENT <br /> OFFICER/MEMBER EXCLUDED? <br /> EL DISEASE - EA EMPLOYEE <br /> tf yes, describe under <br /> SPECIAL PROVISIONS b~ow E,L DISEASE - POLICY LIMIT <br /> OTHER $500,000 EACH CLAIM <br />B CRIME EKS3040297 06/01/2011 06/01/2012 <br /> $500,000 AGGREGATE <br /> $10,000 RETENTION <br />C OTHER 0305-2453 01/01/2011 01/01/2012 $1,000,000 EACH CLAIM <br /> MANAGED CARE $3,000,000 AGGREGATE <br /> ERRORS & OMISSIONS <br /> COVERAGE $20,0000 DEDUCTIBLE EACH CLAIM <br />DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> <br />ADDITIONAL INSURED <br /> <br />CANCELLATION <br /> <br /> 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 -!!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 KIND UPON THE INSURER. ITS AGENTS OR <br /> REPRESENTATIVES. <br /> AUTHORIZED REPRESENT!,T"'" C' ') <br /> ,. \ /) . QZ ,) {'.-- <br /> ~,_..f~. .-I.."-"~' IV. ...--.-- ./'....4._~. -"--'-r--~ <br /> <br />ACORD 25 (2001/08) <br />TLS (CrOlcp, LL(~ d..Jlofa C /ASS','c. C~,*(f'E'q5 <br />RFP ;\l(), '. 1.,:2- 03 -.0;).. <br /> <br />@ACORD CORPORATION 1988 <br /> <br />'PJ~ 3'-1 <br />