2016-210-E Health - Stratus Video, LLC for video remote interpretation

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DocuSign Envelope ID:818337D8-7142-453C-8DE1-5D9B9AO37D1E 72/8/2016 E(MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE L....".� 2/5/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LOCKTON COMPANIES CONTACT NAME: 500 West Monroe,Suite 3400 PHONE FAX IA/C.No Ext: A/C No): CHICAGO IL 60661 E-MAIL (312)669-6900 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Hartford Underwriters Insurance Company 30104 INSURED Video Group Holdings,LLC INSURER B:Hartford Casualty Insurance Company 29424 1408101 Stratus Video,LLC INSURER C:Aspen Specialty Insurance Company 10717 33 N Garden Ave,Suite 1000 INSURER D:Hartford Fire Insurance Company 19682 Clearwater,FL 33755 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 13891819 REVISION NUMBER: XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR IN SD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X N N $3UUN2II0043 2/5/2016 2/5/2017 DAMAGE TO RENTED CLAIMS-MADE � OCCUR PREMISES Ea occurrence) $ 300,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PE� 1:1 [::] LOC PRODUCTS-COMP/OP AGG $ Included OTHER: $ B AUTOMOBILE LIABILITY N N 83UUN2I30043 2/5/2016 2/5/2017 COMBINED SINGLE LIMIT $ Ea accident 1 000'000 ANY AUTO BODILY INJURY(Per person) $ XXXXXXX ALL AUTOS OWNED SCHEDULED BODILY INJURY(Per accident) $ XXXXXXX X X NON-OWNED PROPERTY DAMAGE $ XXXXXXX HIRED AUTOS AUTOS Per accident $ XXXXXXX B X UMBRELLA LIAB OCCUR N N 83RIIUVV9733 2/5/2016 2/5/2017 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ $ XXXXXXX WORKERS COMPENSATION NOT APPLICABLE __7—ER OTH- AND EMPLOYERS'LIABILITY TATUTE Y ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N A E.L.EACH ACCIDENT $ XXXXXXX OFFICER/MEMBER EXCLUDED? / (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ XXXXXXX If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ XXXXXXX C E&O N N LP81772 2/5/2016 2/5/2017 $3,000,000 Agg. D Property 83UUN2I10043(Property) 2/5/2016 2/5/2017 $3,163,004 BPP C Coastal Property ESP730276500 2/5/2016 2/5/2017 $3,104,682 Per Occ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The following are included as Named Insureds:Video Group Holdings,LLC;Stratus Video Group,LLC;Stratus Video,LLC CERTIFICATE HOLDER CANCELLATION 13891819 Stratus Video,LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Clearwater,FL THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE r R r, d -20@ ' 1988 14 ACORD CO RPOR TON. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD