2017-487-E Health - Stratus Video, LLC for video remote interpretation

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DocuSign Envelope ID:C3ACE658-720C-402F-AE1C-C7B9F4726DB6 ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) �.,.,. 2/5/2018 2/6/2017 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LOCKTON COMPANIES CONTACT NAME: 500 West Monroe,Suite 3400 PHONE FAX (A/C.CHICAGO IL 60661 E-MAILo Ext): (A/C,No): (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 1407437 CSDVRS,LLC&CSDVRS INSURER C: Management Services,Inc. INSURER D: 600 Cleveland St.,Ste 1000 Clearwater,FL 33755 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 14499527 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 ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY N N 83UUNZH0043 2/5/2017 2/5/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE RETE CLAIMS-MADE X OCCUR PREMISES O(Ea occur ence) $ 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 PRO-JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: B AUTOMOBILE LIABILITY N N 83UUNZH0043 2/5/2017 2/5/2018 COMBINED NGLE LIMIT $ (Ea accident)SI 1,000,000 ANY AUTO BODILY INJURY(Per person) $ XXXXXXX AUTOOWNED ONLY SCHEDULED BODILY INJURY(Per accident) $ XXXXXXX X HIRED y NON-OWNED PROPERTY DAMAGE $ XXXXXXX AUTOS ONLY AUTOS ONLY (Per accident) $ XXXXXXX B x UMBRELLA LIAB OCCUR N N 83RHUVV9773 2/5/2017 2/5/2018 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ $ XXXXXXX WORKERS COMPENSATION NOT APPLICABLE PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ XXXXXXX OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ XXXXXXX If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ XXXXXXX DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 14499527 Evidence of Insurance SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRE4,ENTATI J i q 0 88-2 5 ACORD O 19 �1'' � CORD CORPORA TIN. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD