318-22 Exhibit A-Coronis Health for Emergency Transport Third Party Billing - 2022.pdf

@ = DATE (MMIDDIYYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE ae 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 fiaues°” Dan McMullen. Woodruff-Sawyer & Co. oe 617-658-7103 TE One Liberty Square, Suite 600 4alC, to ext, 617-658-7 INE, Not: Boston MA 02109 AbbREss: dmemullen@woodruffsawyer.com INSURER(S) AFFORDING COVERAGE NAIC # insurer A: Hartford Fire Insurance Company 19682 INSURED : Hartford Casual Cc 29424 Coronis Health, LLC INSURER B wa a 7 a insurance ompany a (See Below for Full Named Insured Listing) usurer ¢: Trumbull Insurance Company 5963 Exchange Drive, Suite #114 INSURER D: Sykesville MD 21784 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 2133032501 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. re TYPE OF INSURANCE Rea POLICY NUMBER (HMIODH TY) | (MDB Lams C |X | COMMERCIAL GENERAL LIABILITY Y ‘OB8UUNBB1832 712ai2022 | 7/24/2023 | EacH OCCURRENCE $1,000,000 cuams-mave [X] occur PREMISES (ca cwsurence) | $300,000 |_| MED EXP (Any one person) _| § 10,000 ba PERSONAL & ADVINJURY | $ LIMITED | GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE __| $2,000,000 LX] poucy |_| S807 Loc PRODUCTS - CoMPIOP AGG | § 2,000,000 OTHER: Ss C | AUTOMOBILE LIABILITY ‘08UENBB9182 7124/2022 | 7/24/2023 |

| GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE __| $2,000,000 LX] poucy |_| S807 Loc PRODUCTS - CoMPIOP AGG | § 2,000,000 OTHER: Ss C | AUTOMOBILE LIABILITY ‘08UENBB9182 7124/2022 | 7/24/2023 | GOMBINEDSINGLELIMIT | $7,000,000 (ANY AUTO. BODILY INJURY (Per person) | $ SgHEQULED BODILY INJURY (Per aon] § NON-OWNED PROPERTY DAMAGE AUTOS ONLY (Per ident) ® |X Jumereuauas [XT occur ‘O8XHUBB1412 7242022 | 7124/2023 | EacH OCCURRENCE $5,000,000 EXCESS AB CLAIMS-MADE AGGREGATE $5,000,000 peo | X [RETENTIONS 4 ona ‘A [WORKERS COMPENSATION, vm ‘OBWEAGSB1U 7ieai2o22 | 7124/2023 |X |EERure | [eat ANYPROPRIETORUPARTNERVEXECUTIE aa EL. EACH ACCIDENT $1,000,000 |(Mandatory In NH) E.L, DISEASE - EA EMPLOYEE] § 1,000,000 ELL. DISEASE - POLICY LIMIT | $ 1,000,000 yes, describe under DESCRIPTION OF OPERATIONS bolow DESCRIPTION OF OPERATIONS / LOCATIONS // VEHICLES (ACORD 101, Additional Ramarks Schadulo, may bo attached If more space Is roquired) Additional Named Insureds: CORONIS HEALTH RCM, LLG SUPPORTMED, LLC CORONIS GLOBAL, LLC CRT MEDICAL SYSTEMS, INC. ML. MEDICAL BILLING COMPANY MEDICAL BILLING UNLIMITED, INC. CORONIS GLOBAL, INC. See Attached... CERTIFICATE HOLDER. CANCELLATION ‘SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. HORIZED REPRESENTATIVE = — WX © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD