Medeline Charles - Policy AH-59645-062221

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CERTIFICATE OF INSURANCE

Your professional liability insurance is written on a claims made basis and provides coverage for those claims which are the result of medical incidents
occurring subsequent to the prior acts date stated and which are first made against you while this insurance is in force. Please discuss with your program
administrator.
Prior Acts Date: 2021-06-22
Purchasing Group Certificate Number Policy Period
Professional Services Purchasing Group from: 12:01 AM Standard Time on: 2021-06-22
AH-59645-062221
1707 Post Oak Blvd #279, Houston TX 77056 to: 12:01 AM Standard Time on: 2022-06-22
Named Insured and Address Business Address Program Administrator
Medeline Charles 9380 Marino Cir Greenhill Insurance Services
9380 Marino Cir Naples, FL 34114, USA, 1707 Post Oak Blvd, #279,
Naples, FL 34114, USA, #Apt 308 #Apt 308 Houston, TX 77056

Medical Specialty: Insurance Provided by:


Certified Nursing Assistant (CNA) Certain Underwriters at Lloyd's, London
COVERAGE PARTS LIMITS OF LIABILITY
A. PROFESSIONAL LIABILITY Deductible - $0
Professional Liability (PL) $1,000,000 each claim $6,000,000 aggregate
Good Samaritan Liability included above
Personal Injury Liability included above
Malplacement Liability included above
B. Coverage Extensions: Coverage part C. Workplace Liability does not apply if Coverage part D. General Liability is
made part of this policy.
License Protection $10,000 per proceeding $10,000 aggregate
Deposition Representation $10,000 aggregate
First Aid $2,500 aggregate
Medical Payments $2,500 aggregate
Damage to Property of Others $500 per incident $10,000 aggregate
C. WORKPLACE LIABILITY Coverage part C. Workplace Liability does not apply if Coverage part D. General Liability is
made part of this policy.
Workplace Liability included in A. PL Limit shown above
Fire & Water Legal Liability included in A. PL Limit above subject to $150,000 sub-limit
Personal Liability $150,000 aggregate
D. GENERAL LIABILITY Coverage part D. General Liability does not apply if Coverage part C. Workplace Liability is
made part of this policy
General Liability (GL) N/A N/A
included in the GL limit above
Fire & Water Legal Liability $250,000 sub-limit
subject to
Personal Liability included in the GL limit included in the GL limit
Policy forms and endorsements attached at inception:

Keep this document in a safe place. It is evidence of your insurance coverage.


Master Policy #001-02242020-20

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