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ACORD, CERTIFICATE OF LIABILITY INSURANCE 2/7/2018 DATE(MM/DD/YYYY) 2/16/2017 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 8110 E. Union Avenue Suite 700FAII Denver CO 80237 CONT CT NAME: PHONE A/C, No Ext : A/C No): E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # (303) 414-6000 INSURER A: Arch Specialty Insurance Company 21199 INSURED N/ellDyneRX, LLC. INSURER B : Zurich American Insurance Company 16535 1424829 500 Eagles Landingg Drive Lakeland, FL 33810 INSURER C : Lexington Insurance Company 19437 INSURER D : INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 14516082 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑OCCUR X N N FLP006017700 2/16/2017 2/7/2018 EACH OCCURRENCE 1,000,000 DAMAGERENTED PREMISESS( Ea occurrence 100,000 MED EXP (Any oneperson) 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY❑ JEC ❑ LOC OTHER: GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OPAGG $ 3,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO AUTOSDONLY SCHEDULED AUTOS ONLY X AUUTOS ONL� N N FLP006017700 2/16/2017 2/7/2018 Ee aaadentSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ }{}{}{XXXX BODILY INJURY (Per accident $ XXXXXXX X Pear a.,denDAMAGE $ XXXXXXX $XXXXXXX A X UMBRELLA LIAB EXCESS LIAB [IOCCUR CLAIMS -MADE N N FLP006017700 2/16/2017 2/7/2018 EACH OCCURRENCE $ 10,000000 AGGREGATE $ 10,000 000 DED I I RETENTION $ $ xxxxXXx H WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A N WC014390900 2/16/2017 2/7/2018 X PER- OER E.L. EACH ACCIDENT $ �000 000 $ E.L. DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 A C Pharmacy Prof. Liability PBM E&O Liability N N FLP006017700 094274097 2/16/2017 2/7/2017 2/7/2018 2/7/2018 $1,000,000/$3,000,000 Limit. $8M/Retention $250K DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) LICK 1 IFIGA 1 t HULUtK GANULLLA I IUN ° SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLE F E THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 14516082 AUTHORIZED REPRESENTATIVE City of Santa Ana ATTN: Christy Kindig 20 Civic Center Plaza, M-21 Santa Ana, CA 92701 ff j ACORD 25 (2016103) ©198812015 ACORD CORPO ATION. All riahts reserved -0 The ACORD name and logo are registered marks of ACORD