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2025-03-04_scygan_Canada - 2025 COI -Renewal - #305-37 Richard Way SW Calgary AB T3E 7M8.docx
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Home Health Care Renewal Information/Updates
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Please submit your updates to our office no later than 30 days PRIOR to your renewal
If you have made changes to the services you provide or need changes to your coverage please include a brief description of your new operations/requirements in your return email.
Operations Description: Home Health Care Provider
Employees, Income and Payroll
‘Last Year’ numbers come from the form you submitted for your previous renewal and/or application form.
Please show annual figures, not monthly figures.
The numbers you provide affect your coverage. Under-reporting could affect your Business Interruption and Professional Liability coverage so please be as accurate as possible.
For the staff numbers/hours, use the total amount for this past year. If you have knowledge of a new contract (or expiry of an existing contract) which would affect your upcoming staffing levels, please add a note providing the details when you submit this year’s form (include the staffing details - RNs/RPNs/PSWs/Homemakers and projected hours).
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B Facility Staffing - Please advise the percentage of your annual revenues derived from Facility Staffing
You do currently have this coverage
As a result of the volume of pandemic lawsuits and class action suits, Facility Staffing is now specifically excluded from your policy.
Coverage, if required, can be added to you policy via endorsement
If you are providing staffing to long-term care, retirement homes, hospitals or any other type of *multi-residential facility please advise the percentage of your revenue derived from Facility Staffing
*NOTE: Your current policy will not provide coverage for staff provided to Correctional Institutions. This type of operation requires a specialized insurance product. If you are providing staff to any type of Correctional Institute please notify us immediately
C CERTIFICATES
The following holders of ‘Certificates of Insurance’ are on file, please confirm whether or not updated certificates are required.
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D. Current Coverage/Limits
*It is your responsibility as the policyholder to select the values to insure on your policy. You must NOT construe any insured limit shown, as a representation from us, that it will be sufficient coverage.
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PLEASE confirm the following
I/We are not aware of any circumstances, complaints, claims, potential claims, losses, penalties or fines levied against Home Care Assistance of Toronto o/b SJD Care Services Inc. and Mavencare Inc., in relation to the risks for which we are insured.
No claims OR describe any/possible/potential claims (if any):
Are you looking after children under the age of 18? Yes or No
Signature: ___
Print Name ___
Title/Position ___
YES, please renew my First Insurance Funding – Monthly Payment Plan.
Payment in full by cheque
Policy #: | 220466 | Renewal Date: April 30th | Account #: | HOMECAR-23
Insured: | THE KEY o/b SJD Care Services Inc. and Mavencare Inc., Prairie Seniors at Home Inc. and Prairie Senior Care Inc., Orofresh Enterprises Inc, Arya Healthy Living Inc & Arya Healthy Liv. Oakville Inc, 2004437 Alberta Ltd & HCA Care Ass. Canada Inc. | Telephone: | 416-488-8777
Mailing Address:
Risk Location:
Risk Location:
Risk Location:
Risk Location:
Risk Location:
Risk Location: | 2011-2300 Yonge St, Toronto, ON M4P 1E4
Same
104 - 375 University Ave. E, Waterloo ON N2K 3M7
344-530 Kenaston, Blvd, Winnipeg MB R3N 1Z4
#305-37 Richard Way SW Calgary AB T3E 7M8
1861 Marine Drive West, Vancouver BC V7V 1J7
#352 – 3100 – 15331 – 16th Ave., Surrey BC V4A 1R6
Contact: | Laszio Kovacs | Email: | laszlo.kovacs@thekey.com
Home Care Assistance Winnipeg o/b Prairie Seniors at Home Inc. and Prairie Senior Care Inc. | Home Care Assistance Winnipeg o/b Prairie Seniors at Home Inc. and Prairie Senior Care Inc. | Home Care Assistance Winnipeg o/b Prairie Seniors at Home Inc. and Prairie Senior Care Inc. | Home Care Assistance Winnipeg o/b Prairie Seniors at Home Inc. and Prairie Senior Care Inc. | Home Care Assistance Winnipeg o/b Prairie Seniors at Home Inc. and Prairie Senior Care Inc. | Home Care Assistance Winnipeg o/b Prairie Seniors at Home Inc. and Prairie Senior Care Inc.
2024 Reported Updates | 2024 Reported Updates | This Year’s Updates | This Year’s Updates
# | Hours Worked | # | Hours Worked
RNs
RPNs
PSWs
Homemaker/Companion
Others ?
Footcare, Physiotherapists, Occupational Therapists, etc? | 0 | Describe:
#
Office/Admin.
Student Placements
please include field of study | 0
Annual GROSS Revenue | $ 2,999,743. | $ .
Annual Payroll | $ | $ .
TheKey o/b 2004437 Alberta Ltd. and HCA Home Care Assistance Canada Inc. | TheKey o/b 2004437 Alberta Ltd. and HCA Home Care Assistance Canada Inc. | TheKey o/b 2004437 Alberta Ltd. and HCA Home Care Assistance Canada Inc. | TheKey o/b 2004437 Alberta Ltd. and HCA Home Care Assistance Canada Inc. | TheKey o/b 2004437 Alberta Ltd. and HCA Home Care Assistance Canada Inc. | TheKey o/b 2004437 Alberta Ltd. and HCA Home Care Assistance Canada Inc.
2024 Reported Updates | 2024 Reported Updates | This Year’s Updates | This Year’s Updates
# | Hours Worked | # | Hours Worked
RNs
RPNs
PSWs
Homemaker/Companion
Others ?
Footcare, Physiotherapists, Occupational Therapists, etc? | 0 | Describe:
#
Office/Admin.
Student Placements
please include field of study | 0
Annual GROSS Revenue | $ 2,342,044 | $ .
Annual Payroll | $ | $ .
Home Care Assistance of Toronto o/b SJD Care Services Inc. and Mavencare Inc & Home Care Assistance Waterloo o/b Arya Healthy Living Inc. and Home Care Assistance | Home Care Assistance of Toronto o/b SJD Care Services Inc. and Mavencare Inc & Home Care Assistance Waterloo o/b Arya Healthy Living Inc. and Home Care Assistance | Home Care Assistance of Toronto o/b SJD Care Services Inc. and Mavencare Inc & Home Care Assistance Waterloo o/b Arya Healthy Living Inc. and Home Care Assistance | Home Care Assistance of Toronto o/b SJD Care Services Inc. and Mavencare Inc & Home Care Assistance Waterloo o/b Arya Healthy Living Inc. and Home Care Assistance | Home Care Assistance of Toronto o/b SJD Care Services Inc. and Mavencare Inc & Home Care Assistance Waterloo o/b Arya Healthy Living Inc. and Home Care Assistance | Home Care Assistance of Toronto o/b SJD Care Services Inc. and Mavencare Inc & Home Care Assistance Waterloo o/b Arya Healthy Living Inc. and Home Care Assistance
2024 Reported Updates | 2024 Reported Updates | This Year’s Updates | This Year’s Updates
# | Hours Worked | # | Hours Worked
RNs
RPNs
PSWs
Homemaker/Companion
Others ?
Footcare, Physiotherapists, Occupational Therapists, etc? | 0 | Describe:
#
Office/Admin.
Student Placements
please include field of study | 0
Annual GROSS Revenue | $ 10,126,665 | $ .
Annual Payroll | $ | $ .
Greater Vancouver Home Care Assistance o/b Orofresh Enterprises Inc./Loving Homecare Services Ltd | Greater Vancouver Home Care Assistance o/b Orofresh Enterprises Inc./Loving Homecare Services Ltd | Greater Vancouver Home Care Assistance o/b Orofresh Enterprises Inc./Loving Homecare Services Ltd | Greater Vancouver Home Care Assistance o/b Orofresh Enterprises Inc./Loving Homecare Services Ltd | Greater Vancouver Home Care Assistance o/b Orofresh Enterprises Inc./Loving Homecare Services Ltd | Greater Vancouver Home Care Assistance o/b Orofresh Enterprises Inc./Loving Homecare Services Ltd
2024 Reported Updates | 2024 Reported Updates | This Year’s Updates | This Year’s Updates
# | Hours Worked | # | Hours Worked
RNs
RPNs
PSWs
Homemaker/Companion
Others ?
Footcare, Physiotherapists, Occupational Therapists, etc? | 0 | Describe:
#
Office/Admin.
Student Placements
please include field of study | 0
Annual GROSS Revenue | $ 10,100,696. | $ .
Annual Payroll | $ | $ .
Percentage of annual revenues derived from Facility Staffing
Home Care Assistance Winnipeg o/b Prairie Seniors at Home Inc. and Prairie Senior Care Inc. | % RESPONSE REQUIRED
Percentage of annual revenues derived from Facility Staffing
TheKey o/b 2004437 Alberta Ltd. and HCA Home Care Assistance Canada Inc. | % RESPONSE REQUIRED
Percentage of annual revenues derived from Facility Staffing
Home Care Assistance of Toronto
o/b SJD Care Services Inc. and Mavencare Inc. | % RESPONSE REQUIRED
Percentage of annual revenues derived from Facility Staffing
Home Care Assistance Waterloo o/b Arya Healthy Living Inc. and Home Care Assistance | % RESPONSE REQUIRED
Percentage of annual revenues derived from Facility Staffing
Greater Vancouver Home Care Assistance o/b Orofresh Enterprises Inc./Loving Homecare Services Ltd | % RESPONSE REQUIRED
Certificate Holder | Required | Not Required
Proof of Insurance – Generic, To Whom it May Concern
Allied Properties Management GP Limited
Mavencare Inc.
HCA Home Care Assistance Canada Inc,(multiple) Home Care Assistance of Toronto
Prime Time (Abbey Lane) Inc., et al. (Lease-#352-15331-16th Ave in the name of The Key o/b Orofresh Enterprises Inc.
RioCan Management Inc., RioCan Real Estate Investment Trust, RioCan Yonge Eglinton LP, and RioCan, and RioCan YEC Holdings Inc (Lease -#2011-2300 Yonge St. Toronto)
District of West Vancouver - o/b Orofresh Enterprises Inc, re: Contract #ID011393
Vancouver Coastal Health Authority
Canadian Western Bank
CWB Maxium Financial Inc.
Peter Benninger (Landlord - #104-375 University Ave. E. Waterloo)
The Regional Municipality of Waterloo
Calgary Intrinsic Opportunity Fund II Ltd. and Riverpark Properties Ltd. (Lease at #305-37 Richard Way SW., Calgary AB)
Saint Elizabeth Health Care and Saint Elizabeth Health Services
Kenaston Grant Holdings Ltd.c/o Superior Management Ltd.
(Lease: #344-530 Kenaston Boulevard, Winnipeg, MB, R3N 1Z4)
Coverage | Limits | Comments
General Liability | $ 5,000,000. | Higher limits are available.
Abuse Liability | $ 1,000,000. | If you have made any changes to your Abuse Policy and/or Proceedures please send/attach an updated copy.
Professional Liability | $ 5,000,000. | Occurrence Basis or Claims Made Basis
Crime | $ 50,000.
$ 25,000. | - Employee Dishonesty
- Third Party Employee Dishonesty
Facility Staffing Liability | $ 5,000,000
Legal Expense | Included
Business Property | A signed Statement of Values form is required
Office Contents | $ 26,250. | Desks, chairs, cabinets, equipment – 344-530 Kenaston Blvd, Winnipeg MB R3N 1Z4
Office Contents | $ 26,250. | Desks, chairs, cabinets, equipment – #305-37 Richard Way S.W., Calgary, AB T3E 7M8
Office Contents | $ 26,250. | Desks, chairs, cabinets, equipment – #2011-2300 Yonge St. Toronto, ON M4P 1E4
Office Contents | $ 26,250 | Desks, chairs, cabinets, equipment – #104-375 University Ave. E., Waterloo, ON N2K 3M7
Office Contents | $ 36,750 | Desks, chairs, cabinets, equipment – 1861 Marine Dr. W., West Vancouver, BC V7B 1J7
Office Contents | $ 36,750 | Desks, chairs, cabinets, equipment – #352 – 3100 – 15331 – 16th Ave, Surrey BC V4A 1R6
Leasehold Improvements
If applicable, please provide a value to insure | $ 0. | Interior walls, plumbing, wiring, HVAC, flooring etc.
Stock | $ 0. | Any goods/items that you sell to clients
Business Property Limits
Under the terms of your policy it is required that you insure your Business Property and Leasehold Improvement to 100% of the replacement cost so, for better accuracy we are requesting a breakdown of the value of your Property
Office contents –Furnishings (desks, chairs, cabinets), Equipment (copier, printer etc.), Stock (paper, promotional materials etc.)
Leasehold Improvements/Betterments - most leases make the tenant responsible for the physical structures/finishes within your
unit(s). This includes items such as interior walls, plumbing, wiring, HVAC, flooring etc.
- If you are responsible for the tenants improvements/betterments please provide a
a value to insure. If you are unsure of the value please provide the square footage of
your unit.
Stock – (if applicable) any goods/items/product that you sell to clients
A ssigned Statement of Values form is required (the form is included in this email)