0000950123-14-012495 Sample Contracts

PROGRAM ADMINISTRATOR AGREEMENT WORKERS COMPENSATION INSURANCE PROGRAM PATRIOT UNDERWRITERS, INC. AND GUARANTEE INSURANCE COMPANY Effective as of August 6, 2014
Program Administrator Agreement • November 24th, 2014 • Patriot National, Inc. • Insurance agents, brokers & service • Florida

This Program Administrator Agreement (the “Agreement”), by and between Guarantee Insurance Company, a Florida corporation with principal offices at 401 East Las Olas Boulevard, Suite 1650 (the “Company”) and Patriot Underwriters, Inc.1 a Delaware corporation with principal offices at 401 East Las Olas Boulevard, Suite 1650, Fort Lauderdale, Florida 33301 (the “Program Administrator” or “PA”), is entered into this 6th day of August, 2014 (the “Effective Date”).

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SUBROGATION SERVICES AGREEMENT
Subrogation Services Agreement • November 24th, 2014 • Patriot National, Inc. • Insurance agents, brokers & service • Florida

This Subrogation Services Agreement (this “Agreement”) is made and entered into effective as of April 25, 2011 by and between Guarantee Insurance Company, a Florida corporation and Florida domiciled insurance company with its principal place of business at 401 E. Las Olas Blvd, Suite 1650, in Fort Lauderdale, FL 33301 (“Guarantee”) and Contego Services Group, LLC, a Delaware limited liability company with its principal place of business at 401 E. Las Olas Blvd, Suite 1650, in Fort Lauderdale, FL 33301 (“Contego”).

MANAGED CARE SERVICES AGREEMENT
Managed Care Services Agreement • November 24th, 2014 • Patriot National, Inc. • Insurance agents, brokers & service • Florida

This Managed Care Services Agreement (this “Agreement”) is made and entered into as of the 6th day of August, 2014 (the “Effective Date”), by and between Guarantee Insurance Company, a Florida corporation (“GIC”), and Patriot Care Management, Inc., f/k/a Managed Care Risk Services, Inc., a Delaware corporation (“PCM”).

MASTER EQUIPMENT LEASE AGREEMENT
Master Equipment Lease Agreement • November 24th, 2014 • Patriot National, Inc. • Insurance agents, brokers & service • Ohio

This Master Equipment Lease Agreement (this “Master Lease”) dated as of December 3, 2013 is made by and among FIFTH THIRD BANK, an Ohio banking corporation (“Lessor”), and PATRIOT NATIONAL INSURANCE GROUP, INC., a corporation organized under the laws of the State of Delaware and having a principal place of business at 401 East Olas Blvd, Fort Lauderdale, FL 33301 and STEVEN M. MARIANO, an individual residing in the State of Florida and having a principal place of residence at 5212 Fisher Island Drive, Miami, FL 33109 (collectively, “Lessees” and individually, each a “Lessee”).

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