ADDENDUM # 4 RFP # FY 2016‐2017‐003 FULLY INSURED GROUP MEDICAL AND PRESCRIPTION BENEFITS 

  

Please ensure you check the City’s website for the latest addendum released for this project. Below find the link to the City’s website:  www.cohb.org\solicitations.  Firm  must  provide  this  form  signed  by  an  authorized  officer  of  your  firm  to  acknowledge  receipt  of ADDENDUM # 4 and provide with your firm’s response.   

Please note:   The  City  is  releasing  Exhibit  D.1  ‐ Medical  Census  Supplemental  Information, attached to this addendum.  PLEASE NOTE RECEIPT OF ADDENDUM # 4 BY SIGNING BELOW AND INCLUDE WITH YOUR FIRM’S SUBMISSION.  

I ACKNOWLEDGE RECEIPT OF ADDENDUM # 4:  

Company:     

Name:   

Title:    

Signature:     

Date:   

 Sincerely, 

 Andrea Lues, Director, Procurement Department 

Employee Status Date of Birth Age Hire Date Service Date Home City 1 Home State 1 Home Zip 1 Insurance Coverage

1004 FULL TIME 07/04/1956 60 08/19/1974 01/06/2003 MIAMI FL 33179 emp +2

1006 FULL TIME 02/24/1955 62 05/31/1977 12/01/2006 WEST PARK FL 33023 emp +1

1007 FULL TIME 06/17/1953 63 12/26/1977 08/05/1983 HOLLYWOOD FL 33024 emp only

1010 FULL TIME 06/22/1960 56 10/10/1977 04/13/2009 TAMARAC FL 33321 emp only

1012 FULL TIME 09/23/1958 58 02/25/1980 06/25/2012 HOLLYWOOD FL 33021 emp +1

1020 FULL TIME 07/22/1957 59 01/18/1982 11/09/1995 HALLANDALE FL 33008 emp only

1029 FULL TIME 05/26/1955 61 03/01/1983 01/03/2013 HALLANDALE BEACH FL 33009 emp only

1040 FULL TIME 05/21/1962 54 04/08/1985 03/11/2002 WEST PARK FL 33023 emp only

1049 FULL TIME 11/03/1959 57 11/12/1986 06/29/2002 HOLLYWOOD FL 33024 emp +1

1050 FULL TIME 07/18/1958 58 12/01/1986 07/18/1996 PLANTATION FL 33317 emp +1

1051 FULL TIME 06/10/1963 53 12/15/1986 12/15/1986 WESTON FL 33331 emp +2

1057 FULL TIME 06/15/1954 62 07/29/1987 09/21/1992 HALLANDALE BEACH FL 33009 emp +1

1060 FULL TIME 03/02/1955 62 11/23/1987 09/15/2003 HOLLYWOOD FL 33023 emp +1

1068 FULL TIME 08/29/1963 53 03/27/1989 05/19/2001 HOLLYWOOD FL 33024 emp +2

1074 FULL TIME 01/09/1960 57 03/02/2015 03/02/2015 PEMBROKE PINES FL 33024 emp +2

1075 FULL TIME 09/25/1954 62 01/02/1990 11/27/1995 HOLLYWOOD FL 33020 emp only

1078 FULL TIME 06/06/1964 52 04/23/1990 04/23/1990 PEMBROKE PINES FL 33026 emp only

1079 FULL TIME 02/07/1956 61 05/21/1990 05/21/1990 HALLANDALE BEACH FL 33009 emp only

1083 FULL TIME 06/16/1957 59 09/04/1990 09/04/1990 MIRAMAR FL 33023 emp only

1084 FULL TIME 09/27/1957 59 01/02/1991 05/16/2005 WEST PARK FL 33023 emp +2

1085 FULL TIME 01/28/1969 48 04/03/1991 04/12/2010 HOLLYWOOD FL 33023 emp +2

1093 FULL TIME 07/12/1972 44 06/09/1992 04/30/2001 PEMBROKE PINES FL 33024 emp +2

1097 FULL TIME 09/19/1961 55 03/22/1993 03/22/1993 MIAMI FL 33156 emp +2

1098 FULL TIME 02/10/1962 55 03/22/1993 10/01/2005 NAPLES FL 34117 emp +2

1100 FULL TIME 09/18/1964 52 03/22/1993 03/22/1993 STUART FL 34997 emp +1

1101 FULL TIME 11/11/1960 56 03/29/1993 10/01/2013 TAMARAC FL 33321 emp +1

1102 FULL TIME 01/30/1963 54 04/05/1993 03/18/2006 DAVIE FL 33325 emp +2

1105 FULL TIME 10/28/1960 56 06/03/1993 06/03/1993 MIAMI FL 33187 emp +2

1106 FULL TIME 08/27/1970 46 06/14/1993 08/22/2015 PLANTATION FL 33324 emp only

1107 FULL TIME 02/22/1968 49 05/16/1992 01/08/2007 HOLLYWOOD FL 33020 emp only

1108 FULL TIME 06/05/1963 53 07/12/1993 07/12/1993 PEMBROKE PINES FL 33020 emp +2

1109 FULL TIME 03/27/1960 57 07/17/1993 09/09/2009 MIAMI FL 33165 emp +2

1112 FULL TIME 10/29/1970 46 11/28/2016 07/28/1993 DAVIE FL 33325 emp +2

1115 FULL TIME 09/15/1957 59 11/29/1993 03/04/1995 PEMBROKE PINES FL 33026 emp only

1116 FULL TIME 02/08/1964 53 03/07/1994 03/07/1994 HIALEAH FL 33014 emp +2

1117 FULL TIME 08/14/1969 47 03/07/1994 08/22/2015 CORAL SPRINGS FL 33067 emp +2

1120 FULL TIME 08/11/1962 54 04/11/1994 10/03/2011 STUART FL 34997 emp +1

Exhibit D.1 - Medical Census Supplemental Information

Employee Status Date of Birth Age Hire Date Service Date Home City 1 Home State 1 Home Zip 1 Insurance Coverage

Exhibit D.1 - Medical Census Supplemental Information

1123 FULL TIME 02/26/1961 56 05/09/1994 04/30/2009 COOPER CITY FL 33330 emp +1

1125 FULL TIME 09/20/1969 47 05/09/1994 11/01/2000 JUPITER FL 33478 emp +2

1126 FULL TIME 07/28/1968 48 05/23/1994 12/24/2003 MIAMI FL 33186 emp only

1128 FULL TIME 09/20/1964 52 12/27/1994 10/04/2009 OAKLAND PARK FL 33334 emp +1

1129 FULL TIME 03/13/1972 45 08/02/1990 03/31/2008 HALLANDALE BEACH FL 33009 emp +2

1133 FULL TIME 07/29/1968 48 04/29/1988 05/15/1995 HOLLYWOOD FL 33024 emp +2

1134 FULL TIME 03/28/1956 61 06/05/1995 10/01/2012 NORTH LAUDERDALE FL 33068 emp +1

1135 FULL TIME 12/23/1965 51 11/22/1994 11/17/2016 PLANTATION FL 33322 emp +1

1137 FULL TIME 07/20/1960 56 08/21/1995 07/02/2011 MIAMI FL 33127 emp only

1138 FULL TIME 03/09/1961 56 08/28/1995 08/28/1995 FORT LAUDERDALE FL 33334 emp +2

1140 FULL TIME 12/21/1961 55 12/01/1995 03/03/2014 HOLLYWOOD FL 33020 emp +2

1141 FULL TIME 10/15/1957 59 12/11/1995 10/01/2005 DAVIE FL 33317 emp only

1143 FULL TIME 12/08/1967 49 01/22/1996 12/12/2015 MIAMI FL 33170 emp +2

1145 FULL TIME 04/18/1958 59 03/18/1996 03/18/1996 PLANTATION FL 33317 emp only

1146 FULL TIME 08/28/1958 58 04/01/1996 07/21/2007 DAVIE FL 33328 emp +2

1148 FULL TIME 11/24/1952 64 11/01/1995 09/09/1996 MIAMI FL 33169 emp +1

1149 FULL TIME 06/28/1967 49 10/14/1996 10/14/1996 COOPER CITY FL 33328 emp +2

1150 FULL TIME 08/30/1972 44 10/14/1996 04/16/2011 HALLANDALE BEACH FL 33009 emp +1

1151 FULL TIME 09/10/1965 51 07/12/1995 10/08/2004 FT. LAUDERDALE FL 33312 emp +2

1152 FULL TIME 08/02/1968 48 01/27/1997 01/06/2008 FT. LAUDERDALE FL 33308 emp +2

1153 FULL TIME 09/13/1969 47 02/03/1997 01/15/2010 SOUTHWEST RANCHES FL 33332 emp +2

1154 FULL TIME 10/09/1974 42 09/30/1996 03/06/2006 HOLLYWOOD FL 33020 emp +2

1155 FULL TIME 03/16/1964 53 05/12/1997 06/10/2006 LOXAHATCHEE FL 33470 emp +2

1156 FULL TIME 02/28/1973 44 06/06/1997 10/01/2007 DEERFIELD BEACH FL 33442 emp +2

1157 FULL TIME 01/04/1962 55 07/28/1997 01/23/2017 FT. LAUDERDALE FL 33317 emp +1

1158 FULL TIME 11/20/1960 56 08/25/1997 03/29/2004 HOLLYWOOD FL 33024 emp +1

1160 FULL TIME 07/18/1961 55 10/13/1997 12/12/2015 STUART FL 34997 emp +2

1161 FULL TIME 03/21/1970 47 10/13/1997 01/15/2010 MIRAMAR FL 33027 emp +2

1162 FULL TIME 02/27/1957 60 10/20/1997 10/01/2013 PLANTATION FL 33324 emp only

1164 FULL TIME 11/03/1968 48 03/30/1998 12/22/2014 NORTH MIAMI BEACH FL 33179 emp +2

1166 FULL TIME 02/20/1952 65 04/27/1998 04/27/1998 PEMBROKE PINES FL 33026 emp only

1168 FULL TIME 06/07/1972 44 08/17/1998 08/17/1998 SUNRISE FL 33326 emp +2

1169 FULL TIME 08/11/1959 57 08/17/1998 08/17/1998 FORT LAUDERDALE FL 33332 emp +1

1170 FULL TIME 07/07/1967 49 08/24/1998 08/24/1998 COCONUT CREEK FL 33073 emp +2

1171 FULL TIME 10/31/1965 51 10/28/1998 10/28/1998 HALLANDALE BEACH FL 33009 emp only

1172 FULL TIME 02/16/1976 41 11/19/1998 01/07/2008 CORAL SPRINGS FL 33071 emp only

1173 FULL TIME 06/29/1962 54 11/19/1998 11/19/1998 MIRAMAR FL 33023 emp +2

Employee Status Date of Birth Age Hire Date Service Date Home City 1 Home State 1 Home Zip 1 Insurance Coverage

Exhibit D.1 - Medical Census Supplemental Information

1174 FULL TIME 02/10/1971 46 11/19/1998 08/22/2015 PEMBROKE PINES FL 33025 emp +1

1175 FULL TIME 01/14/1970 47 11/23/1998 09/08/2008 MIAMI FL 33167 emp +2

1176 FULL TIME 02/15/1976 41 12/07/1998 01/08/2004 PEMBROKE PINES FL 33024 emp +2

1177 FULL TIME 08/10/1959 57 01/18/1999 09/01/2007 PEMBROKE PINES FL 33024 emp +2

1179 FULL TIME 11/17/1969 47 02/03/1999 02/03/1999 PLANTATION FL 33324 emp +1

1183 FULL TIME 08/12/1967 49 07/12/1999 10/01/2007 WEST PALM BEACH FL 33412 emp +2

1184 FULL TIME 03/01/1969 48 07/26/1999 08/22/2015 HOLLYWOOD FL 33019 emp only

1185 FULL TIME 03/21/1968 49 07/26/1999 07/26/1999 SUNNY ISLES BEACH FL 33316 emp +2

1186 FULL TIME 05/09/1974 42 07/26/1999 07/26/1999 OAKLAND PARK FL 33334 emp +2

1187 FULL TIME 10/07/1975 41 07/26/1999 07/26/1999 PEMBROKE PINES FL 33029 emp +2

1189 FULL TIME 06/28/1971 45 11/29/1999 11/27/2010 MIAMI FL 33157 emp +2

1192 FULL TIME 11/16/1973 43 03/20/2000 10/01/2006 MIAMI FL 33147 emp +1

1193 FULL TIME 06/17/1974 42 08/11/1998 07/10/2006 HALLANDALE BEACH FL 33009 emp +1

1194 FULL TIME 05/19/1964 52 02/05/1997 04/10/2000 HALLANDALE BEACH FL 33009 emp +1

1195 FULL TIME 02/28/1950 67 08/31/1996 04/05/2004 HALLANDALE BEACH FL 33009 emp +1

1196 FULL TIME 08/07/1975 41 07/12/1999 08/22/2015 SUNRISE FL 33322 emp +2

1197 FULL TIME 01/17/1961 56 11/28/1994 06/07/2000 NORTH MIAMI BEACH FL 33162 emp +2

1198 FULL TIME 10/05/1968 48 10/22/1996 06/07/2000 MIRAMAR FL 33023 emp +2

1201 FULL TIME 08/06/1973 43 02/25/2000 01/13/2014 HOLLYWOOD FL 33023 emp +2

1202 FULL TIME 08/31/1972 44 07/12/1999 03/22/2014 SOUTHWEST RANCHES FL 33332 emp +2

1205 FULL TIME 01/18/1980 37 10/09/2000 07/16/2011 MIRAMAR FL 33025 emp only

1207 FULL TIME 08/20/1961 55 11/24/1999 06/19/2013 HALLANDALE BEACH FL 33009 emp only

1208 FULL TIME 08/07/1970 46 11/27/2000 11/27/2000 HOLLYWOOD FL 33020 emp +1

1209 FULL TIME 03/02/1976 41 08/21/2000 08/22/2015 DANIA BEACH FL 33312 emp +2

1211 FULL TIME 06/22/1968 48 01/29/2001 10/01/2013 HOLLYWOOD FL 33021 emp +2

1212 FULL TIME 10/08/1974 42 05/26/1997 01/12/2005 HOLLYWOOD HILLS FL 33021 emp +1

1213 FULL TIME 06/20/1961 55 02/05/2001 02/05/2001 CAROL CITY FL 33055 emp only

1214 FULL TIME 04/03/1975 42 02/07/2001 02/07/2001 COOPER CITY FL 33328 emp +2

1216 FULL TIME 02/25/1968 49 06/05/1993 04/21/2001 HALLANDALE BEACH FL 33009 emp +2

1219 FULL TIME 08/22/1976 40 06/27/2001 08/08/2016 POMPANO BEACH FL 33060 emp only

1220 FULL TIME 06/05/1965 51 08/27/2001 08/27/2001 COCONUT CREEK FL 33073 emp only

1221 FULL TIME 08/21/1975 41 09/24/2001 08/22/2015 MIAMI BEACH FL 33139 emp +2

1223 FULL TIME 10/13/1958 58 04/07/1998 10/01/2001 HOLLYWOOD FL 33020 emp +1

1227 FULL TIME 06/08/1962 54 11/05/2001 04/30/2009 COCONUT CREEK FL 33073 emp +2

1232 FULL TIME 01/07/1957 60 12/17/2001 03/26/2011 HOLLYWOOD FL 33021 emp +1

1233 FULL TIME 03/15/1976 41 12/24/2001 12/24/2001 HOLLYWOOD FL 33024 emp +2

1234 FULL TIME 11/08/1956 60 01/14/2002 06/01/2004 HALLANDALE BEACH FL 33009 emp only

Employee Status Date of Birth Age Hire Date Service Date Home City 1 Home State 1 Home Zip 1 Insurance Coverage

Exhibit D.1 - Medical Census Supplemental Information

1239 FULL TIME 04/25/1967 50 04/29/2002 04/29/2002 NORTH MIAMI BEACH FL 33162 emp +2

1240 FULL TIME 04/06/1984 33 06/03/2002 08/01/2015 HOLLYWOOD FL 33020 emp only

1241 FULL TIME 10/10/1961 55 04/15/2002 02/16/2012 NORTH MIAMI BEACH FL 33179 emp +1

1243 FULL TIME 11/20/1965 51 04/02/2002 05/12/2014 HOLLYWOOD FL 33020 emp +2

1244 FULL TIME 03/25/1967 50 08/08/2002 02/22/2010 DANIA BEACH FL 33004 emp only

1246 FULL TIME 09/11/1969 47 09/30/2002 09/30/2002 DAVIE FL 33325 emp +2

1247 FULL TIME 12/20/1977 39 10/23/2000 06/05/2014 HOLLYWOOD FL 33020 emp +1

1248 FULL TIME 05/18/1972 44 06/17/2002 05/28/2011 HIALEAH FL 33015 emp +2

1249 FULL TIME 11/04/1968 48 11/12/2002 02/05/2007 BOCA RATON FL 33434 emp +2

1251 FULL TIME 09/21/1974 42 01/13/2003 01/13/2003 PEMBROKE PINES FL 33026 emp +2

1252 FULL TIME 02/23/1973 44 03/10/2003 03/10/2003 PEMBROKE PINES FL 33025 emp only

1253 FULL TIME 07/13/1973 43 03/10/2003 03/10/2003 MIRAMAR FL 33025 emp +2

1254 FULL TIME 10/30/1974 42 09/30/2002 09/30/2002 BOYNTON BEACH FL 33472 emp +2

1257 FULL TIME 04/08/1981 36 05/19/2003 03/19/2015 DANIA FL 33004 emp only

1259 FULL TIME 04/17/1980 37 02/03/2003 02/03/2003 COOPER CITY FL 33328 emp only

1260 FULL TIME 01/13/1983 34 07/28/2003 09/01/2010 MIAMI FL 33175 emp +2

1261 FULL TIME 08/20/1979 37 02/03/2003 08/22/2015 SOUTHWEST RANCHES FL 33331 emp only

1262 FULL TIME 01/22/1973 44 03/12/2001 09/16/2003 MIRAMAR FL 33027 emp +2

1269 FULL TIME 05/31/1972 44 02/03/2004 05/27/2013 BOCA RATON FL 33433 emp +2

1270 FULL TIME 09/04/1966 50 02/23/2004 10/01/2011 HOLLYWOOD FL 33020 emp +1

1271 FULL TIME 01/05/1971 46 02/23/2004 02/23/2004 COOPER CITY FL 33026 emp +2

1272 FULL TIME 04/22/1974 43 02/23/2004 07/21/2007 COOPER CITY FL 33328 emp +2

1273 FULL TIME 09/19/1967 49 03/22/2004 03/22/2004 HALLANDALE BEACH FL 33008 emp only

1276 FULL TIME 08/16/1967 49 05/09/2003 04/05/2004 OPA-LOCKA FL 33056 emp +2

1277 FULL TIME 04/11/1969 48 04/19/2004 10/01/2015 MIRAMAR FL 33023 emp +2

1278 FULL TIME 06/12/1977 39 04/19/2004 04/19/2004 COOPER CITY FL 33026 emp +2

1280 FULL TIME 08/18/1964 52 05/31/2004 01/23/2008 HALLANDALE BEACH FL 33009 emp +2

1281 FULL TIME 07/25/1973 43 05/21/2003 05/02/2005 HALLANDALE BEACH FL 33009 emp only

1282 FULL TIME 09/22/1964 52 06/07/2004 02/22/2010 MIAMI GARDENS FL 33055 emp only

1283 FULL TIME 08/21/1958 58 07/07/2003 08/22/2005 MIAMI GARDENS FL 33055 emp +1

1285 FULL TIME 12/04/1968 48 08/09/2004 10/01/2012 MIAMI FL 33150 emp +1

1286 FULL TIME 06/06/1976 40 08/16/2004 08/16/2004 PLANTATION FL 33317 emp +2

1290 FULL TIME 04/29/1979 38 09/20/2004 11/06/2006 HALLANDALE BEACH FL 33009 emp +2

1291 FULL TIME 07/05/1984 32 10/11/2004 10/20/2010 HOMESTEAD FL 33031 emp only

1294 FULL TIME 07/21/1973 43 11/15/2004 08/23/2010 HOLLYWOOD FL 33023 emp +2

1298 FULL TIME 02/20/1955 62 02/07/2005 02/07/2005 PEMBROKE PINES FL 33025 emp +1

1299 FULL TIME 10/29/1971 45 02/14/2005 02/14/2005 HOLLYWOOD FL 33023 emp only

Employee Status Date of Birth Age Hire Date Service Date Home City 1 Home State 1 Home Zip 1 Insurance Coverage

Exhibit D.1 - Medical Census Supplemental Information

1300 FULL TIME 03/10/1961 56 02/14/2005 02/14/2005 HOLLYWOOD FL 33021 emp +1

1301 FULL TIME 05/27/1970 46 03/28/2005 01/30/2014 HALLANDALE BEACH FL 33009 emp +1

1302 FULL TIME 10/05/1979 37 04/04/2005 05/27/2013 CORAL SPRINGS FL 33076 emp +2

1303 FULL TIME 12/13/1962 54 06/23/2004 11/26/2007 MIAMI FL 33055 emp +2

1311 FULL TIME 07/23/1966 50 07/05/2005 05/01/2008 PLANTATION FL 33313 emp +2

1313 FULL TIME 11/01/1978 38 07/11/2005 07/11/2005 COOPER CITY FL 33026 emp +2

1314 FULL TIME 12/26/1976 40 07/11/2005 07/11/2005 DAVIE FL 33325 emp only

1325 FULL TIME 05/20/1981 35 09/19/2005 10/02/2010 DAVIE FL 33324 emp +2

1327 FULL TIME 01/18/1956 61 10/03/2005 10/03/2005 SUNRISE FL 33322 emp only

1330 FULL TIME 01/13/1959 58 10/24/2005 10/24/2005 HALLANDALE BEACH FL 33009 emp only

1331 FULL TIME 06/07/1983 33 10/31/2005 10/31/2005 MIRAMAR FL 33027 emp only

1333 FULL TIME 01/04/1964 53 11/07/2005 11/07/2005 HOLLYWOOD FL 33024 emp only

1334 FULL TIME 03/21/1981 36 11/07/2005 11/07/2005 BOYNTON BEACH FL 33473 emp only

1336 FULL TIME 05/28/1980 36 11/09/2005 11/09/2005 HALLANDALE BEACH FL 33009 emp +2

1338 FULL TIME 09/19/1979 37 08/16/2004 05/26/2008 DANIA FL 33004 emp only

1339 FULL TIME 05/26/1984 32 12/19/2005 03/24/2012 BOYNTON BEACH FL 33473 emp +2

1342 FULL TIME 05/21/1965 51 11/14/2005 10/01/2012 MIRAMAR FL 33023 emp only

1345 FULL TIME 06/11/1980 36 02/14/2005 02/01/2006 PEMBROKE PINES FL 33023 emp only

1348 FULL TIME 09/22/1968 48 02/21/2006 02/21/2006 HOLLYWOOD FL 33020 emp +2

1349 FULL TIME 06/03/1960 56 02/27/2006 02/27/2006 COOPER CITY FL 33328 emp +2

1353 FULL TIME 07/18/1971 45 03/27/2006 09/23/2013 MIRAMAR FL 33025 emp only

1354 FULL TIME 01/18/1980 37 04/17/2006 10/07/2011 HALLANDALE BEACH FL 33009 emp only

1356 FULL TIME 11/18/1980 36 05/01/2006 05/01/2006 PLANTATION FL 33317 emp +1

1357 FULL TIME 05/26/1979 37 05/08/2006 05/08/2006 HOLLYWOOD FL 33023 emp only

1358 FULL TIME 08/04/1974 42 05/15/2006 05/15/2006 DAVIE FL 33324 emp +2

1364 FULL TIME 06/14/1979 37 05/30/2006 05/30/2006 HOLLYWOOD FL 33020 emp +2

1365 FULL TIME 04/04/1967 50 10/24/2005 12/22/2008 DEERFIELD BEACH FL 33441 emp +2

1366 FULL TIME 08/03/1961 55 06/12/2006 06/12/2006 DAVIE FL 33325 emp +1

1367 FULL TIME 07/10/1969 47 09/12/2005 05/01/2008 PEMBROKE PINES FL 33025 emp +2

1372 FULL TIME 03/12/1968 49 06/26/2006 06/26/2006 COOPER CITY FL 33328 emp +1

1376 FULL TIME 08/13/1982 34 07/17/2006 07/17/2006 PEMBROKE PINES FL 33024 emp +2

1377 FULL TIME 02/02/1971 46 12/01/2000 12/27/2014 PEMBROKE PINES FL 33029 emp +2

1379 FULL TIME 11/09/1966 50 08/14/2006 08/14/2006 NORTH MIAMI BEACH FL 33179 emp only

1380 FULL TIME 03/22/1968 49 08/14/2006 08/14/2006 PEMBROKE PINES FL 33024 emp +2

1385 FULL TIME 08/15/1975 41 08/28/2006 10/01/2015 MIAMI FL 33168 emp only

1387 FULL TIME 12/22/1975 41 08/28/2006 08/28/2006 FORT LAUDERDALE FL 33334 emp only

1393 FULL TIME 07/13/1970 46 10/02/2006 10/02/2006 HALLANDALE BEACH FL 33009 emp +1

Employee Status Date of Birth Age Hire Date Service Date Home City 1 Home State 1 Home Zip 1 Insurance Coverage

Exhibit D.1 - Medical Census Supplemental Information

1396 FULL TIME 04/20/1980 37 10/16/2006 10/16/2006 PEMBROKE PINES FL 33029 emp +2

1397 FULL TIME 03/18/1964 53 10/23/2006 10/23/2006 NORTH MIAMI FL 33179 emp +1

1398 FULL TIME 11/23/1982 34 01/23/2006 10/30/2006 HOLLYWOOD FL 33020 emp only

1400 FULL TIME 07/24/1970 46 11/20/2006 04/17/2012 MIRAMAR FL 33023 emp +2

1404 FULL TIME 09/05/1973 43 12/26/2006 06/04/2007 MIAMI FL 33147 emp only

1408 FULL TIME 11/20/1969 47 01/03/2007 01/03/2007 CORAL SPRINGS FL 33071 emp +2

1409 FULL TIME 11/16/1973 43 01/08/2007 01/08/2007 CORAL SPRINGS FL 33065 emp only

1410 FULL TIME 12/26/1978 38 01/08/2007 01/08/2007 DAVIE FL 33314 emp only

1411 FULL TIME 06/26/1952 64 01/09/2007 01/09/2007 MIRAMAR FL 33029 emp +1

1413 FULL TIME 12/29/1963 53 01/22/2007 05/01/2012 HALLANDALE BEACH FL 33009 emp +2

1421 FULL TIME 03/20/1985 32 12/19/2005 04/17/2012 MIRAMAR FL 33023 emp +1

1423 FULL TIME 06/11/1971 45 03/05/2007 11/19/2007 SUNRISE FL 33351 emp only

1424 FULL TIME 08/05/1979 37 03/12/2007 03/12/2007 BOCA RATON FL 33433 emp only

1426 FULL TIME 07/05/1974 42 03/12/2007 03/12/2007 MIAMI LAKES FL 33014 emp +2

1429 FULL TIME 02/03/1982 35 03/19/2007 03/19/2007 MIRAMAR FL 33027 emp +2

1441 FULL TIME 07/29/1979 37 05/07/2007 11/29/2016 DAVIE FL 33331 emp only

1442 FULL TIME 08/26/1986 30 05/07/2007 05/27/2013 JUPITER FL 33478 emp only

1444 FULL TIME 09/07/1990 26 05/20/2007 06/28/2014 HALLANDALE BEACH FL 33009 emp only

1446 FULL TIME 08/01/1973 43 05/28/2007 05/28/2007 PEMBROKE PINES FL 33028 emp +2

1461 FULL TIME 10/16/1984 32 07/30/2007 07/30/2007 HIALEAH FL 33014 emp only

1465 FULL TIME 12/12/1975 41 02/20/2006 08/13/2007 PEMBROKE PINES FL 33029 emp only

1466 FULL TIME 08/05/1983 33 08/13/2007 08/13/2007 SUNRISE FL 33351 emp only

1467 FULL TIME 02/07/1975 42 08/13/2007 08/13/2007 NORTH LAUDERDALE FL 33068 emp only

1468 FULL TIME 07/14/1973 43 08/20/2007 08/20/2015 DAVIE FL 33314 emp only

1469 FULL TIME 06/17/1971 45 10/08/2007 10/08/2007 MIAMI FL 33194 emp +2

1470 FULL TIME 05/14/1984 32 10/08/2007 10/08/2007 PLANTATION FL 33322 emp only

1471 FULL TIME 10/22/1959 57 10/15/2007 10/15/2007 HALLANDALE BEACH FL 33009 emp +2

1472 FULL TIME 02/08/1978 39 10/15/2007 10/15/2007 HOLLYWOOD FL 33019 emp +2

1473 FULL TIME 06/28/1967 49 10/15/2007 10/15/2007 SUNRISE FL 33313 emp only

1474 FULL TIME 10/06/1982 34 10/15/2007 10/15/2007 MIAMI FL 33169 emp only

1475 FULL TIME 02/17/1973 44 10/15/2007 10/15/2007 HOLLYWOOD FL 33021 emp only

1480 FULL TIME 04/09/1955 62 11/05/2007 11/05/2007 HOLLYWOOD FL 33024 emp +1

1481 FULL TIME 02/27/1987 30 06/12/2006 11/19/2007 DAVIE FL 33314 emp +2

1488 FULL TIME 06/09/1974 42 12/17/2007 12/17/2007 NORTH BAY VILLAGE FL 33141 emp only

1490 FULL TIME 03/20/1986 31 12/17/2007 03/02/2013 PEMBROKE PINES FL 33028 emp only

1493 FULL TIME 04/22/1972 45 01/07/2008 03/12/2012 WEST PARK FL 33023 emp +2

1499 FULL TIME 01/20/1951 66 02/04/2008 02/04/2008 HOLLYWOOD FL 33312 emp only

Employee Status Date of Birth Age Hire Date Service Date Home City 1 Home State 1 Home Zip 1 Insurance Coverage

Exhibit D.1 - Medical Census Supplemental Information

1504 FULL TIME 09/28/1984 32 03/03/2008 04/28/2014 BOYNTON BEACH FL 33473 emp only

1506 FULL TIME 09/26/1983 33 03/03/2008 12/12/2015 MIRAMAR FL 33027 emp +1

1508 FULL TIME 06/02/1971 45 03/10/2008 03/10/2008 COOPER CITY FL 33328 emp +2

1513 FULL TIME 05/20/1964 52 04/21/2008 11/30/2015 HALLANDALE BEACH FL 33009 emp only

1514 FULL TIME 01/27/1974 43 04/28/2008 10/29/2012 MIAMI GARDENS FL 33169 emp +1

1515 FULL TIME 09/16/1982 34 04/28/2008 04/28/2008 MIAMI FL 33165 emp only

1516 FULL TIME 03/13/1965 52 02/05/2007 06/05/2014 DAVIE FL 33024 emp only

1520 FULL TIME 07/25/1977 39 05/19/2008 05/19/2008 SUNRISE FL 33323 emp +2

1521 FULL TIME 06/16/1943 73 06/02/2008 06/02/2008 CORAL SPRINGS FL 33065 emp only

1537 FULL TIME 08/16/1984 32 07/21/2008 07/21/2008 MIRAMAR FL 33029 emp +2

1538 FULL TIME 04/04/1977 40 08/04/2008 08/04/2008 MARGATE FL 33063 emp only

1539 FULL TIME 02/25/1983 34 08/04/2008 08/04/2008 MARGATE FL 33063 emp +1

1542 FULL TIME 05/23/1942 74 08/25/2008 08/25/2008 NORTH MIAMI BEACH FL 33179

1546 FULL TIME 08/13/1963 53 09/15/2008 09/15/2008 HALLANDALE BEACH FL 33009 emp +1

1547 FULL TIME 03/14/1960 57 09/15/2008 06/05/2014 HALLANDALE BEACH FL 33009 emp +2

1549 FULL TIME 09/22/1950 66 09/22/2008 06/03/2013 SUNRISE FL 33322 emp only

1555 FULL TIME 06/11/1984 32 12/08/2008 12/20/2012 HOLLYWOOD FL 33020 emp only

1560 FULL TIME 05/13/1983 33 09/15/2008 11/21/2011 PLANTATION FL 33317 emp +1

1562 FULL TIME 11/08/1968 48 02/02/2009 12/12/2015 PORT SAINT LUCIE FL 34953 emp only

1564 FULL TIME 03/29/1965 52 02/17/2009 02/17/2009 SUNRISE FL 33322 emp +2

1566 FULL TIME 07/14/1968 48 02/12/2007 01/06/2014 HOLLYWOOD FL 33021

1570 FULL TIME 06/01/1985 31 03/23/2009 03/23/2009 BOCA RATON FL 33434 emp only

1571 FULL TIME 09/23/1980 36 03/24/2009 11/08/2011 HALLANDALE BEACH FL 33009 emp only

1573 FULL TIME 05/06/1985 32 03/30/2009 03/30/2009 BONAVENTURE FL 33326 emp +1

1574 FULL TIME 08/21/1984 32 03/30/2009 03/30/2009 PLANTATION FL 33324 emp only

1576 FULL TIME 05/22/1988 28 04/06/2009 04/06/2009 PEMBROKE PINES FL 33028 emp only

1578 FULL TIME 06/13/1965 51 11/17/2008 06/05/2014 HOLLYWOOD FL 33020 emp +2

1579 FULL TIME 04/08/1972 45 06/08/2009 06/08/2009 DANIA FL 33004 emp +2

1580 FULL TIME 07/05/1983 33 06/08/2009 06/08/2009 WESTON FL 33327 emp only

1582 FULL TIME 11/27/1981 35 06/08/2009 06/08/2009 SUNRISE FL 33351 emp only

1594 FULL TIME 06/27/1967 49 08/31/2009 08/31/2009 MIRAMAR FL 33025 emp +2

1598 FULL TIME 11/24/1974 42 11/30/2009 11/30/2009 SUNRISE FL 33323 emp +2

1607 FULL TIME 09/04/1970 46 04/05/2010 04/05/2010 DANIA FL 33004 emp +2

1609 FULL TIME 07/22/1986 30 04/26/2010 04/26/2010 SUNRISE FL 33323 emp +2

1610 FULL TIME 06/20/1961 55 04/28/2010 04/28/2010 HOLLYWOOD FL 33020 emp +2

1612 FULL TIME 02/07/1986 31 05/10/2010 05/10/2010 MIAMI FL 33175 emp only

1613 FULL TIME 09/17/1972 44 05/19/2008 05/17/2010 FORT LAUDERDALE FL 33334 emp only

Employee Status Date of Birth Age Hire Date Service Date Home City 1 Home State 1 Home Zip 1 Insurance Coverage

Exhibit D.1 - Medical Census Supplemental Information

1615 FULL TIME 04/27/1981 36 05/17/2010 05/17/2010 BOCA RATON FL 33433 emp only

1625 FULL TIME 02/12/1988 29 07/26/2010 03/17/2014 SUNRISE FL 33323 emp +1

1627 FULL TIME 10/23/1959 57 08/23/2010 08/23/2010 PEMBROKE PINES FL 33023 emp +2

1628 FULL TIME 09/19/1983 33 08/30/2010 08/30/2010 SUNRISE FL 33351 emp +2

1629 FULL TIME 12/14/1959 57 08/30/2010 08/30/2010 HALLANDALE BEACH FL 33009 emp only

1630 FULL TIME 02/09/1984 33 08/30/2010 08/30/2010 HOLLYWOOD FL 33021 emp +2

1634 FULL TIME 09/12/1974 42 03/22/2010 10/01/2010 MIRAMAR FL 33023 emp only

1635 FULL TIME 09/06/1983 33 10/04/2010 10/04/2010 COCONUT CREEK FL 33073 emp +2

1636 FULL TIME 01/08/1990 27 10/04/2010 10/04/2010 PLANTATION FL 33323 emp only

1641 FULL TIME 10/14/1964 52 01/10/2011 03/25/2014 HOLLYWOOD FL 33021 emp only

1651 FULL TIME 05/18/1955 61 05/16/2011 05/16/2011 SUNRISE FL 33322

1658 FULL TIME 10/01/1954 62 10/12/2009 06/20/2011 HOLLYWOOD FL 33020 emp only

1663 FULL TIME 01/29/1985 32 08/01/2011 03/02/2015 LAUDERHILL FL 33319 emp only

1665 FULL TIME 03/28/1989 28 09/12/2011 09/12/2011 PLANTATION FL 33317 emp only

1668 FULL TIME 10/12/1983 33 11/01/2011 11/01/2011 LAUDERHILL FL 33151 emp +2

1669 FULL TIME 06/10/1983 33 11/01/2011 11/01/2011 DANIA FL 33004 emp only

1670 FULL TIME 07/04/1985 31 11/01/2011 11/01/2011 HOLLYWOOD FL 33019 emp only

1671 FULL TIME 09/29/1976 40 11/14/2011 11/14/2011 HOLLYWOOD FL 33009 emp +2

1672 FULL TIME 08/19/1981 35 12/05/2011 07/29/2015 PEMBROKE PINES FL 33025 emp +2

1678 FULL TIME 08/06/1953 63 01/09/2012 10/01/2013 PEMBROKE PINES FL 33027 emp only

1680 FULL TIME 04/19/1952 65 01/17/2012 01/17/2012 BOCA RATON FL 33434 emp +1

1685 FULL TIME 04/15/1974 43 01/08/2007 02/09/2012 NORTH MIAMI BEACH FL 33179 emp only

1686 FULL TIME 03/08/1990 27 02/13/2012 02/13/2012 MARGATE FL 33063 emp +1

1687 FULL TIME 07/11/1986 30 02/24/2012 02/24/2012 NORTH MIAMI BEACH FL 33162 emp only

1690 FULL TIME 09/24/1982 34 03/26/2012 10/01/2015 COCONUT CREEK FL 33073 emp +2

1691 FULL TIME 06/27/1961 55 03/30/2012 03/30/2012 HALLANDALE BEACH FL 33009 emp +1

1692 FULL TIME 11/03/1968 48 04/02/2012 04/02/2012 HALLANDALE BEACH FL 33009 emp only

1696 FULL TIME 12/09/1964 52 04/23/2012 04/23/2012 WELLINGTON FL 33449 emp +2

1697 FULL TIME 02/16/1989 28 04/30/2012 04/30/2012 SUNRISE FL 33313 emp only

1702 FULL TIME 02/12/1985 32 06/04/2012 06/04/2012 MARGATE FL 33071 emp only

1707 FULL TIME 01/20/1994 23 06/11/2012 02/29/2016 MIAMI FL 33179 emp only

1713 FULL TIME 04/30/1989 28 06/20/2012 01/16/2016 HALLANDALE FL 33009 emp only

1717 FULL TIME 02/20/1984 33 06/09/2008 07/02/2012 HALLANDALE BEACH FL 33009 emp +1

1719 FULL TIME 11/22/1984 32 01/29/2007 07/09/2012 HALLANDALE FL 33009 emp only

1720 FULL TIME 10/31/1966 50 07/23/2012 07/23/2012 HALLANDALE BEACH FL 33008-0623 emp +2

1721 FULL TIME 03/20/1985 32 07/23/2012 04/02/2013 MIAMI FL 33147 emp only

1722 FULL TIME 05/26/1971 45 07/30/2012 07/30/2012 LAKE WORTH FL 33467 emp +2

Employee Status Date of Birth Age Hire Date Service Date Home City 1 Home State 1 Home Zip 1 Insurance Coverage

Exhibit D.1 - Medical Census Supplemental Information

1723 FULL TIME 06/27/1984 32 07/30/2012 07/30/2012 SUNNY ISLES FL 33160 emp +2

1725 FULL TIME 07/17/1985 31 07/30/2012 07/30/2012 JUPITER FL 33478 emp only

1728 FULL TIME 04/05/1963 54 07/20/2009 03/23/2017 PEMBROKE PINES FL 33025 emp only

1729 FULL TIME 03/23/1965 52 09/24/2007 09/04/2012 MIRAMAR FL 33023 emp +1

1731 FULL TIME 05/28/1989 27 09/08/2012 09/08/2012 WEST PARK FL 33023 emp only

1734 FULL TIME 01/09/1966 51 09/15/1987 09/08/2012 MIRAMAR FL 33027 emp +2

1735 FULL TIME 11/03/1959 57 09/11/2012 09/11/2012 HOLLYWOOD FL 33020 emp +2

1743 FULL TIME 09/07/1983 33 09/17/2012 12/01/2014 FORT LAUDERDALE FL 33312 emp +2

1745 FULL TIME 12/22/1982 34 09/17/2012 09/17/2012 HIALEAH FL 33010 emp only

1746 FULL TIME 02/19/1974 43 09/17/2012 11/30/2015 MIAMI FL 33174 emp only

1749 FULL TIME 04/14/1960 57 09/24/2012 01/21/2017 MIAMI FL 33147 emp +1

1759 FULL TIME 10/25/1962 54 10/15/2012 10/15/2012 HIALEAH FL 33014 emp +2

1765 FULL TIME 06/07/1969 47 11/13/2012 11/13/2012 PLANTATION FL 33322 emp only

1771 FULL TIME 12/06/1946 70 12/13/2012 12/13/2012 MIAMI FL 33174 emp only

1779 FULL TIME 12/04/1992 24 02/25/2013 11/02/2015 HOLLYWOOD FL 33020 emp only

1780 FULL TIME 12/17/1984 32 03/28/2011 02/25/2013 PEMBROKE PINES FL 33024 emp only

1782 FULL TIME 08/30/1988 28 12/27/2011 02/25/2013 MIAMI FL 33133 emp only

1783 FULL TIME 09/05/1983 33 10/06/2008 02/25/2013 HOLLYWOOD FL 33021 emp only

1784 FULL TIME 05/23/1992 24 09/17/2012 03/01/2013 POMPANO BEACH FL 33060 emp only

1785 FULL TIME 05/06/1990 27 09/17/2012 03/02/2013 PEMBROKE PINES FL 33029 emp only

1795 FULL TIME 08/15/1961 55 04/18/2013 06/01/2015 MIAMI FL 33180 emp +2

1799 FULL TIME 12/17/1972 44 02/13/2012 04/29/2013 MIRAMAR FL 33027 emp +1

1804 FULL TIME 10/27/1960 56 05/13/2013 05/13/2013 HALLANDALE BEACH FL 33009 emp only

1806 FULL TIME 07/19/1986 30 08/16/2008 05/20/2013 MIRAMAR FL 33023 emp only

1807 FULL TIME 05/23/1984 32 11/06/2006 05/20/2013 HALLANDALE BEACH FL 33009 emp only

1808 FULL TIME 11/23/1952 64 05/31/2013 05/31/2013 DELRAY BEACH FL 33444 emp +2

1810 FULL TIME 06/08/1975 41 06/03/2013 06/03/2013 MIAMI FL 33193 emp +2

1828 FULL TIME 12/05/1984 32 07/15/2013 07/15/2013 MIAMI GARDENS FL 33169 emp only

1829 FULL TIME 01/23/1984 33 07/15/2013 06/24/2016 HOLLYWOOD FL 33021 emp only

1830 FULL TIME 04/17/1992 25 07/30/2013 07/30/2013 HIALEAH FL 33013 emp only

1831 FULL TIME 11/24/1963 53 08/12/2012 07/01/2016 HALLANDALE BEACH FL 33009 emp only

1833 FULL TIME 03/17/1985 32 02/25/2013 02/05/2017 HALLANDALE FL 33008 emp +2

1834 FULL TIME 08/07/1970 46 10/22/2012 08/26/2013 MIAMI GARDENS FL 33054 emp only

1836 FULL TIME 02/13/1977 40 09/16/2013 09/16/2013 HOLLYWOOD FL 33020 emp +1

1837 FULL TIME 12/31/1990 26 09/17/2013 01/11/2014 MIAMI FL 33167 emp only

1839 FULL TIME 07/08/1986 30 03/25/2013 10/01/2013 DEERFIELD BEACH FL 33064 emp +2

1840 FULL TIME 10/01/1977 39 10/14/2013 10/14/2013 CORAL SPRINGS FL 33065 emp +1

Employee Status Date of Birth Age Hire Date Service Date Home City 1 Home State 1 Home Zip 1 Insurance Coverage

Exhibit D.1 - Medical Census Supplemental Information

1843 FULL TIME 04/30/1975 42 10/21/2013 10/21/2013 CORAL GABLES FL 33133

1845 FULL TIME 06/18/1966 50 10/21/2013 05/19/2014 PEMBROKE PARK FL 33023 emp +1

1846 FULL TIME 11/11/1988 28 08/02/2012 10/21/2013 HALLANDALE BEACH FL 33008 emp +1

1848 FULL TIME 04/16/1977 40 10/21/2013 10/21/2013 HALLANDALE BEACH FL 33009 emp only

1850 FULL TIME 08/19/1989 27 11/01/2013 11/01/2013 TAMARAC FL 33319 emp only

1851 FULL TIME 10/07/1992 24 10/08/2012 11/07/2013 HOLLYWOOD FL 33021 emp +2

1854 FULL TIME 03/07/1980 37 11/18/2013 11/18/2013 MIAMI FL 33142 emp +1

1855 FULL TIME 07/04/1987 29 11/18/2013 11/18/2013 WEST PARK FL 33023 emp only

1858 FULL TIME 12/30/1979 37 12/02/2013 12/02/2013 HOLLYWOOD FL 33020 emp +2

1862 FULL TIME 10/31/1988 28 12/23/2013 12/23/2013 MIRAMAR FL 33025 emp only

1864 FULL TIME 08/22/1989 27 01/06/2014 07/25/2016 DANIA FL 33004 emp only

1866 FULL TIME 08/02/1969 47 01/27/2014 01/27/2014 PEMBROKE PINES FL 33026 emp +2

1878 FULL TIME 07/11/1987 29 04/07/2014 06/20/2016 HIALEAH GARDENS FL 33018 emp +2

1887 FULL TIME 10/05/1968 48 04/28/2014 04/28/2014 DAVIE FL 33328 emp +2

1889 FULL TIME 06/12/1983 33 04/28/2014 04/28/2014 BOCA RATON FL 33486 emp +2

1891 FULL TIME 11/08/1985 31 05/13/2014 10/31/2016 HALLANDALE BEACH FL 33009 emp +1

1894 FULL TIME 07/26/1977 39 05/13/2013 07/12/2014 HOLLYWOOD FL 33023 emp +1

1895 FULL TIME 04/17/1976 41 05/27/2014 05/27/2014 PEMBROKE PINES FL 33027 emp only

1896 FULL TIME 10/04/1981 35 05/29/2014 05/29/2014 HALLANDALE FL 33009 emp only

1897 FULL TIME 03/05/1967 50 06/06/2014 04/11/2016 SUNNY ISLES BEACH FL 33160 emp +2

2006 FULL TIME 09/21/1980 36 06/23/2014 06/23/2014 MIAMI FL 33167 emp only

2018 FULL TIME 12/09/1970 46 06/16/2014 06/16/2014 HALLANDALE BEACH FL 33009 emp only

2024 FULL TIME 06/03/1973 43 06/16/2014 07/03/2014 MIAMI BEACH FL 33139 emp only

2030 FULL TIME 06/12/1971 45 10/28/2013 03/23/2017 HALLANDALE BEACH FL 33009 emp only

2031 FULL TIME 07/04/1978 38 06/02/2014 06/02/2014 MIAMI FL 33134 emp only

2033 FULL TIME 01/22/1980 37 12/05/2011 10/01/2013 FORT LAUDERDALE FL 33326 emp +2

2034 FULL TIME 01/07/1964 53 02/27/2012 02/27/2012 MIRAMAR FL 33023 emp +2

2041 FULL TIME 02/22/1968 49 07/13/2014 05/16/2015 HALLANDALE BEACH FL 33009 emp only

2047 FULL TIME 09/13/1989 27 03/20/2017 03/20/2017 HALLANDALE BEACH FL 33009 emp only

2049 FULL TIME 01/31/1972 45 06/30/2014 06/30/2014 HOLLYWOOD FL 33020 emp +1

2055 FULL TIME 01/01/1986 31 05/01/2017 05/01/2017 HALLANDALE BEACH FL 33009

2062 FULL TIME 06/16/1972 44 08/25/2014 09/14/2015 MIAMI FL 33141 emp only

2069 FULL TIME 07/26/1965 51 09/08/2014 09/08/2014 FORT LAUDERDALE FL 33328 emp only

2070 FULL TIME 04/28/1989 28 09/08/2014 01/30/2017 HOLLYWOOD FL 33024 emp +1

2078 FULL TIME 04/30/1989 28 09/15/2014 09/15/2014 FORT LAUDERDALE FL 33311 emp only

2084 FULL TIME 08/12/1981 35 04/24/2017 04/24/2017 POMPANO BEACH FL 33065

2087 FULL TIME 03/11/1970 47 04/17/2017 04/17/2017 POMPANO BEACH FL 33065

Employee Status Date of Birth Age Hire Date Service Date Home City 1 Home State 1 Home Zip 1 Insurance Coverage

Exhibit D.1 - Medical Census Supplemental Information

2088 FULL TIME 08/13/1964 52 10/08/2014 10/08/2014 OAKLAND PARK FL FL 33334 emp +1

2099 FULL TIME 02/18/1987 30 12/01/2014 12/01/2014 MIAMI SPRINGS FL 33166 emp +2

2100 FULL TIME 12/07/1988 28 12/01/2014 12/01/2014 POMPANO BEACH FL 33060 emp only

2102 FULL TIME 03/10/1974 43 12/01/2014 12/01/2014 MIAMI FL 33160 emp only

2106 FULL TIME 09/17/1957 59 12/15/2014 12/15/2014 POMPANO BEACH FL 33071 emp only

2107 FULL TIME 05/12/1982 34 12/29/2014 09/05/2015 MIAMI FL 33174 emp only

2108 FULL TIME 08/15/1978 38 01/05/2015 01/05/2015 HOLLYWOOD FL 33023 emp only

2109 FULL TIME 06/27/1957 59 01/05/2015 01/05/2015 PEMBROKE PINES FL 33024 emp +1

2115 FULL TIME 09/27/1977 39 01/12/2015 01/12/2015 MIAMI FL 33179 emp +2

2119 FULL TIME 07/05/1982 34 01/26/2015 01/26/2015 FORT LAUDERDALE FL 33309 emp +1

2121 FULL TIME 02/06/1993 24 02/02/2015 02/02/2015 HIALEAH FL 33014 emp only

2122 FULL TIME 01/27/1990 27 02/02/2015 02/02/2015 HOLLYWOOD FL 33026 emp only

2124 FULL TIME 08/31/1989 27 02/05/2015 07/29/2015 TAMARAC FL 33321 emp only

2125 FULL TIME 04/25/1991 26 02/05/2015 07/29/2015 TAMARAC FL 33321 emp only

2131 FULL TIME 11/18/1964 52 02/17/2015 10/31/2015 PORT SAINT LUCIE FL 34953 emp +2

2140 FULL TIME 07/08/1973 43 03/09/2015 03/09/2015 PEMBROKE PINES FL 33024 emp +1

2141 FULL TIME 02/09/1982 35 03/11/2015 03/11/2015 HIALEAH FL 33015 emp only

2146 FULL TIME 03/14/1961 56 03/30/2015 03/30/2015 FORT LAUDERDALE FL 33351 emp +2

2152 FULL TIME 02/21/1979 38 05/04/2015 05/04/2015 MIAMI FL 33167 emp only

2156 FULL TIME 01/05/1967 50 05/18/2015 05/18/2015 DAVIE FL 33328 emp only

2157 FULL TIME 04/06/1990 27 05/18/2015 05/18/2015 HALLANDALE BEACH FL 33009 emp only

2159 FULL TIME 03/06/1977 40 05/18/2015 05/18/2015 HIALEAH FL 33015

2165 FULL TIME 06/29/1981 35 06/01/2015 06/01/2015 FORT LAUDERDALE FL 33309 emp +2

2173 FULL TIME 08/22/1985 31 06/15/2015 06/15/2015 OPA LOCKA FL 33055 emp only

2179 FULL TIME 02/05/1992 25 06/15/2015 04/11/2016 MIAMI FL 33179 emp only

2186 FULL TIME 04/03/1962 55 07/06/2015 08/15/2016 HOLLYWOOD FL 33023 emp only

2187 FULL TIME 11/07/1991 25 07/13/2015 07/13/2015 MIAMI FL 33185 emp only

2189 FULL TIME 01/26/1979 38 07/16/2015 07/25/2016 MIAMI FL 33147 emp only

2190 FULL TIME 06/03/1985 31 07/21/2015 07/21/2015 FORT LAUDERDALE FL 33308-4357

2191 FULL TIME 07/10/1974 42 07/27/2015 07/27/2015 HALLANDALE BEACH FL 33009 emp only

2196 FULL TIME 06/02/1992 24 09/21/2015 01/21/2017 HIALEAH FL 33012 emp only

2200 FULL TIME 11/22/1966 50 10/05/2015 10/05/2015 FORT PIERCE FL 34953 emp +2

2203 FULL TIME 01/06/1975 42 10/12/2015 10/12/2015 POMPANO BEACH FL 33073 emp +2

2204 FULL TIME 12/10/1952 64 10/12/2015 10/12/2015 JUPITER FL 33469 emp +1

2207 FULL TIME 03/28/1962 55 11/30/2015 11/30/2015 FORT LAUDERDALE FL 33326 emp +2

2208 FULL TIME 01/17/1981 36 11/30/2015 11/30/2015 NORTH LAUDERDALE FL 33068 emp only

2209 FULL TIME 11/30/1981 35 11/30/2015 11/30/2015 MIRAMAR FL 33025 emp +1

Employee Status Date of Birth Age Hire Date Service Date Home City 1 Home State 1 Home Zip 1 Insurance Coverage

Exhibit D.1 - Medical Census Supplemental Information

2210 FULL TIME 07/09/1984 32 11/30/2015 11/30/2015 MIAMI FL 33173 emp +1

2211 FULL TIME 03/06/1979 38 12/07/2015 12/07/2015 MIAMI FL 33189 emp +2

2212 FULL TIME 01/28/1965 52 12/07/2015 12/07/2015 HALLANDALE BEACH FL 33009 emp only

2213 FULL TIME 08/25/1988 28 07/20/2016 BOYNTON BEACH FL 33435 emp only

2214 FULL TIME 09/01/1978 38 01/05/2016 01/05/2016 HIALEAH FL 33018 emp +1

2217 FULL TIME 04/10/1964 53 01/19/2016 01/19/2016 SOUTHWEST RANCHES FL 33331 emp +2

2220 FULL TIME 04/27/1990 27 01/25/2016 01/25/2016 HALLANDALE BEACH FL 33009 emp only

2221 FULL TIME 12/08/1986 30 01/25/2016 01/25/2016 FORT LAUDERDALE FL 33313 emp only

2222 FULL TIME 02/26/1986 31 02/01/2016 02/01/2016 HALLANDALE BEACH FL 33009 emp only

2224 FULL TIME 06/03/1978 38 02/16/2016 02/16/2016 MIRAMAR FL 33027 emp +2

2225 FULL TIME 08/22/1960 56 02/16/2016 02/16/2016 HOLLYWOOD FL 33024

2228 FULL TIME 08/24/1956 60 02/16/2016 02/21/2017 HOLLYWOOD FL 33027 emp only

2230 FULL TIME 01/20/1971 46 02/29/2016 02/29/2016 HALLANDALE BEACH FL 33009 emp only

2231 FULL TIME 06/02/1990 26 03/21/2016 03/21/2016 MIAMI FL 33147 emp only

2234 FULL TIME 05/24/1965 51 07/18/2016 03/21/2017 HOLLYWOOD FL 33027 emp only

2237 FULL TIME 12/21/1989 27 05/02/2016 05/02/2016 HOLLYWOOD FL 33025 emp only

2244 FULL TIME 05/02/1960 57 06/06/2016 06/06/2016 MIAMI FL 33175 emp only

2245 FULL TIME 05/10/1990 26 06/06/2016 06/06/2016 NORTH MIAMI BEACH FL 33162 emp only

2246 FULL TIME 07/26/1976 40 06/13/2016 06/13/2016 HALLANDALE BEACH FL 33009 emp +1

2262 FULL TIME 04/29/1967 50 07/05/2016 07/05/2016 MIAMI FL 33175 emp only

2354 FULL TIME 01/17/1958 59 07/25/2016 02/27/2017 HOLLYWOOD FL 33023 emp +1

2357 FULL TIME 02/03/1991 26 07/25/2016 07/25/2016 FORT LAUDERDALE FL 33314 emp only

2358 FULL TIME 11/20/1988 28 07/25/2016 07/25/2016 HOLLYWOOD FL 33026 emp only

2359 FULL TIME 01/11/1977 40 08/01/2016 08/01/2016 HALLANDALE BEACH FL 33009 emp only

2361 FULL TIME 02/09/1990 27 07/25/2016 07/25/2016 MIAMI FL 33161 emp only

2364 FULL TIME 07/26/1990 26 08/01/2016 08/01/2016 MIAMI FL 33162 emp only

2366 FULL TIME 07/24/1992 24 10/10/2016 10/10/2016 HIALEAH FL 33018 emp only

2367 FULL TIME 04/26/1984 33 08/08/2016 08/08/2016 FORT LAUDERDALE FL 33308 emp only

2368 FULL TIME 07/10/1977 39 10/10/2016 10/10/2016 DANIA FL 33004 emp +2

2371 FULL TIME 02/07/1982 35 08/25/2016 09/12/2016 OPA LOCKA FL 33055 emp only

2372 FULL TIME 06/07/1973 43 08/29/2016 02/13/2017 DANIA FL 33004 emp +1

2373 FULL TIME 08/09/1963 53 08/31/2016 08/31/2016 BOYNTON BEACH FL 33426 emp +1

2375 FULL TIME 12/04/1984 32 09/12/2016 09/12/2016 MIAMI FL 33190 emp only

2376 FULL TIME 04/16/1982 35 09/12/2016 09/12/2016 OPA LOCKA FL 33055 emp only

2379 FULL TIME 09/29/1976 40 09/26/2016 09/26/2016 HOLLYWOOD FL 33025 emp +2

2382 FULL TIME 07/17/1956 60 09/26/2016 09/26/2016 POMPANO BEACH FL 33065 emp +2

2384 FULL TIME 05/29/1983 33 10/24/2016 10/24/2016 OPA LOCKA FL 33056 emp +2

Employee Status Date of Birth Age Hire Date Service Date Home City 1 Home State 1 Home Zip 1 Insurance Coverage

Exhibit D.1 - Medical Census Supplemental Information

2385 FULL TIME 05/27/1986 30 10/31/2016 10/31/2016 MIAMI FL 33169 emp only

2386 FULL TIME 03/02/1989 28 10/31/2016 10/31/2016 PEMBROKE PINES FL 33025 emp +2

2390 FULL TIME 04/11/1962 55 12/12/2016 12/12/2016 HOLLYWOOD FL 33023

2393 FULL TIME 12/29/1963 53 01/03/2017 01/03/2017 HALLANDALE BEACH FL 33009 emp only

2394 FULL TIME 10/31/1980 36 01/30/2017 01/30/2017 TAMARAC FL 33319 emp +1

2395 FULL TIME 11/07/1995 21 01/30/2017 01/30/2017 FORT LAUDERDALE FL 33325 emp only

2398 FULL TIME 02/09/1981 36 02/06/2017 02/06/2017 HIALEAH FL 33014 emp +2

2399 FULL TIME 05/09/1947 69 02/06/2017 02/06/2017 HALLANDALE BEACH FL 33009

2401 FULL TIME 08/15/1982 34 02/21/2017 02/21/2017 MIRAMAR FL 33027 emp +2

2402 FULL TIME 11/30/1973 43 02/21/2017 02/21/2017 FORT LAUDERDALE FL 33331 emp +2

2403 FULL TIME 04/03/1988 29 03/06/2017 03/06/2017 MIAMI BEACH FL 33139 emp +1

2404 FULL TIME 07/25/1986 30 03/06/2017 03/06/2017 MIAMI FL 33126

2405 FULL TIME 03/25/1957 60 03/13/2017 03/13/2017 HIALEAH FL 33015 emp +1

2406 FULL TIME 07/12/1958 58 03/20/2017 03/20/2017 MIAMI FL 33154 emp only

2407 FULL TIME 06/29/1981 35 03/20/2017 03/20/2017 MIRAMAR FL 33025 emp +1

2408 FULL TIME 12/24/1985 31 03/20/2017 03/20/2017 FORT LAUDERDALE FL 33313 emp +2

2409 FULL TIME 02/11/1977 40 03/27/2017 03/27/2017 FORT LAUDERDALE FL 33317 emp +1

2411 FULL TIME 08/08/1957 59 03/31/2017 03/31/2017 FORT LAUDERDALE FL 33316