Via Email: adybi4@r.postjobfree.com

An Authorized Agent of Associated Industries Insurance Company, Inc.

Post Office Box 89404 • Cleveland, OH 44101

Richard Brooks

** ***** *** ** *** 17

Lakeworth, FL 33460

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An Authorized Agent of Associated Industries Insurance Company, Inc. AmTrust North America

Post Office Box 89404 • Cleveland, OH 44101

(p) 888-***-**** • (f) 678-***-****

07/11/2022

Richard Brooks

35 South Jay St Apt 17

Lakeworth, FL 33460

Re: Carrier: Associated Industries Insurance Company, Inc. Policy: AWC1181027

Claim Number: 3521584-1

Insured: BTO Management Corp

Claimant: Richard Brooks

Date of Loss: 06/30/2022

Jurisdiction Claim No.:

Dear Richard Brooks:

This letter is to inform you that you are authorized to seek medical treatment at the below listed facility. Please report to the following:

Concentra Medical Center @ 4455 Medical Center Way, West Palm Beach, FL 33407 Phone: 561-***-****

Hours: M-F: 8am-5pm

PLEASE NOTE

You are free to have your prescription filled at a pharmacy of your choice if the prescription is written by an authorized treating physician. If you have not already received a pharmacy card identifying your employer as a policyholder with an AmTrust entity, please contact me at the number listed below. An Authorized Agent of Associated Industries Insurance Company, Inc. AmTrust North America

Post Office Box 89404 • Cleveland, OH 44101

(p) 888-***-**** • (f) 678-***-****

2

Sincerely,

Karson Whitfield

Karson Whitfield

Claims Adjuster Asso

AmTrust North America

Post Office Box 89404

Cleveland, OH 44101

407-***-**** Phone

678-***-**** Fax

adybi4@r.postjobfree.com

www.amtrustfinancial.com