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PROCARE WORK INJURY CENTER
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PROCARE WORK INJURY CENTER
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Last modified
4/16/2020 3:12:02 PM
Creation date
4/16/2020 3:08:48 PM
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Contracts
Company Name
PROCARE WORK INJURY CENTER
Contract #
N-2020-083
Agency
Human Resources
Expiration Date
6/30/2021
Insurance Exp Date
3/18/2021
Destruction Year
2026
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COOPERATIVE OF <br />AMERICAN PHYSICIANS <br />CERTIFICATE OF COVERAGE <br />Coverage through December 31, 2020 <br />Member: David W. Cheshire, MD ✓ <br />Address: 17232 Redhill Ave <br />Irvine, CA 92614 <br />This certificate confirms that, effective on the coverage date below, the above -named physician is a member of the Cooperative <br />of American Physicians, hie. (CAP) and a participant in the Mutual Protection Trust (NTT). MPT is an unincorporated <br />interindemnity arrangement organized under California Insurance Code section 1280.7. This certificate confers no rights upon <br />the member and does not amend, extend or alter the coverage afforded render the terms, conditions and exclusions of the NTT <br />Agreement, <br />Membership Number <br />Medical Specialty <br />Coverage Date <br />Retroactive Coverage Date <br />17429 <br />Occupational Medicine <br />January 1, 2008 <br />December 15, 1983 <br />subspecialty <br />Family Medicine, With Minor Surgery <br />Coverage (Claims made and paid) <br />Current Limits of Liability <br />$1,000,000 for all Claims based <br />Medical Professional Liability Coverage <br />upon an Occurrence <br />$3,000,000 ✓ each calendar year <br />aggregate <br />The member must remain a Member in good standing or arrange for Tail Coverage for any open or potential Claim that may <br />arise during the Coverage Period. Neither CAP nor NET undertake any obligation to advise any party, other than the named <br />member, of any changes to or termination of this coverage. <br />Cooperative of American Physicians, Inc. <br />December 26, 2019 <br />Alfred De Leon Date <br />Vice President, Membership Services <br />Mutual Protection Trust REVIEWED & APPROVEL <br />By Risk MANAGEMENT DivisiON <br />R 0�2020 <br />ANGIE ACEVEd© <br />
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