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Francine R. Villareal mua°e I5l9n.a uyr,.ko.a w�: xaxoaeJe nsuzaarar A� " CERTIFICATE OF LIABILITY INSURANCE DATE(MM DN THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Assurance Agency, Ltd 20 North Martingale Road Suite 100 CON ACT NAME Lindsay Boloz PHONE FAX 847 797-57D0INC.Na: 847 440-973D ADDRE-MAIESS, lboloz@assuranceagency.com INSURERS AFFORDING COVERAGE NAICa Schaumburg IL 60173 INSURERA: Sentinel Insurance Company Ltd 11000 INSURED MEDITAL-D1 Medica Testing Group, Inc. 3 Pointe Drive, Suite 107 INSURER B INSURERC: INSURER D Brea CA 92821 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 1507884447 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INBR LTR TYPE OF INSURANCE AOOL SUER POLICYNUMBER MM/�DV� MMIDDVYYYYY LIMITS A GENERAL LIABILITY 83SBMAE3725 8/18/2020 B/1B/2021 EACH OCCURRENCE $1,000,000 TCOMMERCIAL CLAIMS -MADE F_x1 OCCUR DAMAGEPTO REMISESPREMISES RENT nonce) $ MED EXP (Any one person) $ PERSONAL BADV INJURY $ GEN'L AGGREGATE LIMIT APPLI ES PER: GENERALAGGREGATE $2,000,000 POLICY PRO- ❑ LOG X JECT PRODUCTS - COMPIOP AGO $ $ OTHER: A AUTOMOBILE LIABILITY 83SBMAE3725 6/18/2020 8/18/2021 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ AUTO OWNED SCHEDULED AUTOS ONLY AUTOS IANY BODILY INJURY (Per accident)$ X PROPERTY DAMAGE Per.Wdent $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER OTH- STATUTE ER E.L. EACH ACCIDENT $ ANYPROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBEREXCLUDED7 ❑ NIA E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) U yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORO 101, Additional Remarks Schedule, maybe attached if more space is required) It is agreed that the City of Santa Ana, its officers, agents, representatives, employees and volunteers are Additional Insured, when required by written contract, on the General Liability on a primary and non-contributory basis with respect to operations performed by the Named Insured in connection With this project. Policy includes a separations of insureds provision. The cancellation clause has been amended to include a 30 day notice for City of Santa Ana. City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th Floor Santa Ana CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ��j)y TL4 9)1988-2015 ACORD C ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD WdrMarugemmtDiwfan el.s' REVIEV/EDfi APPROV®BY: ® R¢k Management Analyst