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UNI-11"1JneJ try RnW..a Francine R. Vll Iareal VIIN,nA Nte:l@Gaero 1e61da 0'0a' CERTIFICATE OF LIABILITY INSURANCE DATE (MMIVY IY) 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 pollcy(les) 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 endorsements). Assurance Agency, Ltd 20 North Martingale Road Suite 100 Schaumburg IL60173 CONTACT. .__._ ._._... _ Ltndsa BOIO2 PHONE FAX ,Est). (847) 797.5700 (Arc Noh (847) 440-g130 E-MAIL ADoasssIboloz assuranceapency.com INSURERIS)AFFORDING COVERAGE NAICN INSUReaA: Sentinel Insurance Company Ltd 11000 INSURED MEDITAL-01 Medica Testing Group, Inc. 3 Pointe Drive, Suite 107 NsuRERB: INSURER C: INSURER D : Brea CA 9282.1 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. '— R TYPE OF INSURANCE OUMBER DYIVYLT MMDmV MMDDIYY LIMITS A X COMMERCIALOENERALLIABILITY CLAIMS -MADE [ OCCUR 836BMAE3725 8/18/2020 811812021 EACH OCCURRENCE $1,000.000 GE TOR REMISES — occurrence) S M80 EXP (Any ane person)$_ PERSONAL&ADV INJURY $ GEN'L AGGREGATELIMIT APPLIES PER: I�I )( POLICY u PRO- ❑OC JECT OTHER: _ GENERALAGGREGATE _ $2.000.000 PRODUCTS - COMPIOP AGO $ $ A AUTOMOBILE I LIABILITY ANY AUTO OWNED SCHEDAUTOS LED AUTOS ONLY NON -OWNED HIRED X NON S NLY AUTOS ONLY AUTOS ONLY BISBMAE3725 8116/2020 8/18/2021 COMBINED DINGLE LIMIT Ea acddant $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY Per acddenl ( ) $ PROPERTY DAMAGE .._ Per acclde( $ $ UMBRELLA LIAR EXCESS LIAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGOREGAT_E_ $ DEO RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETCWPARTNERIEXECUTIVE ❑ OFFICERIMEMBEPEXCLUDED7 (Mandatory In NH) P yes,. describe Under DESCRIPTION OF OPERATIONS below NIA PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE -FA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS [VEHICLES (ACORO Iet, Add111onal Remarks Schedule, maybe allactied U rnwe space is required) It Is agreed that the City of Santa Ana, Its officers, agents, representatives, employees and volunteers are Additional Insured, when requlred 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, hth 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, AUTHORIZED REPRESENTATIVE �s„uc-FI ,'-I �yhaTr' 91988-2015 ACORD C ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ,gy WsklNanlrgemrnEDtvielmt a' 6:vt'•>-p.C°4 rpR�EMEWED&rAPPROVED8Y: 11' � d 1 f'bLhrM�d F, V:1,rr+ Risk Management Analyst I