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� <br /> ACOR& CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYYI <br /> 1* � 1 05/29/2025 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER Calhoun&Associates NAME: <br /> T N Carmen Ponce <br /> NAME: <br /> DBA: Integrity Advisors PHONEo.E>zn: 800-500-9799 AIC 714-664-0614 <br /> FAX <br /> twc.N _ a Nail: <br /> 14771 Plaza Drive, Ste C E4AAIL carmen ante rft advisorS.com <br /> ADDRESS: 9 y- <br /> Tustin CA 92780 INSURER(S)AFFORDING COVERAGE NAICM <br /> INSURER A:REPUBLIC INDEMNITY CO OF AMERICA 19739 <br /> INSURED William H.Nuesse,M.D.and Mary-Ann Nuesse,D.O. INSURER8; <br /> Sunrise Multispecialist Medical Center INSURERC: <br /> 867 South Tustin Street <br /> INSURER O <br /> ORANGE CA 92866 <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE R ADDL SUBR POLICY EFF POLICY EXP <br /> POLICYNUMBER MM/DWYEWFY MMIDD/YYYYV LIMITS <br /> COMMERCIAL GENERAL LIABILITYLi EACH OCCURRENCEDAN <br /> $ <br /> CLAIMS-MADE OCCUR PREMISES(E occurrence) $ <br /> MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> :F N'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S <br /> POLICY❑ PRO JECT 7 LOC PRODUCTS•COMP/OP AGG $ <br /> OTHER $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1 Li <br /> ANYAUTO BODILY INJURY(Per pension) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> MIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY P ent <br /> __ P $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR Id CLAIMS-MADE AGGREGATE $ <br /> DEO I I RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> ANO EMPLOYERS'LIABILITY TATUTE ER <br /> A ANYPROPRIETOR/PARTNER/EXECUTIVE Y i N 25601703 08/01/2024 08101/2025 E.L.EACH ACCIDENT S1,000,000 <br /> OFFICER/MEMBEREXCLUDED'+ Y❑ NIA <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 <br /> If yes.describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 <br /> El <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.Additional Remarks Schedule,may be attached if more space is required) <br /> APPROVED <br /> By Tu Tran Nguyen at 2:17 pm,May 30,2025 <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Santa Ana <br /> 20 Civic Center Plaza SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Santa Ana CA,92702 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> O 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />