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ACOR . CERTIFICATE OF LIABILITY <br />INSURANCE <br />DATE (30/ Y) <br />05/30 23 <br />PRODUCER CASPIAN INSURANCE SERVICES INC <br />P.O. BOX 5508 <br />SHERMAN OAKS CA 91413 <br />TELEPHONE (818) 783-8385 <br />FAX (818) 783-8360 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDINGCOYERAGE <br />INSURED NATIONAL POLYTECHNIC COLLEGE, <br />INC. <br />4105 E. SOUTH STREET <br />LAKEWOOD CA 90712 <br />INSURERA: SCOTTSDALE INSURANCE CO. <br />INSURER B: <br />INSURER C: <br />INSURERD: <br />INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INTO <br />TYPE OFIN6URANCE <br />POLICY NUMBER <br />POLICYEFFECTIVE <br />TE D <br />POLICY EXPIRATION <br />GATE tl <br />LIMITS <br />A <br />GENERAL LIABILITY <br />CPS7647935 <br />09/12/22 <br />09 12 23 <br />EACH OCCURRENCE <br />$ 2000000 <br />_ <br />FIRE DAMAGE (Anyone fire) <br />$ 100000 <br />X COMMERCIALGENERAL LIABILITY <br />MED EXP(Anyone person) <br />$ 5000 <br />CLAIMS MADE OCCUR <br />PERSONAL&ADV INJURY <br />$ 2000000 <br />GENERALAGGREGATE <br />$ 3000000 <br />GENT AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS -COMPIOP AGG <br />$ 2000000 <br />POLICY jEp LOG <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Eaacciden5) <br />$ <br />BODILY INJURY <br />(Per person) <br />$ <br />ALLOWNEDAUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY <br />(Per widenl) <br />$ <br />HIRED AUTOS <br />NONOWNED AUTOS <br />PROPERTYDAMAGE <br />(Par awidenQ <br />$ <br />GARAGE LIABILITY <br />AUTO ONLY-EAACCIDENT <br />$ <br />OTHERTHAN EAADO <br />AUTO ONLY: AGO <br />$ <br />ANY AUTO <br />$ <br />EXCESS LIABILITY <br />OCCUR CLAIMS MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />WORKERS COMPENSATION AND <br />WC STATU- OTH- <br />TORY LIMBS E <br />EL EACH ACCIDENT <br />$ <br />EMPLOYERS' LIABILITY <br />EL DISEASE - EA EMPLOYEE <br />$ <br />E.L. DISEASE -POLICY LIMIT <br />$ <br />OTHER <br />DESCRIPTION OF OPERATIONSlLOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />CLASSES ON:MEDICAL ASSISTANT,HEMODIALYSIS TECHNICIAN,PHLEBOTOMY TECHNICIAN,MRI <br />TECHNOLOGIST,DIAGNOSTIC MEDICAL SONOGRAPHY CARDIOVASCULAR,SONOGRAPHY & HVAC-RTI <br />"THE CITY OF SANTA ANA, ITS OFFICERS, OFFIHALS EMPLOYEES AND VOLUNTEERS ARE <br />NAMED AS ADDITIONAL INSURED PER ATT. BLANKET ADDITIONAL INSURED ENDORSEMENT <br />GLS-150S. COVERAGE IS PRIMARY AND NON-CONTRIBUTORY PER FORM CG 20 01 12 19" <br />BLANKET WAIVER OF SUBROGATION APPLIES.SCHEDULE OF FORMS AND END. ARE ATTACHED. <br />CITY OF SANTA ANA <br />RISK MANAGEMENT DIVISION <br />20 CIVIC CENTER PLAZA <br />SANTA ANA CA 92702 <br />SHOULD ANYOFTHEABOVE DESCRISEDPOLICIES BECANCELLED BEFORETHE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 60 SHALL <br />IMPOSE NO OBLIGATION OR UABI LITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES. n T\ n �- -�. T�.._J 1 <br />2R-S f7/97) <br />1988 <br />