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No: 1973284434 Return Address <br /> This Certificate is provided to: UC Irvine Health <br /> City of Santa Ana-Risk Management-Human Resources 101 The City Drive South <br /> Department Orange, CA 92868 <br /> 20 Civic Center Plaza <br /> Santa Ana CA 92701 <br /> UNIVERSITY OF CALIFORNIA <br /> EVIDENCE OF SELF-INSURANCE <br /> PROFESSIONAL LIABILITY & HOSPITAL LIABILITY <br /> Type of Coverage Self Insured Limits <br /> I. PROFESSIONAL MEDICAL AND HOSPITAL LIABILITY: s,000,000 Each Occurrence <br /> s,000,000 Aggregate <br /> II. SPECIAL TERMS&CONDITIONS: .•• 0 0 0 0 ••• <br /> 1. This certificate is not valid for use by individuals and is only intended to evidence the self insurance of The <br /> Regents of the University of California for institutional exposure as opposed to individual exposures. <br /> 2. The self insurance evidenced herein follows the provisions of the Bylaws and Standing Orders of the <br /> Regents of the University of California and self insurance programs as administered by the University of <br /> California, Office of the President, Office of Risk Services, which do not permit any assumption of liability <br /> which does not result from and is not caused by the negligent acts or omissions of its officers, agents, or <br /> employees. Any indemnification or hold harmless clause with broader provisions than required under such <br /> Bylaws and Standing Orders shall invalidate this certificate. <br /> 3. This certificate is in effect until the expiration date indicated below or termination of applicable contract, <br /> affiliation agreement or termination of University employment, whichever comes first. <br /> Should any of the above described program of self-insurance be materially modified or cancelled before the <br /> expiration date shown below, The Regents of the University of California will give 30 days written notice to the <br /> certificate holder. <br /> Effective Date:07/01/2024 Julie Ann Schneider <br /> 101 The City Drive <br /> Orange CA 92868 <br /> Expiration Date:07/01/2025 Approval Date:6/26/2024 <br /> This Certificate is issued as a matter of information only and confers no rights upon the certificate holder. The Certificate does not <br /> amend, extend or alter the coverage described above. This certificate does not constitute a contract between the holder and the <br /> University of California <br /> oR,N F RiskManagmumtDMslcrn <br /> a� REVIEWED&APPROVED BY: <br /> tq �ceva�o <br /> — J Risk Management Specialist <br /> Form:PL Institutional 0914 NJ <br />