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Account Number: CA GRUE 1440 Date: 11/19/24 Initials: LL <br /> CERTIFICATE OF INSURANCE <br /> ALLIED WORLD INSURANCE COMPANY <br /> C/O: American Professional Agency, Inc. <br /> 95 Broadway, Amityville, NY 11701 <br /> 800-421-6694 <br /> This is to certify that the insurance policies specified below have been issued by the company <br /> indicated above to the insured named herein and that, subject to their provisions and conditions, <br /> such policies afford the coverages indicated insofar as such coverages apply to the occupation <br /> or business of the Named Insured(s) as stated. <br /> THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS <br /> THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE_ <br /> Name and Address of Named Insured: Additional Named Insureds : <br /> ERIC WAYNE GRUVER, PH.D. <br /> 2021 E 4TH STREET <br /> SUITE 116 <br /> SANTA ANA CA 92705 <br /> Type of Work Covered: PROFESSIONAL PSYCHOLOGIST <br /> Location of Operations: N/A <br /> (lf d:fferei.t. Char: addren its ed above; <br /> Claim History: APPROVED <br /> By Cynthia Mora at 1:57 pm, Nov 19, 2024 <br /> Retroactive date is 03/01/1992 <br /> Policy Effective Expiration Limits of <br /> Coverages Number Date Date Liability <br /> PROFESSIONAL/ 2, 000, 000 <br /> LIABILITY 5010-7473 3/01/2024 3/01/2025 4 , 000, 000 <br /> NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED, WHO SHALL <br /> ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING OR RECEIVING NOTICE OF <br /> CANCELLATION_ <br /> Comments: THE COMPANY WILL NOTIFY THE CERTIFICATE HOLDER OF ANY <br /> TERMINATION OF COVERAGE AND FAILURE TO RENEW WITHIN 30 DAYS, <br /> HOWEVER, FAILURE TO GIVE SUCH NOTICE SHALL IMPOSE NO <br /> OBLIGATION OR LIABILITY UPON THE COMPANY OR THE UNDERSIGNED. <br /> CITY OF SANTA ANA IS LISTED AS ADDITIONAL INSURED. <br /> This Certificate Issued to: <br /> Name: CITY OF SANTA ANA <br /> RISK MANAGEMENT DIVISION <br /> Address: 20 CIVIC CENTER PLAZA l( <br /> Authorized Representative <br /> SANTA ANA CA 92702 <br /> APA 00138 00 (06/2014) <br />