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11AARaH <br />PRODUCER <br />Marsh Risk 8 Insurance Services <br />4695 MacArthur Gourt, Suite 700 <br />(949)399-5800 <br />License #0437153 <br />Newport Beach, CA 92660 <br />Attn: heatlhcare.accountsCSS@marsh.com <br />307996-003-003-07-08 <br />INSURED 'A-2002- ~ -- <br />Westcliff Medical Labs, Inc. ~- 57A.` <br />-~----~. <br />Attn: Rodney Brown A-2004-121 <br />1821 E. Dyer Road, Suite 100 "-- <br />Santa Ana, CA 92705 A-2005-144 ' <br />A-2006-164 <br />CERTIFICATE OF INSURANCE CERTIFICATE NUMBER <br />LOS-000523409-OE <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br />NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE <br />POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE <br />AFFORDED BY THE POLICIES DESCRIBED HEREIN. <br />COMPANIES AFFORDING COVERAGE <br />COMPANY <br />A TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA <br />COMPANY <br />B UNITED STATES FIRE INSURANCE COMPANY <br />COMPANY <br />C <br />COMPANY <br />D <br />THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY <br />PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES- AGGREGATE <br />LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS- ~~ <br />CO ~I POLICY EFFECTIVE POLICY EXPIRATION <br />LTR TYPE OF INSURANCE POLICY NUMBER i DATE (MMIDDIYY) DATE (MMlDDlYY) LIMITS <br />A GENERAL LIABILITY 630 154D589A-TIL-07 10/01!07 l OlO1 /OH GENERAL AGGREGATE I $ 2,000,000 <br />X COMMERCIAL GENERAL LIABILITY PRODUCTS - COMPlOP AGG $ Z,000,OOO <br />CLAIMS MADE ~ OCCUR PERSONAL 8 ADV INJURY $ 1 ,000,000 <br />OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE ~ 1 ,000,000 <br /> FIRE DAMAGE (Any one fire) $ 100,000 <br /> MEDEXP(An one erson $ 5,000 <br /> AUTOMOBILE LIABILITY <br />1 <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />$ <br /> ALL OWNED AUTOS <br />SCHEDULED AUTOS BODILY INJURY <br />(Per person) $ <br /> HIRED AUTOS <br />NON-OWNED AUTOS BODILY INJURY i <br />(Per accident) t $ <br /> _-_ PROPERTY DAMAGE $ <br /> <br /> GARAGE LIABILITY <br />_ ~ <br />AUTO ONLY - EA ACCIDENT <br />~ $ <br />_ <br /> ANY AUTO OTHER THAN AUTO ONL~ __ _ <br />_ <br />_ _ <br /> EACH ACCIDENT _ <br />$ _ <br /> I AGGREGATE $ <br />A ExcessuAelurY CUP 154D589A-TIL-07 <br />10/01/07 <br />10/01/08 <br />EACH OCCURRENCE _ <br />$ 2,000,000 <br />~_~ UMBRELLA FORM AGGREGATE $ 2,000,000 <br />'I OTHER THAN UMBRELLA FORM $ <br />i B WORKERS COMPENSATION AND 40$6946242 WC STA U- 0TH- <br />EMPLOYER5'LIABILITY 12/01/07 12/01/08 X TORY LIMITS ER ' _ _ <br />EL EACH ACCIDENT $ 1 ,000,000 <br />THE PROPRIETOR/ 17. I INCL EL DISEASE-POLICY LIMIT $ 1 ,000,000 <br />~ PARTNERSlEXECUTIVE f-1 <br />OFFICERS ARE: ! I EXCL EL DISEASE-EACH EMPLOYEE $ 1,000,000 <br />OTHER <br />A Business Personal 630 154D589A-TIL-07 10/01/07 10/01/08 Limit 6,343,135 <br />i Properly Blanket Limit 'I I Deductible 2,500 <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESlSPECIAL ITEMS <br />10 Day Notice of Cancellation for Non-Payment of Premium. The City of Santa Ana, it's officers, agents and employees are included as Additional Insured <br />~ as required by written contract. <br />