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<br />ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDfYY) <br />~ . 03/15/2001 <br />PRUOUCER (714)990-4430 FAX (714)255-0872 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE .-.. <br />R. W. ~ortimer & Assoc. Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />~BA: HealthCare Professionals' ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />PO Box 9699 INSURERS AFFORDING COVERAGE <br />Brea, CA 92822-9699 <br />INSURED East Edinger Medical Center INSURER A: St. Paul Fire & Marine Ins Co. <br />East Edinger Management Co Llc INSURER B: American Healthcare Indemnity <br />1530 E Ed;nger Avenue INSURER c: <br />Santa Ana, CA 92705 INSURER 0: <br />I INSURER E: <br /> <br />COVERAGES <br /> <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 CERTIf:"ICA TE MAYBE 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. AGG"EGAIE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />I'em TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDIYY) DATE (MMIDDIYY) LIMITS <br /> GENERAL LIABILITY FK06604489 OS/20/2001 OS/20/2002 EACH OCCURRENCE $ 1,000,001 <br /> X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 1,000,001 <br /> J CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $ S,OOl <br />A PERSONAL & ADV INJURY $ I,OOO,O!!! <br /> GENERAL AGGREGATE $ 2,OOO,0(j1 <br /> ~N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM~OPAGG $ <br /> D :..Cl PRO- n <br /> POLICY JECT LOC <br /> AUTOMOBILE LIABILITY FA06600432 OS/20/2001 OS/20/2002 COMBINED SINGLE LIMIT <br /> - (Eaaccident) $ <br /> ANY AUTO <br /> - ALL OWNED AUTOS <br /> BODILY INJURY <br /> X (Per person) $ <br /> SCHEDULED AUTOS <br />A r--- <br /> HIRED AUTOS BODrl Y INJURY <br /> r- (Peracddenl) $ 750,O!!! <br /> NON-OWNED AUTOS <br /> r- ~~22:la~ <br /> PROPERTY DAMAGE $ <br /> - ..... ,~ (Per accident) <br /> GARAGE LIABILITY .. ~, AUTO ONLY - EA ACCIDENT $ <br /> =i ANY AUTO ~ ~~~\ ]1 OTHER THAN EAACC $ <br /> 'It) ,..\~ AUTO ONLY: AGG $ <br /> ~ <br /> EXCESS LIABILITY c:.I;o"\ sa~ ~ EACH OCCURRENCE $ <br /> o OCCUR o CLAIMS MADE . )f. ",.t\O .;y! AGGREGATE $ <br /> P,\S <br /> ~ $ <br /> j, DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION ANO .1 TORY lIMITSl .-l ER <br /> EMPLOYERS' LIABILITY E.L EACH ACCIDENT $ <br /> EL DISEASE ~ EA EMPLOV-,=-E $ <br /> EL DISEASE - POLICY LIMIT $ <br /> OTHER HCFOOOOlS5 07/0l/2000 07/01/2001 <br /> Profess;onal Uab;];ty <br />B laims Made Form $1,000,000 Each Claim <br /> _Ann $3,000,000 Aggregate <br />DESCRIPTION OF OPERATlONSIlOCATlONSNEHICLES/EXCLUSIONSADDED BY ENDORSEME lu~1 It;; --UKlV/ <br />Retroactive Date: 6-17-85 <br /> Michael _VigliiJila f -,-~ -~._--~--~-"'_~M. <br /> Dcpuly City,,' /11,rnl:v <br />CERTIFICATE HOLDER ~ -L ADDITIONAL INSURED; INSURER LETTER: CANCELLATION <br /> SHOULD ANY OF THE AbOVE DESCRlfJED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF. THE ISSUING COMPANYWfLLENDEAVOR TO MAil <br /> City of Santa Ana, its officers, agents & ----1L DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br /> El11Jloyees <br /> ATTN: ROSA FLORES BUT FAILURE TO MAIL SUCH NonCE SHALL IMPOSE NO OBLIGATION OR UABIUTY <br /> 20 Civ;c Center Plaza OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. <br /> Santa Ana, CA 92701 AJ:jZEDRJSE{ZfM J:Ja. <br /> . ~. J -Ltl..<- A/I/\L) <br /> ,..'" '''.'1 FAX: 714 647-S311 , "v.. 0>00 <br /> .- <br /> <br />( ) <br /> <br />