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<br />10/23/01 <br /> <br />12: 15 <br /> <br />LADWP EAP ~ 714 647 5311 <br /> <br />NO. 035 1>01 <br /> <br />Branch <br />32 <br /> <br />1J!A <br />A <br /> <br />Producer # <br />000ZJ60 <br /> <br />1I5U\ Date <br />08( ,,(2[J'[Jl <br /> <br />RenewallReplacement No. <br />lutlfltWAL <br /> <br />PSYCHOLOGISTS PROFESSIONAL LIABILITY <br />CLAIMS-MADE INSURANCE POLICY <br />PURCHASING GROUP POLICY NUMBER: 452-0002000 <br /> <br />NOTICE: TH IS IS A CLAIMS-MADE POLICV, PLEASE READ TH E POllCV CAREFUll V_ <br />Item DECLARATIONS CERTIFICATE NUMBER: 45p-2015329 <br /> <br />1. <br /> <br />NAMED INSURED: <br />ADDRESS <br />(Number &. Streetl Town, <br />County, State &. ZlP No.) <br /> <br />PRXNCE ~ PHELPS CONSULTANTS <br />17215 AI/ENIDA DE LA HElllADURA <br />PACIFIC PALISADES CA 90272-2004 <br /> <br />2. <br /> <br />POLICY PERIOD: <br /> <br />From 10/01/2001 To 10/01/1002 <br />(12:01 A.M. Standard Time At Location Of Desianated Premises) <br /> <br />3. <br /> <br />COVERAGE: <br />Professional Liability <br /> <br />LIMITS OF L~ILITY <br />$1,000,000 $3,000,000 <br />each Incident Agaregate <br /> <br />PREMIUM <br />$1,785.00 <br /> <br />4. BUSINESS OF THE INSURED: 1'IyeholClAY <br /> <br />5. <br /> <br />THE NAMED INSURED IS: <br />( ) Sole Proprietor (including Independent COntractors) (X) Partnership ( ) Corporation <br />( ) OTHER: <br /> <br />6. This policy shall only apply to incidents which happen on or after: a) the policy effective <br />date shown on the Declarations; or b) the effective date of the earliest c1aims.made policy <br />issued by the Company to which this polley is a renewal; or c) tbe date &pecified ill any <br />endorsement hereto. 10/01/1998 <br /> <br />7. This policy is made and accepted subject to the printed conditioll.! of this policy together with <br />the pTovi~ionl, stipulations and agreeme.nts contained in the following form(s) or endorsement(s): <br /> <br />PL~-2008 (10/94) POE-S007 P~E-21S7 (07/001 PLE-2081 <br />PON-2003 PLE-a035 (09/97) <br /> <br />CHICAOO INSURANCE COMPANY <br />55 E. MONR.OE STREET, CHICAGO, IIUNOTS 60603 <br /> <br />REPRESENTATIVE; Agent or Broker: I{irke Van Orsdel <br />Office AddrC$s: 1776 West Laltes Parkway <br />Town and State: West DeG Moinel, IA. 50308 <br />ToIl.free Number: 1-800-852.9987 <br /> <br />INTERSTATE <br />INSURANCE <br />GROUP <br /> <br /> <br />7671 DIIe.ll.~~_1 ~QM. I <br />...... ]).-. ,4.ft~ AI <br />Ca ""tJ. <br />ptyo... '(/lIA JH- SIP' <br />F... CNJ)3'7' J~/3 <br /> <br />PLP-2012 (06/93) (Elec.) <br />PLP.aOOJ (71i41 (E~. LASER) <br />