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<br />~~ ~~ ~... <br /> <br />. : ~ ~ <br /> <br />.. . <br /> <br />. <br /> <br />, <br /> <br />lr.mDI CERTIFICATE OF INSURANCE <br />." . <br /> <br />PAODUCER <br /> <br />INSUIlEO <br /> <br />PAGE 02 <br />ISSUE 0'-' TE (MMlDOIVY) , <br /> <br />I I I <br /> <br />THIS CIEIIITIFICATE . IUUlED ..a A MATTER Of INFOMlATION 0Ml Y ,AND CONflAa <br />NO RIGHTII UPON 1ME CEIn~TI: HQl.Dt!R. ". Cf,IIIT1FICAU: DOES NOT MlI!JIIO. <br />EJTEIlIl DlO .... TEll THE COYE.....GE .- .' THE I'Ol.IClES alLOW. <br /> <br />KENNY T PALMA INSURANCE AGENCY <br />15605 CARMENITA RD SUITE 102 <br />SANTA FE SPRINGS CA 90670 <br />TEL: (562) 926-4416 <br /> <br />COMPANIES AFFORDING COVERAGE <br /> <br />f~~Y A TRUCK INSURANCE EXCHANGE <br /> <br />1"18 ... TO CEJIITIFY THAT ..eUClts OF INSURANCE: LISTED BELOW H.-rE BEEN ISSUE.D fO THE INSURED NAMED "eo"!: FOFl1H':' POL.ICY PEAIOD INDICATED <br />NQTWlttl9TANDING .."'. MQUIREMEfIIT, TEfW OR COtIPlTtON OF ANY CONTRACT OR OTHER DOCUME.N'T WrTH RE~CT TO WHICK THIS CERTIACAT. MAY <br />BE ISSUlD OR YAY PERlAIN, THE INSURAI'tCE AFfORDED 11"1 THIE POLICIES DESCRIBED tttAf'IN 18 SO&lf.C1' TO ALl THIE TEAMS, EllCLUStON8, AND CONDI- <br />TIONS OF sue" f'OLICIU. <br /> <br />i <br /> <br />TUSTIN IRVINE MEDICAL GOURP INC <br />800 N TUSTIN AVE <br />SANTA ANA CA 92705 <br /> <br />COMPANY <br />LETTER . <br />COMPANY C <br />LETTER <br /> <br />TYPE OF INSUAJl.NCE <br /> <br /> <br />GEHEUL u,.,8111TY <br />~RE"E~VE fORM <br />PREloIISESiOPEIlATIONS <br />UNOERGR<)JNO <br />EXPl.OSION . COlLAPSE H~ <br />PflOO\JCTS/tOMPl.EnD OPEIlATIONS <br />CONTRACTUAL <br />INOtPENDENT CONTRACTORS <br />BROAD FOAM PROPERTY OAMAGf <br />Pf:RSON.Al INJURY <br /> <br />POLICY NUMBER POllCTWEC1M I'ClICYEIl~TlON <br /> ()AT~ (MMJOONYl DAlllto&WOl'Nl aOOAEClATE. <br /> ace <br /> BODILY $ S <br />09407-10-51 11-01-0 lNJUAY <br /> CONTINU US pROPERT'Y $ $ <br /> OAM,t.OE <br /> UNITL C NCELLED <br /> <br /> <br />CQMP"NV D <br />LETtER <br /> <br />~ <br /> <br />. . <br /> <br />IE <br /> <br />. <br /> <br />~~~~eo $2MILL S2MILI.. <br /> <br />PERSON.AL INJUAV $ <br />0Kl" <br />""'" $ <br />l"''''l'EfWtIl <br />OKll' <br />"...' $ <br />IIl{AACCf(Itf) <br />PRO PEA"" $ <br />Q,aMaGE <br />II' PO $ <br />COMBIN'fO <br />IlII a PO $ <br />COMBINEO <br />STATuTOR.Y <br /> <br />Aurouo-u LIABILITY <br />ANVAUTO <br />All QWNfO AUTOS (PRI\I PASS,) <br />AlL OWNED AUTOS (~J:Rp~) <br />",RIO AUTOS <br />X NON.OWlIEO AUlDS <br />GAAMiI UAIlIUI'I <br /> <br />-~C'G3"\ <br />'"i<' \ <br />1'5 <br /> <br />\) <br />1'-\,\,\,-0" ~ <br /> <br />--~- <br /> <br /> <br />ElCESIS u~un <br />UMB~llA FORM <br />OTHER Ht.'" lJMBFlEllA FORM <br /> <br />WOflKfllll' COMP~N"TION <br />_NO <br />eMPLOYERS' LI....UTY <br /> <br /> <br />OTHER <br /> <br />DESCRIPTION Of OPERATtON6IlOCATIONSJVEHtCL.E6ISPECIAlITEMS <br />AUDIO TESTING - FROM NOVEMBER 2002 THRU OCTOBER 2003 <br />RISK MANAGEMENT DIVISION <br /> <br />. . . <br /> <br />CITY OF SANTA ANA <br />RISK MANAGEMENT DIVISION <br />20 CIVIC CENTER PLAZA, M-28 <br />SANTA ANA CA 92702 <br /> <br /> <br />(EACH ACCIDlNn <br />(OISEASE-PC\ICY liMIT) <br />(OISEASE.IAC" E.....OyE!) <br />