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Account Number: CA GRUE 1440 Date: 1/11/02 Initials: KK <br />CERTIF'fCATE OF INSURINCE <br />EXECUTIVE RISK INDEMNITY INC. <br />C/O: American Professional Agency, Inc. <br />95 Broadway, Amityville, NY 11701 <br />This is to certify that the insurance policies specified below have been issued by the company indicated <br />above to the insured named herein and that, subject to their provisions and conditions, such policies afford <br />the coverages indicated insofar as such coverages apply to the occupation or business of the Named insur ed(s) <br />as stated. <br />THIS ER <br />ALTERSETHEFCOVERAGE(S)SURANCE AFFORDEDEBYHTHEAPOLICY(IES)YNR LISTEDEONTTHISYCERTIFICATE.TENDS OR <br />Name and Address of Insured: <br />ERIC WAYNE GRUVER,PH.D. <br />17772 17TH ST. <br />SUITE 106 <br />TUSTIN CA 92780 <br />Type of Work Covered: PROFESSIONAL PSYCHOLOGIST <br />Location of Operations: N/A <br />(If different than address listed above) <br />Claim History: <br />Additional Named Insureds. <br />NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED ON THIS <br />POLICY AND HE OR SHE SHALL ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING <br />OR RECEIVING NOTICE OF CANCELLATION. APPROVED AS TO FORM <br />Comments <br />This Certificate Issued to <br />Name: ERIC WAYNE GRUVER,PH.D. <br />17772 17TH ST. <br />Address: SUITE 106 <br />TUSTIN CA 92780 <br />aura Sheedy <br />Deputy City Attorney <br />Autriorized Representative <br />Policy <br />Effective <br />Expiration <br />Limits of <br />Number <br />Date <br />Date <br />Liability <br />Coverages <br />2,000,000 <br />PROFESSIONAL/ <br />008-1751708 <br />3/01/02 <br />3/01/03 <br />4,000,000 <br />LIABILITY <br />NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED ON THIS <br />POLICY AND HE OR SHE SHALL ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING <br />OR RECEIVING NOTICE OF CANCELLATION. APPROVED AS TO FORM <br />Comments <br />This Certificate Issued to <br />Name: ERIC WAYNE GRUVER,PH.D. <br />17772 17TH ST. <br />Address: SUITE 106 <br />TUSTIN CA 92780 <br />aura Sheedy <br />Deputy City Attorney <br />Autriorized Representative <br />