Laserfiche WebLink
<br />Account Number: CA GRUE 1440 <br /> <br />Date: <br /> <br />1/11/02 Initials: KK <br /> <br />CERTIF~CATE OF <br /> <br />INSUR'i{NCE <br /> <br />EXECUTIVE RISK INDEMNITY INC. <br /> <br />C/o: American Professional Agency, Inc. <br />95 Broadway, Amityville, NY 11701 <br /> <br />This is to ce~tlfy that the insurance policies specified below have been issued by the company indicated <br />above to the insu~ed named he~ein 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 insured(s) <br /> <br />THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR <br />ALTERS THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED O~ THIS CERTIFICATE. <br /> <br />as stated. <br /> <br />Name and Address of Insured: <br />ERIC WAYNE GRUVER,PH.D. <br />17772 17TH ST. <br />SUITE 106 <br />TUSTIN CA 92780 <br /> <br />Additional Named Insureds: <br /> <br />Type of Work Covered: PROFESSIONAL PSYCHOLOGIST <br /> <br />Location of Operations: <br />(If different than address listed above) <br /> <br />NIA <br /> <br />Claim History: <br /> <br /> Policy Effective Expiration Limits of <br />Coverages Number Date Date Liability <br />PROFESSIONALI 2,000,000 <br />LIABILITY 008-1751708 3/01/02 3/01/03 4,000,000 <br /> <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. <br /> <br />Comments: <br /> <br />APPROVED AS TO FORM <br /> <br />~~AOO ~ <br />aura Sheedy <br />Deputy City Attorney <br /> <br />This Certificate Issued to: <br /> <br />Address: <br /> <br />ERIC WAYNE GRUVER, PH.D. <br />17772 17TH ST. <br />SUITE 106 <br />TUSTIN CA 92780 <br /> <br /> <br />Name: <br /> <br />/ <br />