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MARSH CERTIFICATE OF INSURANCE CERTIFICATE NUMBER <br />LOS -000523409-06 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br />Marsh Risk & Insurance Services NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE <br />4695 MacArthur Court, Suite 700 POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE <br />(949) 399-5800 AFFORDED BY THE POUCIES DESCRIBED HEREIN <br />License #0437153 COMPANIES AFFORDING COVERAGE <br />Newport Beach, CA 92660 <br />Attn: heatlhcare.accountsCSS@marsh.com COMPANY <br />07996-003003-07-08 A TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA <br />INSURED A-2002-1 <br />COMPANY <br />Westcliff Medical Labs, Inc. 57A <br />B UNITED STATES FIRE INSURANCE COMPANY <br />Attm Rodney Brown ;A-2004-121 <br />1821 E. Dyer Road; Suite 100 A-2005-_ <br />Santa Ana, CA 92705 144 <br />COMPANY <br />C <br />A-2006-164_. ,. <br />COMPANY <br />D <br />COVERAGES This certificate supersedes and replaces any previously issued certificate for the policy period noted below. 2 <br />THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY <br />PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE <br />LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTR <br />T <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE(MMIDDIYY) <br />POLICY EXPIRATION <br />DATE(MMIDDIYY) <br />uMITS <br />A <br />GENERALUABILITY <br />630154D589A-TIL-07 <br />10/01/07 <br />10/01/08 <br />GENERAL AGGREGATE $ 2,000,000 <br />PRODUCTS - COMPIOP AGG $ 2+000,000 <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE I OCCUR <br />PERSONAL & ADV INJURY $ 1,000,000 <br />EACH OCCURRENCE $ 1,000,0()0 <br />OWNER'S & CONTRACTOR'S PROT <br />FIRE DAMAGE (Any one fire $ 100+000 <br />MED EXP (Any oneperson) $ 5,000 <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT $ <br />ANY AUTO <br />BODILY INJURY $ <br />(Per person) <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY $ <br />(Per accident) <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE $ <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />OTHER THAN AUTO ONLY: <br />ANY AUTO <br />EACH ACCIDENT $ <br />AGGREGATE $ <br />A EXCESS LIABILITY <br />CUP 154D589A-TIL-07 <br />10/01/07 <br />10/01/08 <br />EACH OCCURRENCE $ 2,000,000 <br />AGGREGATE $ 2+000+000 <br />X UMBRELLA FORM <br />$ <br />OTHER THAN UMBRELLA FORM <br />B WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />40$6946242 <br />12/01/07 <br />12/01/0$ <br />X TORY LIMITS OTH <br />ER <br />EL EACH ACCIDENT $ 1,000,000 <br />THE PROPRIETOR/ X INCL <br />PARTNERS/EXECUTIVE <br />OFFICERS ARE: EXCL <br />EL DISEASE -POLICY OMIT $ 1,000,000 <br />EL DISEASE -EACH EMPLOYEE $ 1 ,000,000 <br />OTHER <br />A <br />Business Personal <br />630 154D589A-TIL-07 <br />10/01/07 <br />10/01/08 <br />Limit 6,343,135 <br />Property Blanket Limit <br />Deductible 2,500 <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS <br />10 Day Notice of Cancellation for Non -Payment of Premium. The City of Santa Ana, it's officers, agents and employees are included as Additional Insured <br />as required by written contract. <br />CERTIFICATE HOLDER - <br />CANCEL.L.ATION <br />SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. <br />_ <br />THE INSURER AFFORDING COVERAGE 1MLL ENDEAVOR TO MAIL -_A0 DAYS WRITTEN NOTICE TO THE <br />City of Santa Ana <br />20 Civic Center Plaza (M-29) <br />CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR <br />PO Box 1988 <br />LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE <br />Santa Ana, CA 92702 <br />ISSUER OF THIS CERTIFICATE <br />MARSH USA INC. <br />BY: John Graef <br />MM1(3/02) VALID AS OF: 12/04/07 <br />