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<br />" <br /> <br />ACORq CERTIFICATE OF LIABILITY INSURANCE I DATE IMMlDDIVYYY) <br />08/07/2007 <br />PRODUCER (949)305-6161 FAX (949)305-6166 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Colonial Western Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />26691 Plaza Drive, Suite 220 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Mission Viejo, CA 92691 <br /> INSURERS AFFORDING COVERAGE NAIC tI <br />INSURED Correct i ona I Managed Care Med i ca I Corporat i on INSURER A: Lexinqton Insurance Company <br />4211 E, La Pa I ma Ave, A 02.00 " _ Jt { '7 INSURER B: Travelers Insurance Company <br />Anaheim, CA 92807 4 INSURER C: Everest Insurance Company <br /> A - ,2(Xn-' 9'3 INSURER D: <br /> INSURER E: <br /> <br />C <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWlTHST ANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VV1TH RESPECT TO \MilCH THIS CERTIFICATE MAYBE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />Ir;~ ~1l12:! TYPE OP INSURANCE POLICY NUMBER POLICY EFFECTIVE POUCY EXPIRAnON UMITS <br /> ~NERAL UABILITY 0314761 08/01/2007 08/01/2008 EACH OCCURRENCE $ 1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 50,OQC <br /> ~ txJ CLAIMS MADE 0 OCCUR MED EXP (Anyone pemln) $ s,ooe <br />A PERSONAL & ADV INJURY $ 1,000,000 <br /> f- 3,000,OOC <br /> GENERAL AGGREGATE $ <br /> f- 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ <br /> nPOLlCyn~~ nLOC . <br /> ~TOMOBlLE UABIUlY 6809447H706 02/04/2007 02/04/2008 COMBINED SINGLE LIMIT <br /> (Ea accident) $ 1,ooO,OOe <br /> f-- ANY AUTO <br /> ALL OWNED AUTOS BODILY INJURY $ <br /> c-- (Par person) <br /> SCHEDULED AUTOS <br />B - <br /> ~ HIRED AUTOS BODILY INJURY $ <br /> X NON.QWNED AUTOS (Per accident) <br /> I-- <br /> f- PROPERTY DAMAGE $ <br /> (Per accident) <br /> RAABE UABlLITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EAACC $ <br /> AUTO ONLY: AGG $ <br /> OESSlUMBRELLA UABIUTY EACH OCCURRENCE $ <br /> OCCUR 0 CLAIMS MADE AGGREGATE $ <br /> $ <br /> R DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND CA2001 0955061 07/01/2007 07/01/2008 X'- we STATU- IO~ <br /> EMPlOYERS' UABIUlY E.L. EACH ACCIDENT $ 1,000,000 <br />C ANY PROPRIETORlPARTNERlEXECUTIVE E.L. DISEASE. EA EMPLOYEE $ 1,000,000 <br />OFFICERlMEMBER EXCLUDED? <br /> ~~~~Iir=~mrNS baIow E.L. DISEASE - POLICY LIMIT $ 1,000,000 <br /> p01~~essional Liability 0314761 08/0112007 08/01/2008 Prof Liabi I ity: $1mi 1/$3mi I <br />A Managed Care E&O Liab. 0314761 08/01/2007 08/01/2008 Managed Care E&O: $1mi 1/$3mi I <br />DESCRIPTION Of OPERAnONli( LOCATION' I VeHl\lLES I EXClUSIONS ADDED BY ENDO~EMENT J l!PEClAl PROVISIONS <br />10 Days notice 0 cance latlon for non-payment 0 premIum. professional I iabi I ity per <br />ertificate Holder is an Additional Insured for general. I iabi I ity and <br />ndorsement #14 attached. <br /> <br /> <br />ACORD 25 (2001/08) <br /> <br /> <br />Don <br /> <br />PRIETARY <br />CORi~!. '.~TiONAL <br />MANAC.t:D CARE <br /> <br /> <br />, @ACORDCORPORATION1988 <br />(/]('7' / / c <br /> <br />City of Santa Ana <br />Santa Ana City Jai I <br />Attention: Chris Laugenaur, Contracts <br />62 Civic Center Plaza <br />Santa Ana, CA 92702 <br />