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PULMONARY CONSULTANTS & PRIMARY CARE PHYSICIANS MEDICAL GROUP, INC. 4 - 2007
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PULMONARY CONSULTANTS & PRIMARY CARE PHYSICIANS MEDICAL GROUP, INC. 4 - 2007
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Last modified
7/7/2016 1:42:05 PM
Creation date
9/20/2007 3:26:37 PM
Metadata
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Template:
Contracts
Company Name
PULMONARY CONSULTANTS AND PRIMARY CARE PHYSICIANS MEDICAL GROUP, INC.
Contract #
A-2007-192
Agency
POLICE
Council Approval Date
8/20/2007
Expiration Date
6/30/2008
Insurance Exp Date
5/1/2008
Destruction Year
2017
Notes
Amended by A-2008-183, -001, A-2010-155, A-2011-132
Document Relationships
PULMONARY CONSULTANTS & PRIMARY CARE PHYSICIANS MEDICAL GROUP, INC. 4A - 2008
(Amended By)
Path:
\Contracts / Agreements\_PENDING FOLDER\READY TO DESTROY IN 2017
PULMONARY CONSULTANTS & PRIMARY CARE PHYSICIANS MEDICAL GROUP, INC. 4B - 2009
(Amended By)
Path:
\Contracts / Agreements\_PENDING FOLDER\READY TO DESTROY IN 2017
PULMONARY CONSULTANTS & PRIMARY CARE PHYSICIANS MEDICAL GROUP, INC. 4C - 2010
(Amended By)
Path:
\Contracts / Agreements\_PENDING FOLDER\READY TO DESTROY IN 2017
PULMONARY CONSULTANTS & PRIMARY CARE PHYSICIANS MEDICAL GROUP, INC. 4D - 2011
(Amended By)
Path:
\Contracts / Agreements\_PENDING FOLDER\READY TO DESTROY IN 2017
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Deli— AI—han <br />Date Entered: 3/27/2007 <br />ACORD,� CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMSDDIYTYY) <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY <br />THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION <br />PROOUCFR The Doctors' insurance Agency <br />4605 Lankershim Boulevard 4221 <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />No. Hollywood, CA 91602 <br />HOLDER. <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE <br />NAIC 4 <br />(800)576 -7314 <br />456 <br />123 - - -- - <br />-- <br />A <br />WIR ED Pulmonary Consultants i Primary Care Ph y <br />INSURERA:CNA <br />- <br />Claire Higgins <br />INSURER B --- -- - -- - - -- -- <br />_ <br />6A�A�E T6RIENTEt� <br />pREMISESIEeocounnc.�_ Ir_ <br />1310 W. Stewart Dr., Suite 410 <br />INSURER C: - -- <br />Orange, CA 92868 <br />INSURER D: <br />BJSURER C. <br />S 10,000 <br />$ 2 , 000 1006 <br />COVERAGE5 <br />BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE <br />CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY <br />THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />MAY PERTAIN, THE INSURANCE AFFORDED BY <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />-- P <br />— - - - -- -- - — POLICY NNLlER POLA:1/ AA: OLICY EXPIRATION LIMITS <br />ASR EFFECT TS <br />DATE THEREOF, THE ItISI w SAURER RILL ENDEAVOR To mAL30 DAYS WRITTEN <br />Attn: POberta <br />TYPE OF <br />20 Civic Center Plaza <br />I <br />Santa Ana, CA 92702 <br />EACH OCCURRENCE <br />$2,000,000 <br />A <br />GENERAL LIABILITY <br />COMMERCIAL GENERAL LIABILITY <br />2097649319 <br />$/1/2007 <br />$/1/2005 <br />_ <br />6A�A�E T6RIENTEt� <br />pREMISESIEeocounnc.�_ Ir_ <br />$300,000 <br />- <br />y orle pon) I <br />AAEP n ws <br />O EX (A <br />PERSONAL L ADV INJURY <br />'I <br />1� �jI <br />MS MADE OCCUR I <br />CLAIMS <br />f <br />S 10,000 <br />$ 2 , 000 1006 <br />-- — <br />GENERAL AGGREGATE <br />i 4,000, 000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMPIOP AGG <br />— - -- — <br />$ 4 , 600, 000 <br />POLICY LOC <br />AUTOMOBLE <br />LJABIJTY I <br />COMBINED SINGLE LIMB <br />i 1, OOO , 000 <br />A <br />I <br />( Ea acddanq <br />-- <br />_ _ _ _ <br />ANY AUTO <br />I <br />. _. <br />ALL OWNED AUTOS <br />BODILY INJURY I <br />i <br />_ <br />(Par perwn) <br />SCHEDULED AUTOS <br />_ <br />HIRED AUTOS <br />2097649319 <br />5/1/2007 <br />5/1/2009 <br />Be01LYINJURY <br />i <br />(Per accioenll <br />NON-OWNED AUTOS <br />- - -- - -- —=- <br />-- - <br />-- -. .— <br />PROPERTY DAMAGE <br />(ParaccdW) <br />i <br />GARAGE LIABI ITY <br />AUTO ONLY - EA ACCIDENT <br />$ <br />ANY AUTO <br />OTHER THAN EA ACC <br />i _ <br />AUTO ONLY: AGG <br />i <br />EXCESSAMBREIlA LIABILITY <br />EACH OCCURRENCE --�5 <br />— <br />-1,000,000 <br />A <br />OCCUR n CLAIMS MADE <br />2097649336 <br />5/1/2007 <br />5/1/2008 <br />AGGREGATE_ <br />I S 1,000,000 <br />�$ <br />- <br />i DEDUCTIBLE <br />- -- -- <br />i- <br />RETENTION $10,000 <br />i <br />IAfO11KERSCOMPENbAT10NMLD <br />ATU- TH- <br />_ LIMITS R_. <br />EMPLOYERS' L11ABLRY <br />l. EACH ACCIDENT <br />i <br />- - - - - -- <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />- OFysFIICERMEMBER EXCLUDED? <br />( <br />_t - <br />E.L DISEASE - EA EMPLYEE <br />S -._ <br />ff <br />P O below <br />SPECIAL OVIS S <br />E.L. DISEASE - POLICY LIMIT <br />i <br />OTHER <br />their interest aFp6ara. nid s ' <br />WC atA 'H AM T2Lame� s I�al iAa L S <br />'10.00 <br />lt <br />/� VLi <br />GCKIIrIL�AIC nVLAJCR <br />_ — <br />SW"D ANY OF THE AGM DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION <br />City of Santa Ana <br />DATE THEREOF, THE ItISI w SAURER RILL ENDEAVOR To mAL30 DAYS WRITTEN <br />Attn: POberta <br />NOTICE TO THE CERTIRCATE HOLDER NAMED TO THE LEFT, BUT FAILKE TO DO SO SHALL <br />20 Civic Center Plaza <br />BNK" NO OBLIGATION OR LUWMUTY OF ANY KW UPON THE INSURER ITS AGENTS OR <br />Santa Ana, CA 92702 <br />ATNES• <br />Dana o ar <br />NTA <br />_.- w. �wwsr� wAS[fA0AT1A►1 aaIQ4 <br />ACORD 25 (2001108) <br />Prooucod using Forms Boss Plus sartwaro. www.FolmsSo".corn; Impraaive PubeslWp 806208.1977 <br />
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