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12/10/2007 14:06 7145443566 TUSTIN REDHILL INSUR PAGE 02/03 <br />ACORD CERTIFICATE OF LIABILITY INSURANCE OATE(MM OW WI <br />m 1211012007 <br />RODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Tustin Redhill Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />n __ HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />30 Box 540 A a D / — (% I ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Tustin CA 92781 M7 DEC ,q AN 4NOZERS AFFORDING COVERAGE NAIC a <br />NSURBD Luis E Rivera, MD, Inc. rNSURER A SEQUOIA INSURANCE <br />2222 S. Main Street CITY Gii <br />Santa Ana, Ca 92707 (,LE�i1 NU ER C, <br />Fax:714751.905D `� :NSURER0; <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE 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 />�t ICIF. ^,. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />NOR <br />NCR <br />TYPE OFINSL�BM- <br />POLCY NUMBER <br />pOUCY EFFEEX" IPOLIGY <br />EXPRUTION <br />IJIAITS <br />IMPOSE NO ORUGATION OR LIAI UL OF ANY KIND UPON THE INSURER, IEB AGEKT$ OR <br />A <br />X <br />IGEN'L <br />GENERAL MASILITY <br />X COMMERCIALGENERALLIABILITY <br />GLAIM$ MADE ❑ OCCUR <br />SBP2046162 <br />7MM007 <br />7/19/2008 <br />EACH OCCURRENCE <br />; 11000,000 _ <br />DA AGE TD RENTED <br />EM ISES.IEa.PLGEOnrA>_F300,000 <br />MED EXP (Am Ong pBROnt <br />i16,000 <br />PERSONAL A ADV INJURY <br />S 2,900,000 <br />9rNERALAGGRa ATE <br />52,0001000 <br />�• <br />L AGGREGATE LIMIT APPLIES PER; <br />POLICY �� PRO- LOC <br />PRODUCTS COMP/OP AGO <br />AZIOOD,000 <br />A I x <br />AUTOMOIILF <br />X <br />LN181UTY <br />ANY AVTD <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />SOP2046162 <br />07/19/2007 <br />0711912008 <br />'I <br />I <br />I <br />COMBINED SINGI.E LIMIT <br />(a peddent) <br />$ 1x000,000 <br />BODILY INJURY f <br />IPPrpR fl) <br />'BODILY INJURY I5 <br />(PeraWdepl) <br />X <br />PROPERTY DAMAGE <br />(Paracdderd) <br />E <br />r0_ARAOE LIARILM <br />ANY AUTO <br />AUT ONLY - EA ACCIDENT <br />$ <br />OTHER THAN :ACC <br />AUTO ONL °' AGG <br />5 <br />E <br />EXCESSNMBRELLA LIABILITY <br />OCCUR ❑ CLAIMS MADE <br />DEDUCTIBLE <br />RETENTION It <br />EACH O- CCURRENCE <br />S <br />AGGREGATE$ <br />E <br />f <br />S <br />WORKERS EOMPENSA710N ANO <br />EMPLPORYOPRS:C'•TLOARBIPLATRY <br />ANY <br />OFFICERIMEMBBR EXCLUOEO? <br />tt ; deecHbA under <br />ECIA ^IONS <br />. <br />STA7UWC TH- <br />ER „- <br />11.1., EACH ACCIDENT <br />S <br />E.L DISEASE -EA EMPLOYE <br />f <br />E FASE - POLICY LIMIT <br />$ <br />OTHER <br />DESCNPTION OF OPERATIONS I LOCATORS I VEHICLES! EXCLUSIONS ADDED DY ENDORBEMEN71 SPF•CIAL PROVISIONS <br />Interest will receive a ten -day cancellation notice in the event of Non - Payment of premium <br />reeT,v,r ere unl hin CANCELLATION <br />ACORD 25 (2001105) , /vi0� w'r�N.vrc,• �.vnrvrw „vn ,aac <br />SHOULD ANY OF THE ABOVE OBBORISED POLIOMB BE CANMI.LBB BEFORE THE EXPRSATION <br />The City Of Santa Ana <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAR 3Q DAYS WRITTEN <br />20 Civic Center Plaza <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT PAIW RETO DO SO SMALL <br />Santa Ana, CA 92701 <br />IMPOSE NO ORUGATION OR LIAI UL OF ANY KIND UPON THE INSURER, IEB AGEKT$ OR <br />REPRESENTATIVES. <br />AUTHORMID REPRESENTATIV <br />- <br />ACORD 25 (2001105) , /vi0� w'r�N.vrc,• �.vnrvrw „vn ,aac <br />