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12/14/2007 17:14 FAX d 002/004 <br />wnvworert <br />Cfient#: 59052 <br />At CERTIFICATE OF LIABILITY <br />PROD <br />^" "" """' <br />oa1z51o7 <br />INSURANCE OA126107 ' <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Ass <br />ASO inancial Services <br />HOLDER. THIS CERTIFICATE DGES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFOR3ED BYTHE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />248 Dr. Suite 200 Sac5833 <br />INSURED <br />Advanced Critical Care & Internal <br />INSURER A: Fireman's Fund Insul•ance <br />51 000 000 <br />INSURER Br <br />$10L <br />INSURER C. <br />2965 Edinger Avenue <br />INSURER D: <br />Tustin, CA 92780 <br />NSURER R <br />510 000 <br />PEFSONAL$ ADV INJ URY <br />COVERAGES <br />THE <br />ANY <br />MAY <br />POLICIES, <br />LTR <br />A <br />POLICIES <br />REQUIREMENT. <br />PERTAIN, <br />OF IN5URANCE LISTGD BELOW <br />TERM OR CONDITION OF <br />THE INSURANCE AFFORDED <br />AGGREGATE LIMITS SHOWN MAY <br />INSURANCE <br />ITY <br />HAVE BEEN ISSUEDTO THE INSURED <br />ANY CONTRACT OR OTHER DOCUMENT <br />BY THE POLICIES DESCRIBED HEREIN <br />HAVE BEEN REDUCED BY PAID CLAIMS. <br />POLICY NUMBER <br />AZC80803089 <br />NAMED ABOVE <br />WITH RESPECT <br />IS SUBJECT TO <br />POOCY EFFECTIVE <br />DATE <br />07101/07 <br />FOR THE POLICY <br />TO WHICH THIS <br />ALL THE TERMS, EXCLUSIONS <br />POLICY PIRA 0 <br />DATE MID <br />07101/08 <br />PEF:IOD INDICATED, NOTWITHSTANDING <br />C'- RTIFICATE MAYBE ISSUED <br />AND CONDITIONS <br />LIMM <br />OR <br />OF SUCH <br />EAC H OCCURRENCE <br />51 000 000 <br />DAIIA TG RENTED <br />$10L <br />rQENF� <br />GENERAL LIABILITY MADE 51 OCCUR <br />Mel) ERP W+Y Pne Peeen) <br />510 000 <br />PEFSONAL$ ADV INJ URY <br />$1000000 <br />GENERAL AGGREGATE <br />S2 000 000 <br />•COMPNP RGG <br />52 DJEGT <br />TE LIMIT APPLIES PLRPR(X)UCTS <br />LOO <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMB <br />I& BCCldenl) <br />S <br />ANY AUTO <br />ALL OWNCD AUTOS <br />OONLY INJURY <br />(Per pe5on) <br />S <br />SCHEDULED AU MS <br />HIRED AUTOS <br />EMILY INJURY <br />(Pa Qmdcm) <br />S <br />NON.OWNFO AUTOS <br />PR[IPERTY DAMAGE <br />(Pe. ¢iamry <br />S <br />_— <br />WPA06 UABINYY <br />ANY AUTO <br />AU1 0 ONLY - EA ACCIDENT <br />S <br />EA ACC <br />OT, ER THAN <br />AUTOONLY! AGG <br />$ <br />$ <br />EXCESSNMBRELLA LMBIUTY <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />_ <br />OCCUR 17 CLAIMS MADE <br />$ <br />S <br />DEDUCTIBLE <br />RETENTION S <br />WC BTATU- OM- <br />TORY <br />WORRERSCOMPENSATIONAND <br />EMPLOYERS UASIUTT <br />E L. EACH ACCIDENT <br />$ <br />E.L DISEASE.EAEMPLOYE <br />S <br />ANY OFFICERRAEMBERMXCLUDE07ECUME <br />E.L. DISEASE - POLICY LIMIT 5 <br />$1,000,009 Be occ. <br />A <br />II M. aMwW under <br />SPECIAL PROVISIONS Warr <br />OTHER Professional <br />AZC80803089 <br />07101107 <br />07/01/08 <br />Liability <br />DESCRIPTION OF OPERATIONS I LOCATION$ I VEWCLE$1 EXCLUSIONS ADDED BY ENOORSEMENT 1 SPRCML PROVISIONS <br />RE: Advanced Critical Care & Internal Medicine Inc. <br />Lock 2 - 3021 Edinger Avenue; Tustin, CA <br />LOG# 1 -2965 Edinger Ave.; Tustin, CA <br />(See Attached Descriptions) <br />The CRY of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />ACORD 25 (20011DB) 1 of 3 #1029309 <br />SHOULDANY OF THE ABOVE DESCRIBED PCLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _30_ DAYSWIIIITEN <br />NOTICE TO THE CERnFICATE HOLDER NAME D TO THE LEFT, BUT FAILURE TO DO SO BHA" <br />IMPOSE NO OBLIGATION OR UABILnY OF MY VINO UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATP/ES. <br />AMIHIPRIZZ <br />1^1,:;ww NT E <br />ADVANCRIT ✓l1/I�' DZT o ACORD CORPORATION 1988 <br />