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<br />,aco CERTIFICATE OF LIABILITY INSURANCE 6/20F DATE M/DDI12
<br />� 6/20/20
<br />PRODUCER (303) 534-7325 FAX: (303) 623-7325 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Peak 360, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER T lq$-,,,r�-FRTIFICATE DOES NOT AMEND, EXTEND OR
<br />1600 Emerson St. ,n , ALE COI/ RAGE AFFORDED BY THE POLICIES BELOW.
<br />Denver CO 80218 INSURERS AFFQRpING COVERAGE NAIC #
<br />INSURED C INSURER k HO$414,iI\d Insurance Co of NY
<br />WellDyne, Inc.; WellDyneRX; CF Pharmacy Svc wsuRERe:Contirl 'fatal Insurance (CNA)
<br />7472 S. Tucson Way pINsuRERc:
<br />The Hartford 00914
<br />©� a-7 1 INSURER D:
<br />' Centennal CO 80112 V INSURER E:
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
<br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OFSUCH
<br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />ADD'
<br />NSR
<br />TYPE OF INSURANCE
<br />POLICY NUMBER
<br />EFFECTIVE
<br />POLICY /YY
<br />DATE MMIDDYY
<br />POLICY EXPIRATION
<br />DATE MM/DD/YYYY
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 11000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />$ 300,000
<br />A
<br />CLAIMS MADE [A] OCCUR
<br />L-0925-11
<br />12/7/2011
<br />12/7/2012
<br />MED EXP (Any one person)
<br />$ 5,000
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />!
<br />i
<br />GENERAL AGGREGATE
<br />$ 3,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OP AGG
<br />$ 3,000,000
<br />X POLICY !77 PRO- LOC
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />$ 1,000,000
<br />BODILY INJURY
<br />(Per person)
<br />$
<br />B
<br />X
<br />ALL OWNED AUTOS
<br />SCHEDULED AUTOS
<br />4026985883
<br />12/7/2011
<br />12/7/2012
<br />BODILY INJURY
<br />(Per accident)
<br />$
<br />X
<br />X
<br />HIRED AUTOS
<br />NON -OWNED AUTOS
<br />PROPERTY DAMAGE
<br />(Per accident)
<br />$
<br />-e-�
<br />GARAGE LIABILITY
<br />ANY AUTO
<br />1
<br />/
<br />AUTO ONLY - EA ACCIDENT
<br />$
<br />OTHER THAN EA ACC
<br />$
<br />$
<br />AUTO ONLY: AGG
<br />EXCESS I UMBRELLA LIABILITY
<br />X OCCUR CLAIMS MADE
<br />, i.,t. i
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />AGGREGATE
<br />$ 2,000,000
<br />$
<br />$
<br />A
<br />DEDUCTIBLE
<br />-0251-11
<br />12/7/2011
<br />12/7/2012
<br />EXCESS OVER CNA ONLY
<br />$
<br />X RETENTION $ 10,000
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />34WEJI3046
<br />6/1/2012
<br />6/1/2013
<br />I WRYTATU- OTRH-
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYE
<br />$ 1 000,000
<br />If yes, describe under
<br />SPECIAL PROVISIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />I $ 1,000,000
<br />A
<br />OTHER PROF LIABILITY
<br />L-0925-11
<br />12/7/2011
<br />12/7/2012
<br />EACH OCCURRENCE $ 1,000,000
<br />ANNUAL AGGREGATE $ 3,000,000
<br />C
<br />TPA E&O LIABILITY
<br />iPG0257328
<br />12/7/2011
<br />1 12/7/2012
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
<br />CERTIFICATE HOLDER CANCELLATION
<br />ckindig@santa-ana.org
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />CITY OF SANTA ANA
<br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
<br />CHRI STY KIND IG
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
<br />20 CIVIC CENTER PLAZA
<br />SANTA ANA, CA 92701
<br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
<br />REPRESENTATIVES.
<br />AUTHORIZED REPRESENTATIVE _
<br />Gary Friedman/GARY
<br />ACORD 25 (200910l) © 1988-2009 ACORD CORPORATION. All rights reserved.
<br />INS025 (200901) The ACORD name and logo are registered marks of ACORD
<br />
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