Laserfiche WebLink
MARSH <br />CERTIFICATE OF INSURANCE CERTIFICATE NUMBER <br />LOS -00053409-06 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br />Marsh Risk $ InSurance Services <br />NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE <br />460-5 MacArthur Court Suite 700 <br />POLICY THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE <br />(945) 399-5800 <br />AFFORDED BY THE POLICIES DESCRIBED HEREIN <br />License #0437153 <br />COMPANIES AFFORDING COVERAGE <br />Newport Beach CA 92660 <br />M Atin heatlhcare accountsCSSsmarsh-com <br />,c%^ AN <br />079%-003-003-07-08 <br />A TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA <br />INSURED, <br />AIPAN <br />Westcliff Medical Labs Inc. A-2006-164-001 <br />B JNITED STATES FIRE INSURANCE COMPANY <br />Attn Rodnev Brown <br />1821 E Dver Road Suite 103 <br />Santa Ana CA 92705 <br />C <br />D <br />COVERAGES This certificate supersedes and replaces any previously issued certificate for the policy period noted below 2 <br />TSI- IS TO, CERTF' 1-41 INSiuRAN,'F D•=SCRIBED HEREIN HA',E BEEN ISS -ED TC THE INS -RED NAMED HEREIN =0R THE c: IC' aPRICD INDICATED <br />N DT`.'.ITHST4NDING AN1 REC IREMENT TERM , <br />R .:iNDITICN Cl: AN! CONTRACT <br />CR CT -ER DCC-b1ENT '.t9TH RESPECT TGt4E Hl,_ Tt+CERWI :ATE \147 BE ISS -E, MA, <br />--RTAIN T-= INS"R4N.:... -'r R7E.^. 3i THE �CJCIES DESCRGED -+EREIN IS d... HJ_ T TO A__ T-+= TERMS 7pNDITI; V AND LXC­SiO`S 0= f )..Ica'cs AGGREGATE <br />_IN".;TS S- C,%N Mrt r -A',. E SEE, PED --ED R, P41D C,AIVS <br />CO TYPE OF INSURANCE POLICY NUMBER <br />POLICY EFFECTIVE POLICY I_XPIRATION LIMITS <br />LTR <br />DATE(MMIDDIYY) DATE(MMIDDIYY) <br />A GENERAL LIABILITY 630 154D589A-TIL-07 <br />10 01;07 10,01 08 $ 2.000,000 <br />GENERA., AGGREGATE <br />y <br />$ 2000,000 <br />_ _.�.Ilr:.n ;E X --: ...: n <br />C'ERSONAL d AD, iWUR • 1,000,000 <br />1.000.000 <br />j <br />:IRE DWAGE,A.Y'r,e=,e, 5 100.000 <br />MED E)(^,A- nnr nr-s r S 5.000 <br />AUTOMOBILE LIABILITY <br />"?;)MBINED SI\G_E Jb11T S <br />AN A._ To <br />i <br />-�. CANEDA-TOS <br />BODI_[NJ. ; R', qv <br />I <br />�.IRED a.JTGS <br />yUDI_• INJLR. $ <br />I Pei w"cleri i <br />PRCPERi';DAMAGE. <br />GARAGE LIABILITY <br />-C'ra"-EAAt�:i:C�N' <br />_ S <br />AN, A. -Tc <br />OTHER T -41v Ai;TOON,.'( <br />_RE, ._. _= $ <br />i A EXCESS LABILITY CUP 154D589A-TIL-07 <br />10101;07 10:01;08 EACH OCC„RRENCE $ 2.000.000 <br />X h+BRE_.a FORM <br />AGGREGAT1 S 2.000.000 <br />OTHER THAN '.,MBRE_'_A FGRM <br />$ <br />B WORKERS COMPENSATION AND 408694624" <br />12'01'07 12.01 08 X �-RS�e+ Ty <br />EMPLOYERS' LIABILITY_R <br />. I'$ ER <br />E_ EAC— ACCIDENT S i.000.000 <br />Tom_ rRO�'RIETpR X J_ <br />E_ DLSE4SE-PC! IC'' JMIT S 1.000,000 <br />P4RTNER:TR <br />SEY]'�.E <br />S 1,000.000 <br />OTHER <br />q Business Personal 630 154D589A-TIL-07 <br />1001 07 1001 08 Limit 6.343.135 <br />Property Blanket Limit <br />Deductible 2.500 <br />DESCRIPTION OF OPERATIONS4.00ATIONSJVEHICLES%SPECIAL ITEMS <br />10 Day Notice of Cancellation for Non-Pavment of Premium The Citv of Santa Ana it's officers. agents and employees are included as Additional Insured <br />as required by written contract <br />CERTIFICATE HOLDER <br />`\ <br />CANCELLATION <br />J.lC HE PJ. .. F RI E -ERE-14 C _L_D BF_Ir RE -HE EX­TIC1r' 4 THERMr <br />-- <br />TT�� rJ URER FFORDIN31M., _NGEAf R - V.I_CA. VA FI.. lCE HF <br />iitV Of Santa Ana <br />20 Civic Center Plaza (M-29}' <br />ERL•• BL —RE ... WT ,,E' EHA . t _S= N LI 31 R <br />PO BOX 1988 <br />—B I A 111, 01` • E IIE RER A r "R?.!• i C _`Y ERA3t a' -_"d' ': R RE>R ELJJ A rr ES OR r E <br />Santa Ana CA 92702 <br />ss EROFs s.ERn Icve <br />MARSH USA INC. <br />BY John Grae`• <br />MMI(3102) VALID AS OF: 12'04`07 <br />