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^k0wrX14. %.cRiiNGA1C Ur LIABILITY <br />INSURANCE <br />PRowcE" ( 9 49)305-6161 FAX (949)305-6166 <br />Colonial Western Insurance Agency <br />08/25/2009 <br />THIS CERTIFICATE 1S 18SUED AB A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />26691 Plaza Drive, Suite 220 <br />ALTER��yEEpgpEAFFOR�EDBYTHEPOLEX <br />Mission Viejo, CA 92691 <br />fCIESEBELOW. <br />O8/01/201Q <br />I <br />meu�D Correctiona NaReg Care Me ca Corporat on <br />INSURERS AFFORDING COVERAGE NAIC # <br />MSURERA Landmark American Insurance Coag ny <br />4211 E. La PalmAve. <br />Anaheim, CA 928jjLL0��7/y�� <br />msuneft Travelers Insurance Company <br />ImURERa Everest Insurance Compan <br />I <br />'a V L% 8 �. 4 <br />WBUR R Q <br />(roeERe <br />COVERAGES F <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME —MOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH <br />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 <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. ACCRECATE LIMITS SHOWN MAY H10r_ SEEN REDUCED BY PAID CLAIMS. <br />.__.,.—___..- <br />LTR NSR _ TYPE OFINSUKANDE PDI,lDY NUMBkN DATE tY P�FECi(11R1�01.[CYEXFO TjON -- -- <br />._._. DATE A1MID RATE NWD LMUn <br />IHSH nOiX <br />LHC812193 <br />08/01/2009 <br />O8/01/201Q <br />I <br />eAULiocctflR hE 3 2 QQQ,Q�1 <br />COMMFHCWGkNENAJ.LVUfILOY' <br />L t -- i ---i <br />�x CLAIMS WOE I. OCCUR <br />i <br />I <br />I <br />I <br />OAFTGET3kEHFE�-- - <br />IPREMISE SIFe owureneJ 3 yQ,QQ <br />fi <br />A <br />� <br />� <br />) <br />MEO EXP (Ivry areliamxrj 3... <br />_ $,QQ <br />� � _. _ -f <br />i <br />FeR90NALA ADVIrUUR/ _�-T1,000,QD <br />I IOENL AGOREOATC LIMIT APrUES PER: <br />GENERALAGGREGATF �3 3,000 AIjD._ <br />COAROPAGG 3 1 OQQ QQOI <br />P40, r- <br />�PRODUGTS <br />` <br />r_ <br />I I POL(CYI IJECT_..L. 1lOC- <br />�AUTOMOBILEDABILIfY <br />------ <br />6_60944-7H7Qb <br />02/04/2009 <br />02/04/2Q10 <br />I <br />`.-JANYAUTo <br />COMBINED SIYOLE IT I <br />LIMIT <br />I <br />000 CQ <br />- — <br />i - <br />1 ALL OYMEDAUTOS <br />ASCI@DULED <br />t <br />BODILY INJURY <br />$ <br />(({ R <br />AUTOS <br />A A I NIREDAUTOS <br />I <br />1 <br />1 <br />(PerPn:mj <br />I <br />Y --i <br />I 1 }(1 NON -0WNfOAUTOS � <br />FI <br />,,- I <br />� i tad <br />i <br />�i4O <br />BCDILY INJURY <br />(PerezMeM) 1 § , <br />1� <br />A. C}VC <br />'{DEE. <br />i$ __.. _ <br />i <br />I Irl Ryan <br />(POPPERTYDAM&GE <br />I�GRAGfi LUB1LRY <br />I ANYAUTO <br />AUTOONLY-EAAMVeNt ,1 <br />- _ <br />d e <br />EA ACO $ <br />puty Ct <br />y Attorney <br />nAUTOOTHE�T"Mr <br />wr� <br />I <br />ESSIUMBRELLAUABILDY <br />EACH OCCAHE C[ $ <br />ElEXCOCCUR FICLAIMS MACE <br />AOONEt3AlE _ �$ <br />I� DEDUCTIBLE <br />RETENTION $ <br />$ <br />SMCOMPENBAOON I <br />CA20010955091 <br />07/01/2009 <br />07/01/2010 <br />X T '. <br />AN0SwwYfirw L"LffY YIN( <br />E.LEAIDE <br />_CHAOCNI i 11000,000 <br />Iwo <br />ANY PROPRIETOILYARTNERIEXECUTMEF--I� <br />C OF <br />7jMananFId0.'y NHJ <br />wTdcr <br />E.L. DISEASE. EA EAVLOYIEE 1,00000 <br />acs:itc <br />���ECUL PAOVIAIOHS Nryw <br />_ <br />E.L DSEASE-POLICYLLNIT S 1,000 00 <br />ro essionai Liability <br />- LHC812193 <br />08/01/2009 <br />08/01/2010 <br />.Prof Liability: $lmil/$3mil <br />A Care E$O Liab. <br />LHCOIZ193 <br />08/01/1009 <br />08/01/2010 <br />Managed Care ESA: $1mIT/$3mil <br />Managed <br />VEHX,on for non -pa DeY EROORSEMEe um. VPdVg10Na <br />DEC Daysnotice <br />IC Days native of cancelltatTon for non-payment of premium. <br />ertificate Holder is an Additional Insured for general liability and professional liability per <br />ndorsements (Additional Insured - Designated Person or Organization & Waiver of Transfer <br />�f Riohts of Recovery Against Others To Us) attached. <br />City of Santa Ana <br />62 Civic Center Plaza <br />Santa Ana, CA 92702 <br />SHOULOANY OF THE ABOVE DESCRNIEO POLICIES BE CANCELLED SUCRE THE EXPIRATICI <br />DATCTNEREOF,TNEMSUiNGINBURERLNLLENOFAVORTOM" "`30, SAY$WRITTEN <br />NOTICE TO THE CERIIFR:ATE HOLDER NAMED TO THE LEFT, DUT FAILURE TO DO SO SHELL <br />IMPOSE NOOBLNIATION OR LIABILITY OF ANY KY40 UPON THE INSURER, ITSAOENTS OR <br />919U!;.ZM ACpRD CORPORATION. All <br />The ,ACORD nBmo and logo aro regNtArad mnrkf/Df ACORn <br />