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ACORO CERTIFICATE OF LIABILITY INSURANCE 29/2013DATE (MMIOD/YYYY)
<br />1/
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE' DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an. endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER NAMTACT Gary Friedman, CPCD, MSIS, RPLU, ARM, AAI
<br />Peak 360, Inc. PHONE (303)534-7325 rFAXN .(303)623-7325
<br />1600 Emerson St. EMAIL s: gfriedman@peak360.com
<br /> INSURERS AFFORDING COVERAGE NAIC 0
<br />Denver CO 80218 INSURERAArch Specialty Insurance Co.
<br />INSURED INSURERS :Continental Insurance
<br />WellDyne, Inc.; WellDyneRX; CF Pharmacy Svcs. INSURER C Hartford
<br />7472 S. Tucson Way
<br />1 INSURERD:
<br />19,20,9
<br />7)-77191
<br />INSURER E:
<br />Centennial CO 80112 INSURER F:
<br />COVERAGES CERTIFICATE NUMBER'l.iability 2012 REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE A L B
<br />POLICY NUMBER POLICY EFF
<br />(MMIDDNYYYI POLICY EXP
<br />IMMIDDNYYY)
<br />LIMITS
<br />A GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> X COMMERCIAL GENERAL ABILITY P0052 651-00 2/7/2012 2/7/2013 DARMAI R E n $ 100,000
<br /> CLAIMS-MADE Fx7OCCUR MED EXP(My one person) $ 5,000
<br /> PERSONAL B ADV INJURY $ 1,000,000
<br />
<br /> GENERAL AGGREGATE $ 3,000,000
<br />
<br /> GEWL AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 3,000,000
<br /> X POLICY PF'Q.T F7 LOC $
<br />
<br />B
<br />ILE LIABILITY
<br />OMO
<br />
<br />COMBINED SINGLE LIMIT
<br />Eaa id n
<br />
<br />
<br />000 000
<br />A ANY AUTO BODILY IWURV(Per person) $
<br /> P ALLOWNED
<br />AUTOS X SCHEDULED
<br />AUTOS 026985883 2/7/2012 2/7/2013 BODILY INJURY Per accident) $
<br /> HIRED AUTOS X NON-OWNED
<br />AUTOS PROPERTY DAMAGE
<br />Per cciden $
<br />
<br /> X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 2,000,000
<br /> EXCESS UAB CLAIMS-MADE P0052 651-00 2/7/12 2/7/13
<br />AGGREGATE
<br />$ 2,000,000
<br /> DED X RETENTION 10,00 $
<br />$ WORKERS COMPENSATION X WC STATU- OTH-
<br /> ANDEMPLOYERS'UABILIry
<br /> YIN
<br />ANY PROPRIETOWPARTNEWEXECUTIVE
<br />OFFICEWMEMBER EXCLUDED?
<br />
<br />NIA
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br /> (Mandatory in NH)
<br />If
<br />i 4wSJ13046 6/1/2012 6/1/2013 E.L. DISEASE - EA EMPLOYE $ 1,000,000
<br /> yes, descr
<br />be under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1-10-00,000
<br />A PROFESSIONAL LIABILITY P0052 651-00 2/7/2012 2/7/2013 OCCURRENCE/AGGREGATE $1M / $3
<br />C TPA E60 LIABILITY 0 PG 0257328 2/7/2012 2/7/2013 OCCURRENCE/AGGREGATE $1M / $
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, 0 more space is required)
<br />Certificate Holder is an additional insured under the General Liability policy in accordance with all the
<br />terms, conditions, and limitations of the policy and then only for liability caused by the negligent acts
<br />of the named insuradr_MbV2bonly, IIIr}pterest may appear by way of written contract.
<br />ckindig@santa-ana.org
<br />CITY OF SANTA ANA
<br />CHRISTY KINDIG
<br />20 CIVIC CENTER PLAZA
<br />SANTA ANA, CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />Gary Friedman/GARY
<br />n1oRR_7n1n ArnonrnoonoATlnM AIIA-h.-.-.,..,nd
<br />INS025 nn rr,%m Th. Arnon name and Innn a_ .a oicta.n _,,4 of arnRn
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