Laserfiche WebLink
DATE (MM7DDIYYYY) ~! <br />' •~4~t~RD,. C_ER_TIFICATE OF 1-(ABILITY 1N_SUR_ANCE _ _ _ ~ 1210312008 _ <br />_ TH15 CERT~ICATE IS ISSUED AS A MATTER ~ INFORMATION I <br />PRODUCER • ONLY AND CONFERS NO RIGHTS NO SEND, EXTEND AOR I <br />~ Marsh Risk & Insurance Services HOLppZ- THIS CERTIFICATE DOES <br />4695 Macgrttlur Court, Suite 700 ALTER THE COVERAGE AFFORDED BY 'THE POLICIES ~L~• <br />(949)399-5800 <br />License 40437 t 53 <br />Newport Beach, CA 92660 <br />1607996-002-G~2-08-09 <br />iNSUIt~ <br />Wesicliff Medical Labs, Mc. <br />At~1~ Rodney mown <br />18,3, ~. Dyer Road, Sure 100 <br />Sarif~ Ana, CA 92705 <br /> V <br />iNSURFJ2S AFFORDING COVERAGE I NAIC #1 <br />~74 <br />ri <br /> ca <br />tNSURER a Travelers Property Casualty Co. Of Ame <br /> INSURER s:11n8ed Stales Fire f nsurartce Co. ~ 21113 <br /> INSURER c: Nautilus Insurance Company 17370 <br />-~ <br /> SJSURER D: - <br />~ <br /> I ~~_ ~ <br />INSURER E: <br />COVERAGES _ <br />THE POLICIA~~ ANY REQUIREMENT, TERM OR CONDITION OF A~Mf C TONTRACT OR OTHER DOCUMENT~W TN RESPECT 70 WHICH TH~CER IFICATE <br />I NOTWiTHS _ <br />MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS <br />CONDITIONS OF SUCH POLICIES. AC3GREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED~BYC~ p~Y ~~Tlort t,lM11Ts <br />~LRR ADD'L TYPE OF INSURANCE ~ POLS:Y NUMBER DATE (1MWDrYY1 DdLTE (MMIDDR'Y) t 1.004.000 <br />NE g30 154p569A-TIL-08 <br />I A I X ' COMMERCIAL GENERAL LIA9ILITY <br />I ~ j ~i - f- <br />CLAIMS MADE x.^ OUR <br />ERAL AGGREGATE LIMIT APPLIES PE <br />I PRO- --~ <br />I ~ ~ -' POLICY ~ ~ JECT ~ LOC • J <br />• AUTOMweILE uABlurr <br />i X Arn Auro <br />~~ ALL OWNED AUTOS <br />'r <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />~ ~ NOM-OWNEDAUTOS <br />(B 10154 D589A-Tt L-08 1 N01 !08 <br />10/01109 <br />l I <br />A.pPRO ED AS IO FORM <br />~ - Bid; ~ <br />FpAMAt3E TO REIVTEU $ 100,000 <br />~REMISES(Ea occurence,~ <br />MED EXP (Arty one oereoN $ ~ 5,400 <br />`PERSONAL a ADV IN.RIRY ~a 1 ,000,OOq <br />IOENERALAGGREGATE Is 2,000,00 <br />~ COMBINED SINGLE OMIT ~ 1,000,OOQ <br />(Ea accidenQ <br />90[~XLY IN.IURY <br />(Per persDn) s <br /> <br />I <br />i BOOILYIN.fURY i$ <br />(Per exident) <br />PROPERTY DAMAGE <br />f Per accident) <br />I`~ I <br />i _J --' / <br />CID <br />ENT~$ <br />AUTOONLY-EAAC <br />J <br />~ I GARALiE LIA&UTY - <br />- <br />~- <br />EA ACC I~ <br />rr <br />I ~ ANY AUTO I OTHER7HAN <br />AUTO ONLY' a <br />AGG <br />i <br />•I EXCESSruMaREwuAeluTt' CUP 154D589A-TIL-08 <br />10/01/08 EACH OCCURRENCE ~S <br />10/01/09 <br />rF $ 2.000,000 <br />400 <br />00 <br />2 <br />A ~ AGG~cA <br />~ , <br />, <br />I OCCUR ~ CLAMAS MADEi <br />I- ~ - <br />~ <br /> <br />i ~ pEDUCTIBLE I <br />J ~ RETENTIONS <br />WORI~RS COMPENSATION AND WC STATU- OTH- <br />X ITORV I arts _~EB_. ' <br />£ACH ACCi~NT I r 1 ~~ <br />~ i EI~WYERS UAMLI7Y <br />f 408696715-8 <br />AM! pROPRIETpwPARTNEWEXECUTIVE <br />~ 12K11f08 .L. <br />l 12101109 <br />I L. DISEAb'E EA EMPLOYEE $ - <br />1,040,ooO <br />- <br />~ OFFICERfWIEMeEREXCLUOEp~ ~ ~ -'~- <br />L DISEASE -POLICY LNIAIT a 1,004,000 <br />~~ Myea deaclitle urdsr <br />SPECIAL PR'w IBC N8 oe~ov. <br />OTHER <br />PFP1000006P2 <br />C professional <br />IOJ01108 <br />10101!09 Each Claim <br />I Aggregate Llntit 2,000,OOOy <br /> <br />4,000,000 <br />I Liability I ` ~ Dedllctitible 5,40 <br />Retro Date: 6!13!87 <br />I DESCRIPTION OF OPERATIONSIIOCAT(ONSNBIICLES/E7~U ~D ~ E'~~~~IB~~ 0~ ~ and em are included as Additiona <br />ifs officers, ages PbY~ <br />of Santa Ana <br />The Cil <br />ium <br />d P l Insured as <br />y <br />. <br />rem <br />10 Day Notice of Cancellation for Non-Payment , <br />I required by written contract. <br />_ I~ <br />L <br />CERTIFICATE HOLDER <br />1 <br />10101/08 ~ 10/01/09 <br />LOS-00068441fr12 <br />~ City of Santa Ma <br />20 CIVIC Center Plaza (M-29) <br />PO Sox 1988 <br />I Santa Ana, CA 92702 <br />cANCEU.ATtoN <br />SHOULD ANY OF THE A90VE pESCRIBED POLIG~S BE CANCELLED BEFORE THE <br />EXPIRILTION DATE THEREOF, THE ISSUINri INSURER Wltl ENDEAVOR TO 1A111L <br />DAYS WRITTEN NOTICE TO TIIE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />BUT FAILURE TO DO 90 SHALL N~POSE NO OBLKiAT10N OR UA9ILnY OF ANY qND <br />.~_.. ....~ ,.,e,.em rte SITS OR REPRESENTATIVES. <br />Jo}m Oraef <br />_ I <br />1988 <br />V <br />