PULMONARY CONSULTANTS & PRIMARY CARE PHYSICIANS MEDICAL GROUP, INC. 4D - 2011

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CERTIFICATE OF LIABILITY INSURANCE 102 - 192011 THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATEOF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policyli.91 must be endorsed. If SUBROGATiONIS WAIVED, subject to the terms and condhionaof the policy, censin policies may require an endorsement. A statementon this certificate does not confer rights to the Certificate holder in lieu of such endomement(s). PRODUCIOR CONTACT NAME: WOOD GUTMANN & BOGART INS BKR /PHS we NuE.tr: (866)467 -8730 1IArC,N.) 1877)905-045 181021 P:(866)467 -8730 ?:(877)905 -0457 ADDRESS: PO BOX 33015 SAN ANTONIO TX 78265 CUSTOMERID f: INSURER(51 AFFORDING COVERAGE NAIC INSURED INSUREiI A: Hartford Casualty Ins Co PULMONARY CONSULTANTS OF OC MEDICAL INSURER O: GROUP 10 W STEWART DR STE 410 INSURER c INSURER a: ORANGE CA 92868 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A80VE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED SY PAID CLAIMS. IN TYPE OF INfURANCE fR „NVD' POLICY NVM"A (MMlttD YYYYI fmumotYYYYI LMRE I GENERAL UAeRrtY I ( EACH OCCURRENCE s 2,000,000 –_7 COMMERCIAL GENERAL LIABILITY I PREMISES IEa oeeu,rPe.ce1 is 300,000 � CLAIMS•MADE X I OCCUR � MED EXPIAny one w—) s 10,000 A X General Liab 72 SBA IA4429 05/01/2011 05/01/20121 PERSONAL &ADVINJURY 's 2,000,000 GENERAL AGGREGATE 6 4,000,000 GEN'L AGGREGATE LIMIT AP S PER: I AM914M AS FIG KM PRODUCTS - COMPIOP AGG 5 4,000,000 PR POLICY O- I X LOC S AUT0I1PONLE lL1NUTY COMBINED SINGLE LIMIT (Ea KewnG ' 2, 000,000 ANY AUTO ' BODILY INJURY IP. pe 3 S ALL OWNED AUTOS BODILY IN.RIRY -Prr a--- -1 S (SCHEDULED AUTOS A�{ WRED AUTOS i( a C118012 4AIto PROPERTY DAMAGE IPe• a�cdantt X NON -OWNED AUTOS Deputy Ci T IS ' X'..'RRN11A LAS X O,ErM I EACH OCCURRENCE S 1 000,00 EXCESS LIAB CLAIMS -MADE( 72 SBA IA4429 05/01/2011 AGGREGATE S 1, 000,000 05/01 /2012 's A' 'iDEDUCTIBLE X' RETENTION 1 10 0 0 0 s WOWEAS COMPENSATION W S ATU- LOTH -I AeRJTY T RY UMITS ER OYERf' AND 0WL U YIN I ANY PROPRIETOR .'PARTNrRIEXECUTIVED E.L. EACH ACCIDENT $ OFFICER*MPASEREXCLUOEDI jN1Al I fMeMetwY n NMI E.L. DISEASE - EA EMPLOYE S U re.. d.tonne -de, DESCRIPTION OF OPERATIONS bdow E.L. DISEASE - POLICY UNIT S �I I DESCRITON OF OPEAATIONS I LOCATIONS I VEHICLES IAttwh ACORD 101. AddtiaW R—ok. Seh luls. if mo,. ape. Those usual to the Insured's Operations. City of Santa Ana is named as additional insured under the GL policy per the attached SS 00 08 04 05. TE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EMRATWIR OA-TE THEREOF, NOTICE WILL BE City of Santa Ana DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PL Z AUTHORIZ erorArnE SANTA ANA, CA 92701 et / A41-1161� a 1988 -2009 ACORD CORPORATION. AN tights reserved. ACORD 2S (2009109) The ACORD name and logo are registered marks of ACORD