Laserfiche WebLink
DARWIN NATIONAL ASSURANCE COMPANY <br />1/13/12 - Q Psychologfists' Professional Liability Policy <br />THIS TS A CLAIMS MADE POLICY - PLEASE READ CAREFULLY <br />� ENDORSEMENT RETURN PREMIUM * '* * <br />NOTICE: A LOWER LIMIT OF LIABILITY APPLIES TO JUDGMENTS OR SETTLEMENTS WHEN THERE ARE ALLEGATIONS <br />OF SEXUAL MISCONDUCT (SEE THE SPECIAL PROVISION "SEXUAL MISCONDUCT" IN THE POLICY). <br />POLICY NO: S010-7473 END NO 0 1 <br />ITEM 1. (a) NAME AND ADDRESS OF INSURED: <br />ERIC WAYNE GRUVE R , PH . D <br />17772 177H ST <br />SUITE 106 <br />TUSTIN, CA 92780 <br />ITEM 2. ADDITIONAL INSUI <br />CITY OF ANAHEIM <br />ANAHEIM, CA <br />ACCOUNT NO: CA- GRT -TE 144-O 0006288C <br />ITEM 1. (b) ADDITIONAL NAMED INSUREDS: <br />A 1'1'1< o ED AS T4D F015tM <br />\lu.rncy <br />TYPE OF ORG: INDIVIDUAL, <br />CITY OF SANTA ANA ORANGE C O . SHERIFFS DEPT <br />POLICE & PERSONNEL DEPT S S 0 NORTH FLOWER <br />24 CIVIC CENTER PLAZA SANTA ANA, CA 92702 <br />SANTA ANA, CA 92702 <br />/ Continued.../ <br />ITEM 3. POLICY PERIOD: 2:01A.M. STAND RJ OME AT THE ADDRESSOFTHE INSURED AOS S"I'13 <br />ATED HEKk:IN: <br />ITEM 4. L7M7 gl(g S 1pjZjfFTYEFFE(CJIVE 03/01/12 <br />)) <br />2,000, 000 EACH WRONGFUL ACT OR SERIES OF CONTINUOUS, REPEA"I ED <br />OR INTERRELATED WRONGFUL ACTS OR OCCURRENCE <br />(b) S 75,000 COSTS RELATED TO ANY SINGLE PROCEEDING <br />(c) S 4,000, 0O0 AGGREGATE, FOR ALL CLAIMS AND ALL PROCEEDINGS <br />ITEM 5. PREMIUM SCHEDIILF.:- <br />ITEM 6. <br />ITEM 7. EXTENDED REPORTING PERIOD <br />ADDI'T'IONAL PREMIUM (ifexercised):S 1,731.00 SCHEDULED RATING CREDIT <br />ITEM S. POLICY FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY <br />PRGE2000 (3/2006) PRGel069 (1/2006) <br />CLASSIFICATION NUMBER RATE ANNUAL PREMIUM _ <br />ENDORSEMENT - R P 175 . 0 0 <br />----------- NEW ANNUAL PREMIUM ------- ------ --- -- --- - <br />PART TIME PSYCHOLOGISTS 1 971.00 777.00 <br />DEFENSE LIMIT 140.00 <br />ADDITIONAL INSUREDS S 150.00 <br />RETROACTIVE DALE: 03/01/92 <br />7 <br />INCLUDED <br />PRGe1124 (3/2006) <br />THIS IS NOT A BILL. PREMIUM HAS BEEN PAID. AUT RIZED COMPANY REPRESI NTATI VE <br />PRGE2005 (3/2006) Americ rofessional Agency' 95 13roadway, Amityville, NY 11701 <br />GRED <br />*NEW TOTAL PREMIUM: <br />989. 0 0 <br />ITEM 6. <br />ITEM 7. EXTENDED REPORTING PERIOD <br />ADDI'T'IONAL PREMIUM (ifexercised):S 1,731.00 SCHEDULED RATING CREDIT <br />ITEM S. POLICY FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY <br />PRGE2000 (3/2006) PRGel069 (1/2006) <br />CLASSIFICATION NUMBER RATE ANNUAL PREMIUM _ <br />ENDORSEMENT - R P 175 . 0 0 <br />----------- NEW ANNUAL PREMIUM ------- ------ --- -- --- - <br />PART TIME PSYCHOLOGISTS 1 971.00 777.00 <br />DEFENSE LIMIT 140.00 <br />ADDITIONAL INSUREDS S 150.00 <br />RETROACTIVE DALE: 03/01/92 <br />7 <br />INCLUDED <br />PRGe1124 (3/2006) <br />THIS IS NOT A BILL. PREMIUM HAS BEEN PAID. AUT RIZED COMPANY REPRESI NTATI VE <br />PRGE2005 (3/2006) Americ rofessional Agency' 95 13roadway, Amityville, NY 11701 <br />GRED <br />