CORRECTIONAL MANAGED CARE MEDICAL CORPORATION (CMCMC) 5d - 2011

Home Browse Search

ACORD CERTIFICATE OF LIABILITY INSURANCE *M DATE(MM /DD/YYYY) 06/19/2012 THIS CERTIFICATE IS 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 CERTIFICATE OF 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 ADDITION SUR -D,_ he p;jiWyRisDr§ust be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). _ PRODUCER Colonial Western Insurance Agency = ?1�" 26691 Plaza Drive, Suite 220 Mission Viejo, CA 92691 NAME: 1 (949)305 -6161 FAX (A/C, No): (949) 305 -6166 AIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURERA: Arch Specialty Insurance Company LIMITS INSURED Correctional Managed Care Medical Corporation 4211 E. La Palma Ave. Anaheim, CA 92807 INSURERB: Travelers Insurance Company INSURER C: Everest Insurance Company FLP00456790 INSURER D: 08/01/2012 INSURER E: $ 1,000,000 INSURER F, X COMMERCIAL GENERAL LIABILITY X CLAIMS -MADE 1�1 OCCUR COVERAGES CERTIFICATE NUMBER: City of Santa Ana REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE 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 BY PAID CLAIMS. LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER ( MM /DD/YYYY (MM /DD/YYYY ) LIMITS GENERAL LIABILITY FLP00456790 08/01/2011 08/01/2012 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY X CLAIMS -MADE 1�1 OCCUR PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 A PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 3,000,000 POLICY F7 PRO JECT 17 LOC $ AUTOMOBILE LIABILITY 6809447H70 02/04/2012 02/04/2013 ';UMBIN SINGLE LIMIT (Ea accident) $ 1, 000 , 00 BODILY INJURY (Per person) $ ANY AUTO B ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY Per accident ( ) $ X PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTI OFFICER/ MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A CA20010955121 07/0112012 07/0112013 X W A U- H- TORY LIMITS J ER _ E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ l 000 r.00 _ $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Professional Liability anaged Care E&O Liab. FLP00456790 FLP00456790 08/01/2011 08/01/2011 08/01/2012 08/01/2012 Prof Liability: $lmil /$3mil Managed Care E&O: $lmil /$3mil DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) 1`30 Days notice of cancellation, 10 days for non - payment of premium. Certificate Holder is Additional Insured for general & professional liability per endorsements (Additional Insured - Designated Person r Organization & Waiver of Transfer of Rights of Recovery Against Others To M?'Wvmd iro Fonj rk, '] a City of Santa Ana 62 Civic Center Plaza Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED QOytk THE EXPIRATION DATE THEREOF, NOTICE WI B DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ✓ REPRESENTATIVE ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD