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A �® CERTIFICATE OF LIABILITY INSURANCE F DATE (MMlDDlYYYY)6/6/2017 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 ADDITIONAL INSURED, the policy(ies) must 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 CONTACT Sara Davis NAME: Insurance Solutions HO AICNNo Ext: (949) 348-7400 A1C No: (999)348-2373 License #0746539 E-MAIL ADDRESS: Barad@ins-solutions.com 33302 Valle Rd, Suite 200 INSURERIS)AFFORDING COVERAGE NAIL# INSURERA Amco Insurance Co 19100 San Juan Capistrano CA 92675 INSURED INSURER B : CLAIMS -MADE � OCCUR INSURERC : DR GARY A LINNE IAN MD INSURER D: DBA: Pacific Medical Clinic INSURERS: $ 300,000 1534 E WARNER AVE STE A INSURERF: $ 5,000 SANTA ANA CA 92705-5475 COVERAGES CERTIFICATE NUMBER:17-18 All 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMlDDlYYYY POLICY EXP MMlDDlYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ 1,000,000 A CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 5,000 ACP7821875918 6/6/2017 6/6/2018 PERSONAL &ADV INJURY $ 1,000, 000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GEN'L X POLICYPRO- [7 LOC JECT PRODUCTS-COMP/OPAGG $ 2,000,000 $ OTHER. AUTOMOBILE LIABILITY COEa accidentMBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS ACP 7821875918 6/5/2017 6/5/2018 BODILY INJURY (Per accident) $ X NON -OWNED HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accident) ccident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y f N PER OTH- STATUTE ER E.L. EACH ACCIDENT $ ANY PRO PRIETORfPARTNERfEXECUTIVEN OFFICERfMEMBER EXCLUDED? f A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in I If yes, describe under DESCRIPTION OF OPERATIONS below FE L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, its officers, employees, agents and volunteers are included as additional insured per the attached endorsement. CERTIFICATE HOLDER CANCELLATION NKelley@santa-ana.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE T Alessandra/PETERS"" ACORD 25 (2014101) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD