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Mar.12.2014 11:29 AM Eric W. Gruver, Ph.D. 17145444996 PAGE. 2/ <br />Account Number: CA GRUE 1440 Date: 3/12/14 Initials: KB <br />CERTIFICATE OF INSURANCE <br />DARWIN NATIONAL ASSURANCE COMPANY <br />C /O: American Professional Agency, Inc. <br />95 Broadway, Amityville, NY 11701 <br />800 -421 -6694 <br />This is to certify that the insurance policies specified belov have been issued by the company indicated <br />above to the insured named herein and that, subject to their provisions and conditions, such policies afford <br />the coverages indicated insofar as such coverages apply to the occupation or business of the Named insured(s) <br />as stated. <br />THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR <br />ALTERS THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE. <br />Name and Address of Insured: <br />ERIC WAYNE GRUVER, PH.D. <br />2021 E 4TH STREET <br />SUITE 116 <br />SANTA ANA CA 92705 <br />Type of Work Covered: PROFESSIONAL PSYCHOLOGIST <br />Location of Operations: N/A <br />(I£ different than address listed above) <br />Claim History: <br />I?o�rnanf;�,c 'Leto is 0'A Inl /19Q'J <br />Additional Named Insureds: <br />Coverages <br />Policy <br />Number <br />Effective <br />Date <br />Expiration <br />Date <br />Limits of <br />Liabilitv <br />PROFESSIONAL/ <br />LIABILITY <br />5010--7473 <br />3/01/14 <br />3/01/15 <br />2,000,000 <br />4 000 000 <br />NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED ON THIS <br />POLICY AND HE OR SHE SHALL ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING <br />OR RECEIVING NOTICE OF CANCELLATION. <br />Comments: CITY OF SANTA ANA POLICE & PERSONNEL DEPT. IS LISTED ON THIS <br />POLICY AS AN ADDITIONAL INSURED. <br />icate Issued to: <br />Name: ERIC WAYNE GRUVER, PH.D. <br />2021 E 4TH STREET <br />Address: SUITE 116 <br />SANTA ANA CA 92705 <br />APA 00049 00 (05/2012) <br />RECEIVE: NO.1531 03112/2014/WED 10:11AM <br />zed Representative <br />