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'`'C"!`'®® CERTIFICATE OF LIABILITY INSURANCE ItI7/3/2014 DATE (MM/DDmv) 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(les) 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 endorsements . PRODUCER CONTIntACT NAME: < Services License License#0601094 222 Court Street PHONE FAX AIC N.1:6831-638-6801 E-MAIL ADOREss: INSURER(S) AFFORDING COVERAGE NAIC H Woodland CA 95695 INSURERA:The Doctors INSURED USHEA-1 INSURER B: INSURER C: U.S. Healthworks Holding Company, Inc. 25124 Springfield Ct., Ste 200 Valencia CA 91355 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 872461824 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 rypE OF INSURANCE ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF MMIDDIVYYY POLICY EXP MMDD V LIMITS GENERAL LIABILITY EACH OCCURRENCE $ Ri PREMISES Ea occurrence $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑ OCCUR MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GENERALAGGREGATE $ !Y DA TOF'O M GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ POLICY PRO-JFCT LOC j�✓ �V $ AUTOMOBILE LIABILITYCOMBINLIDSINI Ea accident BODILY INJURY (Per person) $ ANY AUTO ` '� 1( ALL OWNED SCHEDULED AUTOS AUTOS 10 BODILY INJURY (Per accident) $ NON -OWNED HIREDAUTOS AUTOS �Ck; Attorney PROPERTY DAMAGE $ (Per accident UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LU B CLAIMS -MADE RETENTION$ $ _77DEO 1 WORKERS COMPENSATION STATU- OTH- AND EMPLOYERS' LIABILITY YIN TWO CRY LIM ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ NIA E.L. DISEASE - EA EMPLOYEE $ (Mandatary In NH) If yes, describe under DE SC RI PTION OF OPERATIONS be. E.L. DISEASE -POLICY LIMIT $ A Medical Malpractice Professional Liability 069727 /1/2014 /1/2015 Aggregate $3,000,000 Limit $1,000,000 Deductible $100,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Re: 1619 East Edinger, Santa Ana, CA 92705 City of Santa Ana 20 Civic Center Plaza Santa Ana CA 92701 ACORD 25 (2010/05) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE (71988-2010 ACORD CORPORATION. All rink}c The ACORD name and logo are registered marks of ACORD