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ACC:)R®® CERTIFICATE OF LIABILITY INSURANCE CERTIFICATE DATEIMM OOIYYYY) 7/3/2014 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 endorsement(s). PRODUCER NAME: Michelle Goodw n, CIC ClSR< InterWest Insurance Services License #0601094 222 Court Street PHOC.NE Exti 831-635-2247 INC.FAX No: 1- 638-6801 E-MAIL ADDREss: oo iwins.com INSURERS AFFORDING COVERAGE NAIC 9 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 O: 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. HER LTRINSR TYPE OFINSURANCE ADDL SUER MD POLICYNUMBER POLICY EFF MWDDNYYY POLICY EXP MMIDDNYYYtEaoccuffence LIMITS GENERAL LIABILITY RENCE $ occurrence $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑ OCCUR one pare." $ ADV INJURY $ REGATE $ GENU AGGREGATE LIMIT APPLIES PER: OMP/OP AGG $ POLICY F7 JECT F7 PRO LOC $ AUTOMOBILE LIABILITY Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED F7 SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE $ Pareccident UMBRELLALIAB H OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIA CLAIMS -MADE DED RETENTION$ I $ WORKERS COMPENSATION WCSTATrU OTH- AND EMPLOYERS' LIABILITY YINrR E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ NIA E.L. DISEASE -EA EMPLOYE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ A Medical Malpractice 0069727 /1/2014 /1/2015 Aggregate $3,000,000 Professional Liability Limit $1,000,000 Deductible $100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more sp�e Is required) 0 �i' 4l Re: 1619 East Edinger, Santa Ana, CA 92705 AP ®vE �S Joseph Straka Assistant City Attorney 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. The ACORD name and logo are registered marks of ACORD Plants reserved,