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Certificate of Insurance (Proof of Coverage) 08/19/2915
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,
<br />THIS CERTIFICATE DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />_orad NaAddress*
<br />am_Aa_LXAA
<br />? (Includes: General Liability, Fire & i
<br />Nancy X Bahl Inc.___._
<br />Administered By:
<br />'Nancy Bahl
<br />CPH and Associates
<br />1881 Business Center Drive, Suite 71
<br />711 S. Dearborn, Suite 205
<br />'San Bernardino, CA 92408
<br />Chicago, IT, 60605
<br />—------
<br />t P. 312-987.9823 F. 312.987.0902
<br />*Additional insured locations are often requested by individual business owners who
<br />iltfn r eplibas.nonu
<br />'have more than one office, Your coverage is portable, meaning that you are covered at
<br />Underwritten By:
<br />any location forpractice finder the occupatlon(s) listed on your policy.
<br />' ] hltnti}e blu Sptterc[rtfty Insu ance COm)
<br />Coverage
<br />_
<br />Pa1teY#:025826 'Effective Date: 08/31/2015
<br />LL)ExpfrattonDate 08/3U2016
<br />iiH-..-„_._...,-.._._�.____..._..-___T ___._
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />fiNDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER. DOCUMENT
<br />'WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE
<br />-POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL'rHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
<br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />_._
<br />EACH OCCURRENCE ' AGGREGATE Coverage Part
<br />(Per individual clams) (Total amornnt per policy year)
<br />�I 000 000 _ - _ 4,000,000 � Prutexsmnul Lmb�,�..,r�: .
<br />DISCLAIMER: The Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and
<br />the certificate holder, nor does it affirmatively or negatively amend, extend, or alter the coverage afforded by the policies listed thereon.
<br />90 ®1A#O1j
<br />? (Includes: General Liability, Fire & i
<br />N/A
<br />N/A = Water Legal Liability, and Personal
<br />_fra6ltPtP)
<br />--_$5,000,000__—.–mentulLla6i_liiy
<br />Unlimited
<br />Unlimited i _ Defense EXense Coveragce
<br />$35,000
<br />$35,000 State Licensing Board Investigation
<br />Defense Coverage
<br />Assuul[Caverag_e :__.......--,,
<br />$10000 _ .
<br />- --- i35,000 .. _. _ _ ._i.___ - Deposfttan Fxpensa Baaefft
<br />Medncaf Evpens Cbv®rn9! ---,.
<br />$15,000
<br />- $15„000 i first Aid Coverit
<br />}3esattpEEonlSpe, a#n11'�av3gCOns, -
<br />_ - _`__.....,._„. ....W__
<br />Certificate holder
<br />Cancellation
<br />,Should any of the above described policy be cancelled before the expiration date thereof,
<br />,,the issuing insurer will endeavor to mail 30 days written notice to the certificate holder
<br />,tamed to the left, but failure to do so shall impose no obligation or liability of any kind
<br />PROOF OF COVERAGE
<br />upon the insurer, Its agents a€rgpKesankatives.,
<br />Holder has also been added to the policy
<br />as an additional insured **
<br />Yes/XNoi
<br />71,Ge,19ay
<br />**If the certificate holder is an ADDITIONAL
<br />s
<br />INSURED, the policyAuthorized Representative
<br />ties) must be endorsed. A statement on
<br />this certificate does not C, Philip Hodson
<br />confer rights to the cerkiftcah, holder in lieu of such endorsement ,
<br />DISCLAIMER: The Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and
<br />the certificate holder, nor does it affirmatively or negatively amend, extend, or alter the coverage afforded by the policies listed thereon.
<br />90 ®1A#O1j
<br />
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