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Certificate of Insurance (,Proof ol'Coverage) Date Issued:: 08/21/2017 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPONTHE CERTIFICATE HOLDER. <br />TIAs CERTIFICATE DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BYTUE POLICIES BELOW. <br />Insured Name and Mailing Address* <br />Program Administrator <br />jVac iey K. Bohl Inc. Ciba The Coienseling Team infernration! <br />Administered By: <br />Naricy K Boh'l <br />1881 Business Center Drive 911 w <br />CPH and Associates <br />711 S. Dearborn, Suite 205 <br />Scan Bernardino, C21 92408 <br />Chicago, IL 60605 <br />P. 312-987-9823 F. 3.12-987.0902 <br />*Additional insured locations are afteu requested by imfividiml business owners who have rraore than one <br />infokiahins.com <br />office. Your coverage is portable, meaning thatyon are cowered at any location fcrr practice ander the <br />Underwritten By: <br />occupations) listed on yourpolicy. <br />Philadelphia Indemnity Insurance Company' <br />Coverage <br />Policy #: 025826 iEffective Date: 08/3.11301.7 <br />lExViration Date: 08/31/2018 <br />THE POLICIES OF INSURANCE LISTED BELOW IIAVE BEEN ISSUED TO THE INSURED <br />NAMED ABOVE FORTHE POLICY PERIOD <br />INDICATED. NOT" vW'1THSTANDNG ANY R.EQUIREMENT, TERM OR CONTIiTTON <br />OF ANY CONTRACTOR OTHER DOCLTM NTWITTI <br />RES['kiCT BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE: TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCMS, <br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />Limits of Liability <br />E"ACtiOCCURl2ENCE At G'REGATE <br />coverage Part <br />(Per inefividual claim) (Total amount per policP;vear) <br />51,000,000 55,000,000 <br />Professional Liability <br />Commercial General Liability <br />N) <br />N/A <br />Includes: General Liability, fire &'4Water Legal Liability <br />and Personal Liability <br />N/A <br />N/A <br />Proalertycovera e <br />$1,000.000 <br />55,0001000, <br />Supplemental Liability <br />Unlimited <br />Unlimited <br />Defense Expense Coverage <br />$35,000 <br />$35,000 <br />State Licensing Board Iirvesti ation Defense Coverage <br />5,15,000 <br />$15,001) <br />Assault Covera&e <br />510,000 <br />$35,000 <br />De osition Emense Benefit <br />5'5,0001 erson <br />550,000 <br />Medical Expense Coverage <br />$15,000 <br />;515,000 <br />First Aid Coverage <br />Desariotion/Soecial Provisions <br />Certificate Bolder Cancellation <br />Santa Ana Police department <br />60 Civic Center Plaza SHOULD ANY OF TIIE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />Santa Ana, CA 92702 1 XPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br />POLICY PROVISIONS. <br />Holder has also been ndded to the policy as an additional insureds** <br />[ X Yes/No 1 <br />**If the certificate holder is an ADDITIONAL INSURED, the poliey(ics) must be ° <br />endorsed. A statement on this certificate does not confer rights to the certificate hulder in Authorized Representative <br />lieu of such endorsement(s)' C. Phill,aHodson <br />DISCLAI1yIER: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 />