LINNEMANN, GARY M.D.-2017 - Laserfiche WebLink

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i A�oRo CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 06/21/2018 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(ies) must have ADDITIONAL INSURED provisions or 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 CONTACT 7himbra Peker NAME: Insurance Solutions A/CN o Ext): (949) 348-7400 FAX No : (949) 348-2373 E-MAIL IbrahimP@ins-solutions.com ADDRESS: License #0746539 INSURER(S) AFFORDING COVERAGE NAIC # 33302 Valle Rd, Suite 200 a : Amco Insurance Co 19100 San Juan Capistrano CA 92675iNsuReR INSURED INSURER B INSURER C Dr Gary A Linnemann MD 1534 E Warner Ave Ste A INSURER D INSURER E MED EXP (Any one person) $ 51000 INSURER F Santa Ana CA 92705-5475 COVERAGES CERTIFICATE NUMBER: 18-19 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 TYPE OF INSURANCE ADDLSUBR INSD WVD POLICY NUMBER POLICY EFF MM/ D YYYY ( ) POLICY EXP MM D YYYY ( ) LIMITS X1LTR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 110001000 CLAIMS -MADE i� OCCUR DAMAGE TO RENTED $ 3001000 PREMISES (Ea occurrence) MED EXP (Any one person) $ 51000 PERSONAL & ADV INJURY $ 110001000 A AC P7831875918 06/06/2018 06/06/2019 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 210001000 X POLICY PRO- JECT LOC PRODUCTS - COMP/OPAGG $ 210001000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 11000,000 (Ea accident) BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS ACP7831875918 06/06/2018 06/06/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) '4%0K HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, its officers, employees, agents and volunteers are included as additional insured per the attached endorsement. CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92702 aslo� © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD