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Samantha DigOally signed by Samantha M. Lambert AA I amhart Date: 1012.04.18 ACOIed® — tzoa:n ui on `� CERTIFICATE OF LIABILITY INSURANCE DATE( MDNYYY) 04/18/2022 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 Calhoun & Associates CONTACT NAME: Carmen Ponce DBA: Integrity Advisors 14771 Plaza Drive, Ste C PHoNo .800-500-9799 uC N,: 714-664-0614 EMAIL carmen Inte rlt advisors.com ADDRESS: @ 9 Y' Tustin CA 92780 INSURERS AFFORDING COVERAGE NAIC# INSURERA_ EMPLOYERS ASSURANCE CO. 36870 INSURED William H. Nuesse, M.D. and Mary -Ann Nuesse, D.O., A Medical INSURER e: 867 S TUSTIN ST. INSURERC: ORANGE CA 92866 INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITYLi CL41M5-MADE OCCUR EACH OCCURRENCE $ FTU RENTED PREMISES Ea occunenrs $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC GENERA -AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITYLi I COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Perpemon) $ ANYAWO OWNED SCHEDULED AUTOS ONLY AUTOS (Par ) BODILY INJURY P ccident $ HIRED AUTOSNON-OWNED LY AUTOS ONLY AUTOS ONLY PROPERTY DAMAGEa Per accident) $ UMBRELLA LIAR OCCUR LJ I FACHOCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOWPARTNERIEXECUTIVE YIN OFFICER/MEMBEREXCLUDEm Y❑ (Mandatory in NH) NIA EIG267502903 08/01/2021 08101/2022 PER OTF4 STATUTE ER E.LEACHACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,000 If OF OPERATIONS below E.L DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Sant Ana 20 Civic Center Plaza (M-34) PO Box 1988 Santa Ana, CA 92702 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 ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD IISAafytINC+A th4saw ® Rbk Management Super,bor