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ACORD CERTIFICATE OF LIABILITY INSURANCE osio7~i2oo <br />PRODUCER (g49) 305-6161 FAX (949) 305-6166 <br />Co I on i a I Western insurance Agency <br />26691 P I aza Drive , Suite 220 <br /> <br />' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />M <br />s ss i on Viejo , CA 92691 <br />INSURERS AFFORDING COVERAGE <br />NAIC a« <br />INSURED Correct i ona I Managed Care Medical Corporation INSURER A: LeX 1 n ton Insurance Company <br />4211 E . La Pa I ma 'Ave , <br />X00 6 _ ~ ~ 7 <br />~ INSURER B: Trave I ers Insurance Company <br />' <br />Anaheim , CA 92807 INSURER c: Everest Insurance Compan <br />A ^ ~ ~~ ^' ~ INSURER D: <br /> INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR DD' TYPE OP INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION OMITS <br /> GENERAL LIABILITY 0314761 08/01 !2007 08/01 /2008 EACH OCCURRENCE f 1 ,QQQ ,QQQ <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE 70 RENTED f 5O , <br /> X CLAIMS MADE ~ OCCUR MED EXP (Any one person) f 5 , QQ <br />A PERSONAL & ADV INJURY S 1 ,QQQ ,QQQ <br /> GENERAL AGGREGATE f 3 ,QQQ , QQ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG f 1 ,QQQ ,QQQ <br /> POLICY PE Q LOC <br /> AUT OMOBILE LUUlILtTY 6809447H706 02/04/2007 02/04/2008 COMBINED SINGLE LIMIT <br /> ANY AUTO (Ea ~~) f 1 ,000 , 00 <br /> ALL ONMED AUTOS <br />BODILY INJURY <br />f <br />S SCHEDULED AUTOS (~ paten) <br /> X HIRED AUTOS <br />BODILY INJURY <br />f <br /> X NON-0WNEDAUTOS (Peracadent) <br /> PROPERTY DAMAGE <br /> <br />(Per ea'.ideM) f <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S <br /> ANY AUTO OTHER THAN ~' ACC f <br /> AUTO ONLY: AGG f <br /> EXCESSIUMBRELLA LUIBWTY EACH OCCURRENCE S <br /> OCCUR ~ CLAIMS MADE AGGREGATE f <br /> s <br /> DEDUCTIBLE f <br /> RETENTION f S <br /> WORKERS COMPENSATION AND CA20010955061 07/01 /2007 07/01 /2008 X `^~ srnru- orl+ <br /> EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT f 1 , 000 , 00 <br />C OFFICERIMEMBER EXCLUDED? E.L. DISEASE • EA EMPLOYE f 1 , OOO , OO <br /> If yes, descAbe under <br />SPECIAL PROVISIONS bebw <br />E.L. DISEASE -POLICY LIMIT <br />f 1 , 000 , OQ <br /> oTH <br />i <br />l Li <br />bili <br />~ 0314761 08/01/2007 08/01/2008 Prof Liability: $lmil/$3mil <br /> ro <br />ona <br />a <br />ess <br />ty <br />A <br />anaged Care E&0 Liab. 0314761 08/01/2007 08/01/2008 Mana ed Care E&0: $1mil!$3mil <br />g <br />OESCRIPTiON OF OPERATIONS LOCATION !VEHICLES! EXCLUSIONS ADDED BY ENDO EMEN7/SPECIAL PROVISIONS <br />~ <br />l <br />premium. <br />10 Days notice ofi cance <br />lation for non-payment o <br />ertificate Holder is an Additional Insured for general liability and professional liability per <br />ndorsement #14 attached. <br />rconcrrerc unr nco ceuccl 1 eTInM <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />C 1 ty of Santa Ana * 30 DAYS YYRITTEN NOTICE TO THE CERTIFICATE HOLDER NAM):D TO THE LEFT, <br />Santa Ana City Jail <br />Attention : Chris Laugenau r , Contracts BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGAnON OR LUIBILITY <br />62 CIVIC Center P I aza OF A NO UPON THE INSURE GENTS OR REPRESENTATIVES. <br />Santa Ana , CA 92702 AUTHORIZED RESENTAmE <br /> Don Emo <br />ACORD 25 (2001!08) <br />rKC~~~~1~TARY <br />CORy~: ~ .` ~~~ONAL <br />MA~v~,~~® CARE <br />©ACORD CORPORATION 1988 <br />~~~- ~~ ~ ~ ~,1 <br />~. <br />