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Policy Number, A0946 -12_09 Date Entered: Odlis/2ni is <br />AC"R C i'IFICAT O LIABILITY INSURANCE I , /Iq r,YYY, <br />d / r'. /7Rt .i <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, <br />IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED, the polley(tes) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder In Ilan of such endorsoment(s ). <br />PRODUCER <br />Koissian InsTxr nca Agency, Ina, <br />11602 Knott St. Suite $4A <br />Garden Grove, Cis 92841 <br />Y7 {StJ. )CO%96ianin3UX'aiACB. CAA% <br />CONTACT <br />MAME <br />`° <br />PHONE (714)901 -5400 x,(714)901 -5 -5008 <br />EdL nkoissian @men, cam <br />wuss: <br />&�B)AFFOIitHiiG.COVERE ; NhICd <br />_fNSiIRt <br />INSURERA: MIA-CEt1"$URY iN5t1TI7tNCB CCt @flt7Y <br />I 1REn FORENSIC NURSE SPECIALISTS, INC. <br />3378 CERRI'TOS AVL, <br />LOS .ALAMITOS, CA 90720 <br />INSURER a: <br />INSURER C:"` <br />wSUaEa O: <br />w$IfRER P: � <br />CUVERAUFS CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAAFID CLAIMS, <br />LTR t <br />TYPEOFINSURANCE .� <br />LNSR <br />O <br />POLICY NUMBER <br />I a3 E%P <br />UNITS <br />GENERALLUUILITY <br />t�UdEiiCA4t GENERAL LWaatTY <br />CIJUMSidARE ❑ OCCUR <br />APPROVED AS <br />�.,RUCW A. <br />TO FO <br />®SSiH1A <br />lvi � <br />EACH OCCURRENCE <br />5 <br />PREARRES a ^curTexca <br />S <br />M W EXP am ) <br />5 <br />PERaaNALaADVeuvaY <br />5 <br />_ <br />GENt AGGRECiATEUMtAFFVCSPMJ � <br />F-1 PaICY I—I PRO- F-1 La: <br />rMT <br />GENERALAGGRFGATE <br />PROOVCTS- C[XAPANa AG4 <br />S <br />5 <br />DR.E LVIMUTY <br />ANY AUTO <br />O!h23EO SCHEDULED <br />TOS AUTOS <br />EDAUTiS A� En <br />A58Y5$M➢1$ CD$�' <br />$$OT'Y1C <br />GISSIHIhEO Tti<` I I}�tisfT� <br />Esc <br />s <br />FS'JOILY R13lfRV (PerPxsen} <br />S <br />WIHLY ENlURY (P$r aisHav} <br />Is <br />FRQP <br />5 <br />R:A <br />URELLAUAH OCCUR <br />ESS LIAR CEAIIA^ -MODE <br />U RETCNIM $ <br />EACH CCCURRENCZ <br />S <br />AGGREGATE <br />5 <br />S COMPENSATION <br />LOYERS` LIAB R.ITY <br />EkrExECUrsvE Y� <br />tMF R ENMU W2 "{ mEL <br />�` WOMOP9+AMMs <br />RIA <br />A.0946 -12 -09 <br />X!2/2Gta <br />/2/2015 <br />� . . <br />T UM ED <br />MI SE -EA EMPLOYEE <br />S1 440 „044 <br />ELF- rxxecY Uxnr <br />51 004.400 <br />OESCRn*notlofoPEhnnmuslLacanaNS )VEHICLES tAHSCnacaROInI. AVdIIwr�IRemawu $P>%awwllnxea.as�tsreywr�et <br />SHOULD ANY OF THE ABOVE DESCRIBED FOUCES BE CANCELLED BEFORE <br />CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />60 CIVIC CZNTBR PLAZA ACCORDANCE WITH THE POLICY PROVIS IONS. <br />SANTA ANA, CA 92701 _ .........,. <br />ACORD 25 (2010146) The ACORD name and logo are registered marks of ACORD <br />ir�a FamsEmsP§axse.KUw,Fsxm�vsx &YSZiXL19Ti <br />