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ACORD M CERTIFICATE OF LIABILITY INSURANCE <br />. <br />DAT040212014YYY) <br />PRODUCER Phone: (714)901 -3494 Fax: (714)9013495 <br />BEACHVIEW INSURANCE BROKERAGE <br />5011 ARGOSY AVENUE #15 <br />HUNTINGTON BEACH CA 92649 <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 />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE MMIDO <br />POLICY E %PIRATION <br />DATE MMIOOIYY <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />A enc Lic #: OG47892 <br />GENERAL <br />LIABILITY <br />INSURED <br />INSURER A: General Casualty Insurance <br />06/04114 <br />FORENSIC NURSE SPECIALIST, INC. <br />3373 Cerritos Avenue <br />INSURER B: <br />X <br />INSURER C: <br />$ 300,000 <br />Los Alamitos, CA 90720 <br />INSURER D: <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMSMADEF7 OCCUR <br />INSURER E: <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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE 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 />INSRADD <br />ITT <br />INSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE MMIDO <br />POLICY E %PIRATION <br />DATE MMIOOIYY <br />LIMITS <br />GENERAL <br />LIABILITY <br />CFB1058360 <br />06/04/13 <br />06/04114 <br />EACH OCCURRENCE <br />$ 2,000,000 <br />X <br />DAMAGET —RENTED <br />PREMISES( a occurenca) <br />$ 300,000 <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMSMADEF7 OCCUR <br />MED. EXP(Anyone person) <br />$ 10,000 <br />PERSONAL & ADV INJURY <br />$ 2,000,000 <br />A <br />GENERAL AGGREGATE <br />$ 4,000,000 <br />GENLAGGREGATE LI MIT APPLIES PER <br />POLICY PRO LOG <br />ECT <br />PRODUCTSAOMP /OP AGO. <br />$ 4,000,000 <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />ANY AUTO <br />ALL OWNED AUTOS <br />A W <br />APPROV <br />D p S TO FO <br />%/'MOaA AC <br />n141rc <br />A1WA <br />(Ea accident) <br />$ <br />BODILY INJURY <br />SCHEDULED AUTOS <br />(Per person) <br />$ <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />a <br />�d���l <br />. Ropsysini <br />(err accident) <br />$ <br />55ns��ffii <br />City At torn <br />PROPERTY DAMAGE <br />Peraccitlenq <br />$ <br />GARAGE <br />LIABILITY <br />AUTO ONLY m EAACCIDENT <br />$ <br />THAN EA ACC <br />$ <br />ANVAUTO <br />$ <br />AUTO ON <br />AUTO ONLY AGG <br />EXCESS / UMBRELLA LIABILITY <br />OCCUR 1-1 CLAIMS MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DEDUCTIBLE <br />RETENTION $ <br />$ <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />WCSTATU- OTHER <br />TORY uMITs <br />E.L. EACH ACCIDENT <br />$ <br />ANY PROPRIETOMPARTNERIE%ECUTIVE <br />OFFICEWMEMBER EXCLUDED? <br />Byes, describe under <br />E.L. DISEASE -EA EMPLOYEE <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />SPECIAL PROVISIONS below <br />OTHER: <br />DESCRIPTION OF OPERATIONS /LOCATIONSIVEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br />Certificate holder is named as an additional insured per the attached 154875 endorsement. Waiver of sub also applies in favor of certificate <br />holder per attached form SP 0497 <br />CERTIFICATE HOLDER r.ANOPI I ATInN <br />City of Santa Ana <br />60 Civic Center Plaza <br />Santa Ana, CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL MAIL 30 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. <br />AUTHORIZED REPRESENTATIVE <br />Attention: <br />a <br />j`°r° / Donna MICy�phers <br />ACORD 25 (200VU8) certificate # 9667 ©ACORD CORPORATION 1988 <br />