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Ac�Rp® CERTIFICATE OF LIABILITY INSURANCE kaa . OA10/0212015 V) 10/02/2015 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(les) must 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 VIG, LLC., dbaThe Vestavia Group 2090 Columbiana Road, Suite 4400 Birmingham, AL 35216 N CT NA E: P"O"E 205-552-0244 AX Np, 205-244-8072 ADDRESS: INSURER($) AFFORDING COVERAGE NAICA INSURER A: Evanston Insurance Company "A" XV 35376 INSURED NaphCare, Inc. 2090 Columbiana Road, Suite 4000 Birmingham AL 35216 INSURERS: The Travelers Insurance Company "A+" XV 19046 INSURER C: INSURER 0: 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. ILTR TYPE OF INSURANCE ODL U R POLICY NUMBER PMfODY EP MMIDOIYYYY LIMITS A X COMMERCIAL GENERALLIABILITY CLAIMS -MADE fOCCUR N N SM909760 09/30/15 09/30/16 EACH OCCURRENCE $ 1,000,000 PREM SES Me occurrence $ 50,060 MEDEXP An ono person) $ 5,000 PERSONAL &ADV INJURY S 1,460,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [�] PRJECT O- r7LOC OTHER: GENERAL AGGREGATE $ 5,000,000 PRODUCTS-COMP/OP AGG $ 1,000,600 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOSULED NON -OWNED HIRED AUTOS Not Applicable CEOMBINEDt SINGLE LIMIT $ XXXXXXX BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident) $ XXXXXXX Per scolde DAMAGE $ XXXXXXX UMBRELLA LIAR EXCESS UAB OCCUR CLAIMS -MADE Not Applicable EACH OCCURRENCE $ XXXXXXX AGGREGATE S XXXXXXX DEO I I RETENTIONS $ XXXXXXX B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETDWARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? tI (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS b.I. NIA TC2NUB-42518723-15 TRKUB-4251 B760-15 09/30/15 09130/16 X STATUTE ERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE-EAEMPLOYE $ 1,000,000 E.L. DISEASE -POLICY LIMIT I S 1,000,000 A Professional Liability Claims Made N N SM909760 09/30/15 09/30116 Each Med. Incident $1,000,000 Ann. Aggregate $5,000,000 DESCRIPTION Op OPERATIONS I LOCATIONS I VEHICLES (ACORD 1101, Additional Remarks Schedule, may be attached if more space Is required) The City of Santa Ana is named as Additional Insured as respects liability. Policies will not be cancelled or materially modified with providing thirty (30) days written notice to the City. f:FRTIFif`ATF HETI nFR OANCELLATION City of Santa Ana Attn: Purchasing Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE q�Gf/J�ft_ Z.Cr �-�✓ ©1988-2014 ACORD CORPORATION. All rights reseryetl. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD