HERNANDEZ, FELICE S. 2-2014 - Laserfiche WebLink

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Client # 986851 MEMORANDUM OF INSURANCE ate Issued 08/21 /2014 Producer This memorandum is issued as a matter of information Mercer Consumer, a service of Mercer Health & Benefits Administration LLC P.O. Box 14576 only and confers no rights upon the holder. This memorandum does not amend, extend or alter coverages afforded by the Certificate listed below. Des Moines, IA 50306-3576 Company Affording Coverage Liberty Insurance Underwriters Inc 1-800-503-9230 Insured Felice Hernandez 320 S. Pixley Street Orange CA 92868 This is to certify that the Certificate listed below has been issued to the insured named above for the policy period indicated not withstanding any requirement, term or condition of any contract or other document with respect to which this emorandum may be issued or may pertain, the insurance afforded by the Certificate described herein is subject to all the terms, exclusions and conditions of such Certificate. The limits shown may have been reduced by paid claims. Type of Insurance Certificate Number Effective Date Expiration Date Limits Professional Liability RehabProf SE Rehabilitation Counselor AHY-754318001 08/21/2014 08/21/2015 PerIncident/ Occurrence $1,000,000 Annual Aggregate $3 000 000 PROOF OF INSURANCE Memorandum Holder: Should the above describe Certificate be cancelled PROOF OF COVERAGE ONLY before the expiration date thereof, the issuing company ill endeavor to mail 30 days written notice to the Memorandum Holder named to the left, but failure t ail such notice shall impose no obligation or liability PROVED AS TO FORN1i I, k _.S_� of any kind upon the company, its agents o representatives. Authorized Representative Laeara A, Rossini Mark Assistant City Attorney ""Brppostowitz Mercer Consumer, a service of Mercer Health & Benefits Administration I.I.C. In CA d/b/a Mercer Health & Benefits Insurance Services LLC. CA Lie.# OG39709