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GREALOS -01 PACL <br />ACORD TM CERTIFICATE OF LIABILITY INSURANCE <br />DA2/1412005 ) <br />PRODUCER License # OB02587 (805) 987.9727 <br />Brown & Brown Insurance / MFC &V Insurance Services <br />P.O. Box 2815 <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 />Camarillo, CA 93011 -2815 <br />,. V:y <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED Lifesigns Inc. <br />2222 Laverna Ave <br />Los Angeles, CA90041-2625 <br />..- <br />pp Y �', <br />11 <br />INSURERA: Philadelphia Insurance Company <br />ED ESENTATIVE <br />INSURER B: <br />INSURER C: <br />I �. <br />, <br />INSURER D: <br />EACH OCCURRENCE <br />$ 1,000,00 <br />,+ <br />INSURER E: <br />A <br />C(1VFRAQFS <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 />INSR <br />TR <br />DD' <br />NS <br />E <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />p 7 <br />POLICY EXPIRATION <br />LIMITS <br />ED ESENTATIVE <br />GENERAL LIABILITY <br />I �. <br />, <br />EACH OCCURRENCE <br />$ 1,000,00 <br />PREMISES EEaaoacurence <br />$ 100,000 <br />A <br />X <br />X COMMERCIAI- GENERALLIABILITY <br />PHPKI04336 <br />12/27/2004 <br />12/27/2005 <br />CLAIMS MADE ® OCCUR <br />MED EXP (Any one person) <br />$ 5,000 <br />PERSONAL &ADV INJURY <br />S 1,000,00 <br />GENERAL AGGREGATE <br />$ 3,000,00 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP /OP AGG <br />5 3,000,00 <br />POLICY PRO LOG <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Ea accl art) <br />$ <br />BODILY INJURY <br />(Per person) <br />$ <br />ALLOWNEDAUTOS <br />SCHEDULED AUTOS <br />- - <br />BODILY INJURY <br />(Per accident) <br />$ <br />HIREDAUTOS <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />GARAGE <br />LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />$ <br />OTHER THAN EA ACC <br />$ <br />ANY AUTO <br />$ <br />AUTO ONLY AGG <br />EXCESSIUMBRELLA LIABILITY <br />EACH OCCURRENCE <br />$ 2,000,00 <br />A <br />X OCCUR D CLAIMS MADE <br />PHUB039472 <br />1212712004 <br />1212712005 <br />AGGREGATE <br />$ 2,000,00 <br />$ <br />DEDUCTIBLE <br />$ <br />X RETENTION $ 10,000 <br />WORKERS COMPENSATION AND <br />WC STATUS OTH- <br />TORY LIMITS ER <br />E.L. EACFIACCIDENT <br />$ <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNERIEXECUTIVE <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />OFFICERIMEMBER EXCLUDED? <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />I <br />I <br />I E.L. DISEASE - POLICY LIMIT <br />$ <br />OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />(10) Day Notice of Cancellation for Non - Payment of Premium <br />Certificate Holder, its officers, employees, agents, volunteers and representatives are named as Additional Insured under the General <br />Liability per the attached form CG2026 11/85. <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (2001108) © ORD CORP R Tf - 1988 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />City of Santa Ana <br />20 Civic Center Plaza <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br />P.O. BOX 1968 <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />Santa Ana, CA 92701 - <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY K)pl ON THE INSURER, ITS AGENTS OR <br />1\ <br />REPRES ATIVES. <br />AUTHOR <br />ED ESENTATIVE <br />I �. <br />, <br />ACORD 25 (2001108) © ORD CORP R Tf - 1988 <br />