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HomeMy WebLinkAboutTUSTIN IRVINE MEDICAL GROUP 1 -2003 ..'.....~.HI~. . N01 FILE.. "1\',)UIII'\1l WORK Mfl. N PROCEED . CLE.RK COUNCIL N-2003-013 o . '2- 1-03 CONSULTANT AGREEMENT (5 ;, THIS AGREEMENT, made and entered into this 21 ~ day of ~ l, 2002 by and between Tustin Irvine Medical Group, a California corporation (hereinafter "Co ultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California (hereinafter "City"). 1'r " ~ :J ~ 0: a::, A. UJ Q i:S l'r) =~u.J ~~ .....0(.) '-" z:~ ~" 00..;2", 0 N LLI>-::J~ 0 (.)<cCI) \ u.. J ~:!;:~ o~ 1:t::::::C:::--l :::.::::.. ~~i= f5~ -~~~ ~~ RECITALS The City desires to retain a consultant having special skill and knowledge in the field of audiology, to perform annual hearing tests for City employees who are occupationally exposed to loud noises. B. Consultant represents that Consultant is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration ofthe mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Consultant shall perform those services as set forth in Exhibit A to this Agreement. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identified in Exhibit A. The total sum to be expended under this Agreement, shall not exceed $5,000.00 during the term of this Agreement. b. Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 3. TERM This Agreement shall commence on November I, 2002 and terminate on October 31, 2003, unless terminated earlier in accordance with Section 12, below. The term of this Agreement may be extended upon a writing executed by the Executive Director of Personnel Services and the City Attorney. 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer-employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1 ,000,000 per occurrence. Consultant shall supply City with a fully executed additional insured endorsement in substantially the form attached hereto as Exhibit B upon execution of this Agreement and shall be approved in form by the City Attorney. b. Reserved. c. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim. 2 e. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: (i) Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form by the City Attorney. (iii) Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. f. If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not effect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 6. INDEMNIFICATION Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including health, and claims for property damage, which may arise from the direct or indirect operations of the Consultant or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section I of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. 7. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of 3 like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation oflaw; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 8. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 9. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by telefacsimile or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 telefacsimile (714) 647-6956 With courtesy copies to: Executive Director of Personnel Services City of Santa Ana 20 Civic Center Plaza (M-28) P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 647-6994 Attn: Emilyn Buenafe and, 4 City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 647-6515 To Consultant: Tustin Irvine Medical Group 800 N. Tustin Avenue, Suite A Santa Ana, California 92705 Telefacsimile (714) 285-0400 Attn: Dr. John G. Alevizos A party may change its address by giving notice in writing to the other party. Thereafter, any notice, tender, demand, delivery, or other communication shall be addressed and transmitted to the new address. If sent by mail, any notice, tender, demand, delivery, or other communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by telefacsimile, any notice, tender, demand, delivery, or other communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 10. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant nor the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 11. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement 5 shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. 12. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 13. DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 14. JURISDICTION - VENUE This Agreement and all questions relating to its validity, interpretation, performance, and enforcement shall be governed and construed in accordance with the laws of the State of California. This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 15. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of her inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 6 16. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: CITY OF SANTA ANA CE:?'~ City Manager ~~~~o ,1 (J'\ ATRICIA E. HEALY 1) Clerk of the Council APPROVED AS TO FORM: JOSEPH W. FLETCHER City Attorney BY~,)/1J,~j, t?007 La ra Sheedy Assistant City Attorney RECOMMENDED FOR APPROVAL: CONSULTANT ~jJ ~' 3:3 -(fJr;, 93/JJ? Employer ID # or Individual SS # 7 FrOm:TIMG SANTA ANA 714 2850400 07/03/200209:37 #120 P.00I/003 . Tustin Irvine Medical Group Employee Heallh Cente.. "'We rakt care of emplo~e healrh while yOu rake care of business. N JULY 2 2002 MISS EMILYN BUENAFE CITY OF SANTA ANA RISK MANAGEMENT DIVISION POBOX 1988 M-28 SANTA ANA, CA 92702 DEAR MISS BUENAFE, THIS IS TO CONFIRM THAT TUSTIN IRVINE MEDICAL GROUP IS CAPABLE OF PERFORMING AUDIO TESTING FOR THE C~ OF SANTA ANA. THE FEE FOR EACH TEST IS S9.00. PAYMENT FOR THE ABOVE MENTIONED SERVICE CAN BE ADDRESSED TO OUR CORPORATE ADDRESS IN SANTA ANA. THIS AGREEMENT SHALL BE VALID FOR ONE YEAR. SEE THE ATTACHED PROTOCOL CREATED FOR AUDIO TEST AND PROOF OF INSURANCE COVERAGE. SINCERELY, Corporale Office Santa Ana Facility 800 N Tushn Avenue Suite ^ Santa Ma, CA 92705 [714) 245-0800 1714) 285-0400 Fax tf~~ ROZE BARRIO DIRECTOR OF MARKETING,SANTA ANA 24-Hour Care Irvine Facility 15374 Alton Parkway Irvine, CA 92618 (949) 788.0960 (949) 753.0423 Fax EXHrRIT A . . EXHIBIT B ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Company This endorsement modifies such insurance as is afforded by the provisions of Policy # relating to the following: I. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 9270 I; its officers, employees, agents, volunteers and representatives are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant ifnot so included. 4. With respect to the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 9270 I. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective Policy # Issued to , this endorsement form as a part of Named Insured Countersigned by Authorized Representative 8 ~ CERTIFICATE HOLDER COPY STATE P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807 COMPENSATION INSURANCE FUN 0 CERTIFICATE OF WORKERS' COMPENSA TrON INSURANCE SEPTEMBER 12, 2002 GROUP: POLICY NUMBER: 1443685-2002 CERTIFICATE 10: 4 CERTIFICATE EXPIRES: 04-01-2003 04-01-2002/04-01-2003 CITY OF SANTA ANA ATTN, JEFF STEVENS, RISK MANAGEMENT DIVISION 20 CIVIC CENTER PLAZA, ROOM #M28 SANTA ANA CA 92702 JOB: CITY OF SANTA ANA AUDIO TESTING This is to certify that we have issued a valid Worker's Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer. We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance 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. -d /~" ~ f(e4o-l-~~'~ PRESIDENT AUTHORIZED REPRESENTATIVE EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS, $1,000,000 PER OCCURRENCE AI'FRO V bJ AS 10 IORl'vJ ~y 4::aura ShC~ Deputy City Attorney EMPLOYER JOHN G ALEVIZOS, DO. INC AND TUSTIN-IRVINE MEDICAL GROUP, INC DBA, JOHN G ALEVIZOS, DO 800 N TUSTIN AVE STE A SANTA ANA CA 92705 selF 10265 IEPF-UI, AE 1 from:TIMG SANTA ANA Jl'.& .. Tustin Irvine Medical Group EmF'loyee Health Centers 'We rake care of employee health while you take care of bU5Iness." Corporate Office Santa Ana facility 800 ~. Tustin Avenue Suite A Sanla Ana, CA 91705 (714) 245-0800 (714) 285-0400 fax 24-Hour Care Irvine Facility , 5374 Alton Parkway Irvine, CA 9261 a (949) 78a-0960 (949) 753.0423 Fax 714 2850400 01/06/2003 16:22 #315 P.001/002 JANUARY 6,2003 CITY OF SANTA ANA EMIL YN BUENAFE RISK MA.~AGEMENT P.O.BOX 1988 M-28 SANTA ANA, CA 92702 IN REGARDS: CAP MPT PROFESSIONAL LIABILITY PROTECTION MEMBERSHIP NUMBER 9275 COVERAGE 12.01.02 THROUGH 12.01.03. IN THE EVENT THAT THE POLlCY COVERAGE OF TUSTIN IRVINE MEDICAL GROUPfCAP-MPT WOULD BE GIVEN A 30 DAY NOTICE OF CANCELLA TIm TUSTIN IRVINE MEDICAL GROUP WILL IMMEDIA TEDL Y GIVE THE CITY 0 SANTA ANA A 30 DAY NOTICE OF POLICY CANCELLATION ~O DIRECTOR OF MARKETING, SANTA ANA SEE ATTACHMENT S 'IU FOR. A r . 1,-0 V ED A '1 ~ ";'jiLU{' . i.-~.~~-~-, ~(dy ;-;~;PU1Y CilY /\ttorney ~~ ~~ ~... . : ~ ~ .. . . , lr.mDI CERTIFICATE OF INSURANCE ." . PAODUCER INSUIlEO PAGE 02 ISSUE 0'-' TE (MMlDOIVY) , I I I THIS CIEIIITIFICATE . IUUlED ..a A MATTER Of INFOMlATION 0Ml Y ,AND CONflAa NO RIGHTII UPON 1ME CEIn~TI: HQl.Dt!R. ". Cf,IIIT1FICAU: DOES NOT MlI!JIIO. EJTEIlIl DlO .... TEll THE COYE.....GE .- .' THE I'Ol.IClES alLOW. KENNY T PALMA INSURANCE AGENCY 15605 CARMENITA RD SUITE 102 SANTA FE SPRINGS CA 90670 TEL: (562) 926-4416 COMPANIES AFFORDING COVERAGE f~~Y A TRUCK INSURANCE EXCHANGE 1"18 ... TO CEJIITIFY THAT ..eUClts OF INSURANCE: LISTED BELOW H.-rE BEEN ISSUE.D fO THE INSURED NAMED "eo"!: FOFl1H':' POL.ICY PEAIOD INDICATED NQTWlttl9TANDING .."'. MQUIREMEfIIT, TEfW OR COtIPlTtON OF ANY CONTRACT OR OTHER DOCUME.N'T WrTH RE~CT TO WHICK THIS CERTIACAT. MAY BE ISSUlD OR YAY PERlAIN, THE INSURAI'tCE AFfORDED 11"1 THIE POLICIES DESCRIBED tttAf'IN 18 SO&lf.C1' TO ALl THIE TEAMS, EllCLUStON8, AND CONDI- TIONS OF sue" f'OLICIU. i TUSTIN IRVINE MEDICAL GOURP INC 800 N TUSTIN AVE SANTA ANA CA 92705 COMPANY LETTER . COMPANY C LETTER TYPE OF INSUAJl.NCE GEHEUL u,.,8111TY ~RE"E~VE fORM PREloIISESiOPEIlATIONS UNOERGR<)JNO EXPl.OSION . COlLAPSE H~ PflOO\JCTS/tOMPl.EnD OPEIlATIONS CONTRACTUAL INOtPENDENT CONTRACTORS BROAD FOAM PROPERTY OAMAGf Pf:RSON.Al INJURY POLICY NUMBER POllCTWEC1M I'ClICYEIl~TlON ()AT~ (MMJOONYl DAlllto&WOl'Nl aOOAEClATE. ace BODILY $ S 09407-10-51 11-01-0 lNJUAY CONTINU US pROPERT'Y $ $ OAM,t.OE UNITL C NCELLED CQMP"NV D LETtER ~ . . IE . ~~~~eo $2MILL S2MILI.. PERSON.AL INJUAV $ 0Kl" ""'" $ l"''''l'EfWtIl OKll' "...' $ IIl{AACCf(Itf) PRO PEA"" $ Q,aMaGE II' PO $ COMBIN'fO IlII a PO $ COMBINEO STATuTOR.Y Aurouo-u LIABILITY ANVAUTO All QWNfO AUTOS (PRI\I PASS,) AlL OWNED AUTOS (~J:Rp~) ",RIO AUTOS X NON.OWlIEO AUlDS GAAMiI UAIlIUI'I -~C'G3"\ '"i<' \ 1'5 \) 1'-\,\,\,-0" ~ --~- ElCESIS u~un UMB~llA FORM OTHER Ht.'" lJMBFlEllA FORM WOflKfllll' COMP~N"TION _NO eMPLOYERS' LI....UTY OTHER DESCRIPTION Of OPERATtON6IlOCATIONSJVEHtCL.E6ISPECIAlITEMS AUDIO TESTING - FROM NOVEMBER 2002 THRU OCTOBER 2003 RISK MANAGEMENT DIVISION . . . CITY OF SANTA ANA RISK MANAGEMENT DIVISION 20 CIVIC CENTER PLAZA, M-28 SANTA ANA CA 92702 (EACH ACCIDlNn (OISEASE-PC\ICY liMIT) (OISEASE.IAC" E.....OyE!) STATE C:OMPE!H,SA1'IQN I tl 5 U fOr", H C E FUND . "-" po. BOX 807, ^ ,', ' . ~RTHOLDER COpy C ,""'>: :fi ''<,:',{:,,1'<, '<',' SAN FRANClsc~e~0;~4 r~~07 SP . _t'" t'C ISSUE DATE: , - - " .', ,,,': .::v <" CERTIFICATE OF; WORKERS' CQMPl!NSATlOl\llNSUJiA:NcE I;! ,~;<: - , - i' ' 04-0t-2o<l3 GROuP: , POLlCY NUMBER: 1443685-2003 ,.CEflTIFICA TE ,10: '.. 4 CERTIFICATE .EXPlRES, 04-01-2004 04-01-2003104-01-2004. , v ,- , ';'(~ -<~ C (TV OF SANTA ANA Sf> c' AnN: 'JEFF St~VEtIS. RI$XANAGEIU.MT lJfV1SI.ON 20 C I VI C CENT~R Pl:AZA.:' ROO/'l."llT28 SANTA ANA CA,~2702 \;;, JOB; uOB; bTY OF SANTA ANA , 'AUDIO 'TESTING, ?i This is to certtfy that we ",ave ,issued a valid W!'rkers' Co~en$ation insurance poliCY in a ',form ~prov~d by the California" msuianc:e Commissiorrer---to'.'tfore employ. -named" bl,tfOw--tor,:the"-pct!cy-pcriod incficlJ1:ed.- This poliCY is not subject to cano"Jlatlbn by tha' FUMo- except upon 10 days' advance written notice to the employer. We will also give YOY"-'0 days'- 'adva'r'lce notice should this poHt:y be cancelled -prior to 'its 'no1rr\al" flxpiratioh. This certifjcate<'of, insurance" is _ not ,an in$Urance, pOlicy'-' by the policies listed here,,,.lII01Wlthstandi/lg atir ,r.eM with respect to which this certificate 6f insurAlrlee nDj! policies ~scribed herein is subject'to all :,the \t$triS},~ - , ,,' , P:~s not arilet1<l. e><.tend' or alter llie CQverage 'afforded fJ;ti.t~,t9rm.- or cQrid.tiOF\ 9f'any comr.ct-br other document , . $Oed -or may'-:.per.Ulin/ the insurance afforded by the-:,' " " ns and condit!-ori~ of 'sueh policies. ~ ' ~-.~~ AUTHORIZED REPReSENTA rive - j}~ t. ~ PRESIDENT '-?; " , EMPLOVER'S LIABILITY LIMIT INCLUDING DEFENSE (:os"'$; $i,Ooo,cioo.oo PER~OcctiRRENCE. { , y- " '\''';,' ,vnIO;! OJ. SV(T1\0)HdV -~ ,- -" ,-', '0\''' , EMPLOYER LEqAL'MAME '''-, -"\. ? 'JOliN G ALEVllO~.. riO. ItIC 8~' N .rUST! NAVE STE A SANTA ANACA 92705 , ", . . ',' '< .', " ;"m<<Gl' ~E\iIZGS ,DO, INC NID "TUSTIN-IRVINE MEOICAL ~. tIC ~:'-,-c,': J y' Y;1", - "_''<:':\'' . '-:i:/. ,"