This Certificate is provided to:
No: Return Address
UNIVERSITY OF CALIFORNIA
EVIDENCE OF SELF-INSURANCE
PROFESSIONAL LIABILITY & HOSPITAL LIABILITY
Type of Coverage Self Insured Limits
I. PROFESSIONAL MEDICAL AND HOSPITAL LIABILITY: Each Occurrence Aggregate
II. SPECIAL TERMS & CONDITIONS:
1. This certificate is not valid for use by individuals and is only intended to evidence the self insurance of The Regents of the University of California for institutional exposure as opposed to individual exposures.
2. The self insurance evidenced herein follows the provisions of the Bylaws and Standing Orders of the Regents of the University of California and self insurance programs as administered by the University of California, Office of the President, Office of Risk Services, which do not permit any assumption of liability which does not result from and is not caused by the negligent acts or omissions of its officers, agents, or employees. Any indemnification or hold harmless clause with broader provisions than required under such Bylaws and Standing Orders shall invalidate this certificate.
3. This certificate is in effect until the expiration date indicated below or termination of applicable contract, affiliation agreement or termination of University employment, whichever comes first.
Should any of the above described program of self-insurance be materially modified or cancelled before the expiration date shown below, The Regents of the University of California will give 30 days written notice to the certificate holder.
Effective Date:
Expiration Date: Approval Date:
This Certificate is issued as a matter of information only and confers no rights upon the certificate holder. The Certificate does not amend, extend or alter the coverage described above. This certificate does not constitute a contract between the holder and the University of California
Form: PL Institutional 0914
2109033047
Redondo Beach Fire Department
Fire Chief Robert Metzger
401 South Broadway
Redondo Beach CA 90277
UCLA Health System
757 Westwood Plaza
Los Angeles, CA 90095
500,000 5,000,000 07/01/2023
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Los Angeles CA 90095
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