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KPCRMEOC 21 (2021 06 28) <br />EVIDENCE OF COVERAGE ISSUE DATE (MM/DD/YY) <br />07/09/2026 <br />SPONSOR <br />Kaiser Foundation Health Plan, Inc. <br />Attention: Corporate Risk Management <br />One Kaiser Plaza, 25th Fl. <br />Oakland, CA 94612 <br />_________________________________________________________ <br />COVERED ENTITIES <br />Kaiser Foundation Health Plan, Inc. <br />Kaiser Foundation Hospitals <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 ARRANGEMENTS SET FORTH BELOW. <br />_________________________________________________________ <br />COVERAGE AFFORDED <br />_________________________________________________________ <br />LETTER A <br />Self-insured <br />COVERAGES <br />CO <br />LTR <br />TYPE OF COVERAGE DESCRIPTION EFFECTIVE DATE <br />(MM/DD/YY) <br />EXPIRATION <br />DATE (MM/DD/YY) <br />LIMITS <br />A Hospital/Physician/Professional <br />Liability <br />Self-Insured 1/1/2026 1/1/2027 Each Occurrence: $ 5,000,000 <br />Annual Aggregate: None <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS <br />This certificate provides evidence of professional liability coverage for the above-named entities in accordance with a written <br />contract or agreement. <br />[RC012512] <br />CERTIFICATE HOLDER <br />Livermore-Pleasanton Fire Department <br />3560 Nevada Street, <br />Pleasanton, CA 94566 <br />CANCELLATION <br />NOT APPLICABLE <br />_________________________________________________________ <br />AUTHORIZED REPRESENTATIVE <br />Martin King, VP <br />Docusign Envelope ID: 1056AD7A-5F75-8291-81D6-7251B9722F37