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'`' CERTIFICATE OF LIABILITY INSURANCE
<br />DATE/10/20YYYY)
<br />�
<br />I�''®�
<br />D5/10/2018
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTHT`ATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed,
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s),
<br />PRDDUCER
<br />S%a#t^Farm SKALA INSURANCE AGENCY INC
<br />4214 N SIERRA WAY
<br />0 MAL
<br />SAN BERNARDINO, CA 92407
<br />CONTACT
<br />NAME:
<br />PHONE909-883-8961 Are FA ___.._..._.._..._........._.._.........,,,_.._.
<br />Na ;
<br />6MAllg
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE NAIC It
<br />INSURER A : State Farm General Insurance Company 25151
<br />INSURED
<br />NANCY K ROHL INC
<br />DBA THE COUNSELING TEAM INTERNATIONAL
<br />AND DBA THE ORGANIZATIONAL NETWORK
<br />INSURER 8: State Farm Mutual Automobile Insurance Company 25178
<br />INSURER C:
<br />INSURER D:
<br />INSURER E:
<br />INSURER F;
<br />n=Vial UIN IYUIVIOMM:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE
<br />FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH
<br />RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED
<br />HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSRI:rR
<br />L'TR
<br />TYPE Or INSURANCE
<br />-ADDL
<br />,
<br />SUER
<br />POLICY NUMBER
<br />POLFCY EFF
<br />MMIDDIYYYY4
<br />PflUCY EXP
<br />MMIODfYYYY
<br />i -----"--'--"
<br />LIMITS
<br />COMMERCIAL GENERAL LIABILITYI
<br />CLAIMS -MADE OCCUR
<br />;:CUI?EACHOREt-0CH
<br />g 1,000,000
<br />t{UNGFTiTiER—tIII
<br />PREMISES.Eaoccurrence!.
<br />S 300000
<br />IF\I
<br />HIRED AUTO
<br />MED EXP (An one porson't
<br />'> 5,000
<br />A
<br />_... ._..............
<br />Y
<br />Y
<br />92LB14261 & 92YD04220
<br />05/10/2018
<br />07/12/2019
<br />ENOL
<br />I PCRSONAL&rOVINJiRY
<br />_
<br />3
<br />` GEN'L AGGREGATE LIMIT APPLIES PER:
<br />r�
<br />'�
<br />GENERAL AGGREGATE
<br />----....---..._.....
<br />' 2,000,00D
<br />' PRC.
<br />POLICYt� L:,:,
<br />PRODUCTS • COMP!OP AGG$
<br />JEGT
<br />OTHER:
<br />..__..
<br />i
<br />AUTOMOBILE
<br />LIABILITY
<br />(I
<br />4414187F2475
<br />05/10/2018
<br />12/24/2018
<br />Wncc UE "t, SINGLE LJMV'
<br />S
<br />B
<br />ANY AnTO
<br />OWSVE: SCHEDULED
<br />I I
<br />BODILYINJURY(Per persal)
<br />_
<br />y 1.000,000
<br />-
<br />BODILY IN -JURY (Per accident)
<br />S 1,000,000
<br />'UTOSGNLY ALTOS
<br />HIRED
<br />NON-O`1NNED
<br />AJrCS OI.iL'v AUrg50NLY
<br />1
<br />PROPERTY DAMAGE
<br />rarci•' ns-
<br />$ 1,000,000
<br />UMBRELLA LIAB OCCUR
<br />EACH OCCURRENCE
<br />S
<br />EXCESS LIAR •
<br />AGGREGATE —
<br />$
<br />OED Pr`I ft?!uN S !
<br />5
<br />WORKERS COMPENSATIO ,, i
<br />AND EMPLOYERS LIABILITY
<br />-)
<br />_
<br />SiT UTE SRH
<br />1, r N E
<br />ANY PROPRIETORtPAf2TNER!'cX£CLifIVE
<br />O°EECERiMtEh4IsER E -Xi LUD O7 f
<br />N ! A
<br />E L F:'tCti AC(:IDENT
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<br />y
<br />)IMandac5,nin
<br />NH) i
<br />!1 yes, describa undrr
<br />E.L.. DISEASE • EA EMPLgvEe
<br />;
<br />E DISEASE . POLICY LIMIT
<br />..
<br />1
<br />CESOR)P`IO'0
<br />OF OPE'RAVOIJS belesv Illj
<br />I
<br />—.-$
<br />DESCRIPTION OF OPERATIONS i LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space Is required)
<br />Business Office Policy Property Locations:
<br />1881 Business Center Dr, San Bernardino, CA 92408 39755 Murrieta Hot Springs Rd, Ste D160, Murrieta, CA 92563 j
<br />1545
<br />Anacape Rd Ste 7C, Victorvilie, CA 92392 135 S State College Blvd Ste 200, Brea, CA 92821 ' a'
<br />444 Camino Del Rio Ste 2015,San Diego, CA 92108 7220 Avenida Encinas Ste 125, Carlsbad, CA 92011
<br />74075 El Paseo Ste A9, Palm Desert, CA 92260 t
<br />232 W Harrison Ste D, Claremont, CA 91711
<br />CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />SANTA ANA POLICE DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS.
<br />60 CIVIC CENTER PLAZA
<br />SANTA ANA, CA 92702 A IZE REPRESENTA
<br />© 1988-201 OR C R I . A Ig reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of A
<br />n s�/� 1001486 132849.12 03-16-2015
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