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Digitallysigned by
<br />Francine R.
<br />Francine R. Villareal
<br />Villareal Date: 1020.09.24
<br />15:30:37-0700'
<br />A`6RO® CERTIFICATE OF LIABILITY INSURANCE
<br />�(1 �30/2aD 0 YI
<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 CERTIFICATE 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 rl hts to the certificate holder in lieu of such endorsements .
<br />PRODUCER
<br />StaiMlIm SKALA INSURANCE AGENCY INC
<br />GENE SKALA, AGENT LIC. B587032
<br />CONE:TACT
<br />A
<br />PHONE 1, 909-883-8861 FAX
<br />ASol!
<br />WAIL s, GENE@GENESKALPLCOM
<br />INSURI AFFORDING COVERAGE
<br />NNCN
<br />4214 N SIERRA WAY
<br />INSURER A: State Farm General Insurance Company
<br />25151
<br />SAN BERN.ARDINO, CA 92407
<br />INSURED
<br />INSURER B: State Farm Mutual Automobile Insurance Company
<br />25178
<br />INSURER C:
<br />NANCY K ROHL INC
<br />INSURER 0:
<br />❑BA THE COUNSELING TEAM INTERNATIONAL
<br />IN$DkEk E:
<br />AND DBA THE ORGANIZATIONAL NETWORK
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
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<br />R
<br />TYPE OF INSURANCE
<br />ADD
<br />aUGR
<br />POLICY NUMBER
<br />MMIDDNY
<br />PCIDIV
<br />LIMITS
<br />COMMERCIAL GENERAL LIABILITY
<br />EACHOCCURRENCE
<br />$ 2,000,000
<br />CLAIM ® OCCUR
<br />-Fjaop ene
<br />$ 300,000
<br />NED EXP (Any we arson
<br />$ 5,000
<br />HIRED AUTO
<br />I ENOL
<br />PERSONAL & ADV INJURY
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<br />921-B14261 & 92YD04220
<br />07)12l2020
<br />07/12/2021
<br />LIMIT APPLIES PER:
<br />GENT AGGRECATEppCT
<br />GENERAL AGGREGATE
<br />$ 4,000,000
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<br />POLICY ❑,IELOG
<br />PRODUCTS - COMP/OP AGG
<br />5
<br />$
<br />OTHER
<br />AUTOMCMLEUABILRY
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<br />06/24/2020
<br />12/24/2020
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<br />$
<br />BODILY INJURY (Perpsn;an)
<br />5 1,000,ODO
<br />ANY AUTO
<br />BODILY INJURY(Peracddmt)
<br />$ 1,000,000
<br />B
<br />OWNED SCHEOULED
<br />AUTOS ONLY AUTOS
<br />HIRED NDN-0 ED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />f1se,
<br />$ 1,000,000
<br />$
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACH OCCURRENCE
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<br />EXCESS UAB
<br />CLFAMSAIAOE
<br />CEO I I RETENTION S
<br />$
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />YIN ANY PROPRILTORIPARI NERiEXECUTIVE
<br />OFFICERIMEMnER EXCLVDFOY ❑
<br />(Mandatory In NH)
<br />NIA
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<br />E.L EACH ACCIDENT
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<br />DEECWRTION OF OPERATIONSILOCAl10Na 1VENN:LES(ACORD1M,Addklenal Rome 5aadub,maybaeaacfiadSmaaespacearequired)
<br />Business Office Policy Property Locations: 41750 Rancho Los Palmas Or Ste D-2, Rancho Mirage, CA 92270
<br />1881 Business Center Dr, San Bernardino, CA 9240E 39755 MUmieta Hot Springs Rd, Ste D160, Murrieta, CA 92563
<br />1545 Anacepa Rd Ste 7C, Vfctorvl4e, CA 92392 135 S State College Blvd Ste 200, Brea, CA 92821
<br />444 Camino Del Rio Ste 2015,San Diego, CA 92108 701 Palomar Airport Rd, #300, Carlsbad, CA 92011
<br />74075 El Peace Ste A9 & A16, Palm Desert, CA 92260 232 Harrison Ave Ste D, Claremont, CA 91711
<br />270 E HWY 246 Ste 11. Buelllon, CA 93427 4160 Temescal Canyon Rd Ste 309, Corona, CA 92883
<br />CITY OF SANTA ANA
<br />RISK MANAGEMENT DIVISION
<br />20 CIVIC CENTER PLAZA 4th FLOOR
<br />SANTA ANA, CA 92701
<br />AGORD 25 (2016103) The ACORD name and logo
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE VALL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />`-/ © 1888-`R43d ACORD
<br />registered marks of ACORD
<br />Ride Managanent Diaisinn
<br />REVIEWED & APPROVED BY:
<br />faaa.o:.r.e Z vdt,4e
<br />'� Risk Management Analyst
<br />
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