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Francine R. Digitally signed by Francine R.
<br />Villareal
<br />Villareal Date: 2021.07.01 17:15:15 -07'00'
<br />DATE (MWDDIYYYY) ` �� CERTIFICATE OF LIABILITY INSURANCE
<br />�
<br />06121 /2021
<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 rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />State Farm SKALA INSURANCE AGENCY INC
<br />GENE SKALA, AGENT LIC. 0587032
<br />CIST CT
<br />NAME:
<br />PHONE . 909-883-8861
<br />IL GENE@GENESKALA.COM
<br />II' 4214 N SIERRA WAY
<br />ftbURER S AFFOROfNG COVERAGE NAILS
<br />INSURER A: State Farm General Insurance Company
<br />25151
<br />SAN BERNARDINO, CA 92407
<br />INSURED
<br />INSURER B : State Farm Mutual Automobile Insurance Company
<br />25178
<br />NANCY K BOHL INC
<br />INSURER C :
<br />INSURER D:
<br />DBA THE COUNSELING TEAM INTERNATIONAL
<br />INSURER 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.
<br />MSR
<br />LTR
<br />TYPE OF INSURANCE
<br />At7S7L
<br />U
<br />POLICY NUMBER
<br />POLICY EFF
<br />IPOWLDi D E7fP
<br />LIMITS
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS -MADE ® OCCUR
<br />REAI - en
<br />S 300,000
<br />$ 5,000
<br />RED AUTO
<br />kENOL
<br />MED EXP hA one raon
<br />A
<br />Y
<br />Y
<br />92LB14261 & 92YD04220
<br />07/12/2021
<br />07/12/2022
<br />PERSONAL &ADV INJURY
<br />$
<br />GEWL AGGREGATE LIMIT APPLIES PER:
<br />POLICY a jE LOC
<br />GENERAL- AGGREGATE
<br />S 4.W0,000
<br />PRODUCTS- COMPfOP AGO
<br />$
<br />$
<br />OTNER:
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />4414187F2475
<br />06/24/2021
<br />12/24/2021
<br />COs xeWg!M MBINED SINGLE LIMir
<br />$
<br />BODILY INJURY (Per person)
<br />$ 1,0f10,000
<br />ANY AUTO
<br />B
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPER7YDAMAGE
<br />Per acc
<br />$ 1,000,000
<br />UMBRELLA LIAR OCCUR
<br />EACH OCCURRENCE
<br />S
<br />4
<br />AGGREGATE
<br />5
<br />EXCESS LIAB CLAIMS -MADE
<br />DED RETENTION $
<br />S
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y 1 N
<br />ANY PROPRIETORIPARTNERIEXECU-nVE ❑
<br />OFFIC ERIMEM BER E7CCL U DEO?
<br />( Mandatotyln NH)
<br />NIA
<br />I PTEAR T OTH-
<br />1~.L. EACH ACCIDENT
<br />S
<br />E.L. DISEASE- EA EMPLOYEE
<br />S
<br />If yes, deserlbe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />S
<br />DESCRIPTION OF OPERATIONS] LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is mqulred)
<br />Business Office Policy Property Locations: 41750 Rancho Los Palmas Dr Ste D-2, Rancho Mirage, CA 92270
<br />1881 Business Center Dr, San Bernardino, CA 92408 39755 Murrieta Hot Springs Rd, Ste D160, Murrieta, CA 92563
<br />1545 Anacepa Rd Ste 7C, Victorville, CA 92392 135 S State College Blvd Ste 200, Brea, CA 02821
<br />444 Camino Del Rio Ste 2015,San Diego, CA 92108 701 Palomar Airport Rd, #300, Carlsbad, CA 92011
<br />74075 EI Paseo Ste A9 & Al6, Palm Desert, CA 92260 232 Harrison Ave Ste D, Claremont, CA 91711
<br />4160 Temesoal Canyon Rd Ste 309, Corona, CA 92883
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF,
<br />NOTICE WILL
<br />BE DELIVERED IN
<br />CITY OF SANTA ANA
<br />CCORDANCE WITH THE POLICY PROVISIONS.
<br />RISK MANAGEMENT DIVISION
<br />20 CIVIC CENTER PLAZA 4th FLOOR
<br />Ur REPR T
<br />SANTA ANA, CA 92701
<br />RiskMarWmerdDMsian
<br />#88-2.015 ACO C
<br />°,$
<br />REVIEWED & APPROVED BY.-
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />Risk Management Analyst
<br />
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