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Tori Pierson01g1fa11ys1gnetlbyionr1 non pat elan Jod6oe inv oros A`"R br CERTIFICATE OF LIABILITY INSURANCE An /13/202"1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER State Farm Insurance License # OG54371 O14210 Culver Dr, Suite A, Irvine CA 92604 NAAI : RICHARD TAY Exul 949) 559 8866 1 ac N,: (949) 269 0683 EaAM. UL ADDRESS: PRODUSTUCER 75-3018 INSURERS AFFORDING COVERAGE I Hai INSURED BRIAN PETERSON ART DBA FACES OF MANKIND 738 N SANTIAGO ST SANTA ANA CA 92701-5361 INSURER A: State Farm General Insurance Company 1 25151 INSURERB: INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR TYPE OF INSURANCE LTR ADOL SUBRi POLICY NUMBER POLICY EFF a U POLICY EXP MWDD LIMITS GENERAL LIABILITY A GEN _ xCOMMERCIAL GENERAL LIABILITY _ CLAIMS -MADE 11, x OCCUR _ GENT AGGREGATE LIMIT APPLIES PER: X POLICY ^ I Pi JECT F LOC II7� 92-EYM1-6-81 1 1 10/30/2027 10/30/2022 EACH OCCURRENCE S 1,000,000 PREMISES _R5NTE occurrence) S 50,000 MED EXP(Any one person) $ 5,000 PERSONAL& ADV INJURY $ 1,000,000 GENERALAGGREGATE S 2,000,000 PRODUCTS - COMP/OP AGO $ 1,000,000 $ AUTOMOBILE LIABILITY — —ANY AUTO _ALL OWNED AUTOS — SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS IF '1. ❑I. COMBINED SINGLE LIMB (Ea mxk1em) E BODILY INJURY (Par person) E BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Peraccldent) E S $ UMBRELLA LIAR OCCUR EXCESS LIAR _ CLAIMS -MADE❑ ❑I Ili EACH OCCURRENCE $ AGGREGATE $ _'. DEDUCTIBLE ".. RETENTION $ $ S WORKERS COMPENSATION ANDEMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? yeMe'dalory In NH1 flfl a, describe un8er N/A �'' - WC STATU- IOTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE -POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ANach ACORD 101, Addldmal Remarks Schedule, N more apace Is required) WITH RESPECT TO GENERAL LIABILITY, NAMED ADDITIONAL INSURED FROM August 06 2021 TO November 20th, 2021 is: The City of Santa Ana, its officers, employees, agents, volunteers & representatives for the location of: 1815 Carnegie Avenue, Santa Ana CA 92705 LJCK I Hiii VA I C K V LUCK VAKGCLLA I I V K Rult Management Drkii City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED I EXPIRATION DATE THEREOF, NOTICE WILL BE 1 - REm sursi a"ovaa By l • Risk Management Division POLICY PROW SIONS. tlfi.1 76-d yP4m,ae clumm 20 Civic Center Plaza esmm.,n,.,eenn,toel,.,taar Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE Ids Tay <iris.tay.mgms@statefann.com> ACORD 25 (2009109) © 1988- 2009 ACORD CORPORATION. The ACORD name and logo are registered marks of ACORD All rights reserved. 1001486 132849.4 02-11-2010