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myltany signed byTnn PWsnn TOO PiersonDins: 2021.1e1e 08:3211 moor a`oRo° CERTIFICATE OF LIABILITY INSURANCE DAM /13/2021 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(ies) 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 14210 Culver Dr, Suite A, Irvine CA 92604 1 CONTACT RICHARD TAY NAME: PHONE(949) 559 8866 Me N.: (949) 269 0683 ADDRESS: PRODUCERCUSTOMER ED S. 75-3018 INSURERS AFFORDING COVERAGE NAIC # INSURED BRIAN PETERSON ART DBA FACES OF MANKIND 738 N SANTIAGO ST SANTAANACA 92701-5361 INSURER A: State Farm General Insurance Company 25151 INSURER B: 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 LTR TYPE OF INSURANCE ADOLSUBR POLICY NUMBER POLICY EFF MIMIOD POLICY EXP MWDO LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FRIOCCUR E� 92-EYM1.6.81 10/30/2021 10/3012022 EACH OCCURRENCE $ 1,000,000 PREMISES _REfTr I5_ $ 50,000 MED EXP(Any one Person) $ 5,000 PERSONAL& ADV INJURY $ 1,000,000 GENERALAGGREGATE $ 2,000,000 GENT AGGREGATE x POLICY LIMIT APPLIES PER: JECTPRo- LOC PRODUCTS - COMP/OP AGO $ 1,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ❑❑ COMBINED SINGLE LIMIT (Ea amidenl) S BODILY INJURY (Per parson) $ BODILY INJURY (Per a¢ident) $ PROPERTY DAMAGE (Peraccident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE OF EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNEMEXECUTIVE OFFICERIMEMBER EXCLUDED? � fiMandatory In NN) f yes, describe under NIA ❑ WC STATU- I OTH- S ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE -POLICY LIMIT $ olo DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Addidonal Remarks Schedule, if more space 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 City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92701 lililY V CLLN 1 1 V IY Rbk MRyalml D'Mtlm SHOULD ANY OF THE ABOVE DESCRIBED I Ink RENEVIE➢&ARPRwmB'r. EXPIRATION DATE THEREOF, NOTICE WILL BE ^�ou Du1=drt POLICY PROVISIONS. � ��— Rne Mn,a9enxntOmral Pitle AUTHOR= REPRESENTATNE Iris Tay <iris.tay.mgms@statefarm.com> C'V /. /a @ 1988- 2009 ACORD CORPORATION. All rlifits reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD 1001486 132849.4 02-11-2010