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KILEY' COMPANY A-2011-068 & A-2014-034 REVIEWED BY: /,,,"L,, EUNICE HEREDIA (PG 'I of 3) <br />►CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDNYYY) 03/10/2025 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION <br />STATE FARM INSURANCE - JOHN LUITHLY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />16277 LAGUNA CANYON RD STE F HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />IRVINE, CA 92618-4011. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />i <br />INSURERS AFFORDING COVERAGE MAIC # <br />INSURED INSURER& state Farm General. Insurance Company 25151 25151 <br />ELIZABETH M KILEY INC _INSURERB: State Farm Mutual Auto insurance Company 25178 <br />DBA KILEY COMPANY INSURERC: State Farm Fire and Casualty Company 25143 <br />2681 DOW AVE STE E INSURER D: <br />TUSTIN, CA, 92780-7244 INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />fAFUL <br />- .. FFE , CTYIV <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />TR <br />LTR <br />INSRDI <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />DATE <br />DATE (Ml <br />LIMITS <br />A <br />X <br />GENERAL LIABILITY <br />92-YG-5250-7 G <br />08/25/14 <br />08/25/15 <br />EACH OCCURRENCE <br />$ 2, 000, 000 <br />COMMERCIAL GENERAL LIABILITY <br />DAMAGE TO RENTED <br />-PREMISES Ea occurrence) <br />$ 2, 000, 000 <br />MED EXP An one person <br />$ 5,000 <br />7 CLAIMS MADE E]OCCUR <br />PERSONAL & ADV INJURY <br />$ 2, 000, 000 <br />• BLDG COV- $50,400 <br />• CONT COV- $56,800 <br />GENERAL AGGREGATE <br />$ 4, 000, 000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMPiOP AGO <br />$ <br />PRO - <br />7 FTECT <br />POLICY [] LOC <br />B <br />X <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />085 9537 -B01 -75J <br />2014 MERCEDES <br />02/01/15 <br />08/01/15 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />BODILY INJURY <br />(Per person) <br />$ 1, 000, 000 <br />X <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />WDDLJ7DB5EA100763 <br />BODILY INJURY <br />(Per accident) <br />$ 1, 000, 000 <br />X <br />X <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE <br />(Per accident) <br />$ 1f000,000 <br />I <br />X <br />IXICOLL <br />COMP DED $500 <br />DED $500 <br />GARAGE LIABILITY <br />AUTO ONLY- EA ACCIDENT <br />OTHER THAN EA ACC <br />$ <br />ANY AUTO <br />AUTO ONLY: <br />AGG <br />$ <br />A <br />X <br />EXCESS/UMBRELLA LIABILITY <br />75 -CD -2498-7 G <br />08/02/14 <br />08/02/15 <br />EACH OCCURRENCE <br />$ 5, 000, 000 <br />AGGREGATE <br />$ <br />OCCUR = CLAIMS MADE <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />C WORKERS COMPENSATION AND 92 -CG -A404-7 F 09/01/14 09/01/15 X WC STATU- OTH- <br />EMPLOYERS' LIABILITY - TORY LIMITS FIR <br />ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1, 000, 000 <br />OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1, 000, 000 <br />If yes, describe under <br />SPECIAL PROVISIONS below E.L.DISEASE -POLICY LIMIT $ 1, 000, 000 <br />OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS <br />A-2011-068 <br />A-2014-034 <br />CER I IFIGA I L HOLULK CANCELLATION <br />ADDITIONAL INSURED: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br />CITY OF SANTA ANA NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />ITS OFFICERS, EMPLOYEES & AGENTS IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />C/O ROSS ANNEX REPRESENTATIVES. <br />20 CIVIC CENTER PLY AUTHORIZED REPRESENTATIVE <br />SANTA ANA, CA 92701-4058 JOHN LUITHLY <br />AUUKU Z3 (ZUU_I1U?5) I ne registration notices inaicate ownersnip Of ine rnarKS Dy tneir respective owners <br />132849 03-13-2007 <br />