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AC� CERTIFICATE OF LIABILITY INSURANCE DATE YY) 08/06/2015 PRODUCER STATE FARM INSURANCE - JOHN LUITHLY 16277 LAGUNA CANYON RD STE F IRVINE, CA 92618-4011 w...a THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED ELIZABETH M KILEY INC DBA KILEY COMPANY 2151 MICHELSON DR STE 205 IRVINE, CA 92612 INSURERA:State Farm General Insurance Company 25151 25151 INSURERB:State Farm Mutual Auto Insurance Company 25178 20 CIVIC CENTER PLZ INSURERC:State Farm Fire and Casualty Company 25143 INSRD INSURER D: POLICY NUMBER INSURER E: DATE (MM/DDIYY) GUVtKAIJt5 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L ITS OFFICERS, EMPLOYEES & AGENTS IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR POLICY EFFECTIVE POLICY EXPIRATION 20 CIVIC CENTER PLZ LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DDIYY) LIMITS A X GENERAL LIABILITY 92—C9—V665-7 06/01/15 06/01/16 EACH OCCURRENCE $ 2, 000, 000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 2 r000, 000 MED EXP (Any one person $ 5, 000 CLAIMS MADE E] OCCUR PERSONAL &ADV INJURY $ 2, 000, 000 GENERAL AGGREGATE $ 4, 000, 000 GENIAGGREGATE LIMITAPPLIES PER: PRODUCTS-COMP/OPAGG $ PRO - POLICY JECT LOC B X AUTOMOBILE LIABILITY ANY AUTO 085 9537—BO1-75J 2014 MERCEDES 02/01/16 08/01/16 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY $ 1, 000, 000 (Per person) X ALL OWNED AUTOS SCHEDULED AUTOS WDDLJ7DB5EA100763 BODILY INJURY $ 1,000,000 (Per accident) X X HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ 1,000, 000 (Per accident) X X COMP DED — $500 COLL DED — $500 GARAGE LIABILITY AUTO ONLY—EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO AUTO ONLY: AGG $ A X EXCESS/UMBRELLA LIABILITY 75—CD-2498-7 08/02/15 08/02/16 EACH OCCURRENCE $ 5, 000, 000 AGGREGATE $ OCCUR F—I CLAIMS MADE $ DEDUCTIBLE $ RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 92—CX—J657-2 09/01/15 09/01/16 X NISTATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1, 0 0 0, 0 0 0 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L DISEASE - EA EMPLOYEE $ 1, 000, 000 E.L. DISEASE - POLICY LIMIT $ 1 , 0 0 0 , 0 0 0 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS A-2011-068 A-2015-155 P__ HY: REVIEWED i �� .�� E�I��P� CGS E REVIEk-IEf---E [SNA QC, p OF ) CERTIFICATE HOLDER CANCELLATION ADDITIONAL INSURED: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN CITY OF SANTA ANA NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL ITS OFFICERS, EMPLOYEES & AGENTS IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR C/O ROSS ANNEX REPRESENTATIVES. 20 CIVIC CENTER PLZ AUTHORIZED REPRESENTATIVE SANTA ANA, CA 92701-4058 JOHN LUITHLY At,umu LJ (LUV Iwo) i Ile regisirauon notices inaicaie ownersnlp or me marKs Dy inelr respective owners US AGUKU GUKYUKA I IUN 19138, ZUU7 132849 03-13-2007 All rights reserved