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� CERTIFICATE OF LIABILITY INSURANCE A Wffrn% D6/27/20 17 006/27/2017 PRODUCER STAT SURANCE - JOHN LUITHLY 192 T Wf DR STE F IRVINE, CA 92618 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 MAIC # INSURED ELIZABETH M KILEY INC DBA KILEY COMPANY 2151 MICHELSON DR STE 205 IRVINE, CA 92612 INSURERA:State Farm General Insurance Company 25151 25151 tNSURERB:State Farm Mutual Auto Insurance Company 25178 LIMITS INSURER C: State Farm Fire and Casualty Company 25143 X INSURER D: 92 -C9 -V665-7 INSURER E: 06/01/18 COVERAGES 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 LTR ADD1POLICY INSRD T1 PE OF INSURANCE POLICY NUMBER EFFECTIVE DATE MMIDDIYY POLICY EXPIRATION DATE MM1DDf/Y LIMITS A X GENERAL LIABILITY 92 -C9 -V665-7 06/01/17 06/01/18 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTE15- PREMISES Ea occurrence $ 2,000,000 COMMERCIAL GENERAL LIABILITY CLAIMS MADE X7 OCCUR MED EXP An one person)$ _51000 PERSONAL &ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GENLAGGREGATELIMITAPPLIESPER: PRODUCTS -COMPIOPAGO $ PRO - POLICY JECT LOC B X AUTOMOBILE LIABILITY 085 9537-BOl-75J 02/01/17 08/01/17 COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO 2014 MERCEDES X ALL OWNED AUTOS SCHEDULED AUTOS WDDLJ7DB5EA100763 BODILY INJURY $ 1,000,000 (Per person) BODILY INJURY $ 1,000,000 (Per accident) X X HIRED AUTOS NONAWNEOAUTOS PROPERTY DAMAGE $ 1,000,000 (Peracddent) X X JCCMP DED - $500 LOLL DED - $500 GARAGE LIABILITY AUTO ONLY- EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO AUTO ONLY: AGG $ A X EXCEss1UMBRELLALIABILITY 75 -CD -2498-7 08/02/16 08/02/17 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ OCCUR 1:1 CLAIMS MADE $ $ DEDUCTIBLE $ RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPAJRTNER/EXECUTIVE 92 -CX -L783-0 09/01/16 09/01/17 X WC LIOTH- TORY LIMITS ER MIT E.L. EACH ACCIDENT $ 000, 000 _1-, El. DISEASE - EA EMPLOYEE $ 1,000,000 OFFICER/MEMBER EXCLUDED? Ifyes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS ! VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE AND ADDITIONAL INSURED COVERS AGREEMENT #A-2015-155, A-2011-�0�68 A-2016-285 REVIEWED BY: C °' EUNICE HEREDIA (PG I OF .M ) 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 _3,Q 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 LIABILI OF ANY KIND UPON THE INSURER, ITS AGENTS OR C/O ROSS ANNEX REPRESENTATIVES. 20 CIVIC CENTER PLZ AUTHORIZED REPRESEATI , SANTA ANA, CA 92701 JOHN LUITHLY 132849