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CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/WYY) INSRD X 05/16/2018 PRODUCER STATE FARM INSURANCE - JOHN LUITHLY 192 TECHNOLOGY 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. POLICY EXPIRATION DATE MM/DD/YY 06/01/2018 LIMITS EACH OCCURRENCE $ 2,000,000 DAMAG O REN ED PREMISES Ea occurrence $ 2, 000, 000 MED EXP (Any oneperson) $ 5, 000 20 CIVIC CENTER PLZ INSURED INSURERS AFFORDING COVERAGE INSURERA: State Farm General Insurance Company 25151 NAIC # 25151 INSURERB:State Farm Mutual Auto Insurance Company 25178 ELIZABETH M KILEY INC DBA KILEY COMPANY 2151 MICHELSON DR STE 205 IRVINE, CA 92612 INSURER C: State Farm Fire and Casualty Company 25143 INSURER D: INSURER E: GENERAL AGGREGATE $ 4, 000,000 C(]VFRAC;FC 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 ADDT LTR A INSRD X TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY POLICY NUMBER 92—C9—V665-7 POLICY EFFECTIVE DATE MM/DD/YY 06/01/2017 POLICY EXPIRATION DATE MM/DD/YY 06/01/2018 LIMITS EACH OCCURRENCE $ 2,000,000 DAMAG O REN ED PREMISES Ea occurrence $ 2, 000, 000 MED EXP (Any oneperson) $ 5, 000 20 CIVIC CENTER PLZ AUTHORIZED REPRESENTATIVE j CLAIMS MADE OCCUR JOHN LUITHLY / k_1L PERSONAL BADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4, 000,000 GEN'L AGGREGATE LPAfiAPPUES PER PRODUCTS-COMP/OPAGG $ 4,000,000 PRO- 0j POLICY JECT LOC X AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS 541 1232-BOl-75F 2018 BMW 540I WBAJE5C52JWA92981 02/01/2018 08/01/2018 COMBINED SINGLE LIMIT (Ea accident) $ $1,000,000 BODILY INJURY (Per person) $ X X HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ X COMP DED - $500 PROPERTY DAMAGE (Per accident) $ X COLL DED - $500 GARAGE LIABILITY AUTO ONLY — EA ACCIDENT $ OTHER THAN FA ACC $ ANY AUTO AUTO ONLY: A X EXCESS/UMBRELLALIABILITY 75—CD-2498-7 08/02/17 08/02/18 AGG $ EACH OCCURRENCE $ 3,000,000 OCCUR EICLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 92—EU—X230-7 09/01/17 09/01/18 X WCSTATU- OTH- TORY LIMITSI ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE AND ADDITIONAL INSURED COVERS AGREEMENT #A-2015-155 AND A201 -285 REVIEWED BY: EUNICE HEREDIA (PG 10F ) ('COTIMI!'ATC UnI r1C0 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 0 THE LEFT, BUT FAILURE TO DO SO SHALL ITS OFFICERS, EMPLOYEES & AGENTSe IMPOSE NO OBLIGATION OR LIABILITY OF AN KIND UPTINSURER, ITS AGENTS OR C/O ROSS ANNEX REPRESENTATIVES. [N 20 CIVIC CENTER PLZ AUTHORIZED REPRESENTATIVE j SANTA ANA, CA 92701 JOHN LUITHLY / k_1L _...._...,.r „.. .. ., ......� .,� .,w' -P-- PNv _x-1 M1.lVRIJ'l`i rV RA1IVIV 7`utsts, ZUU/ 132849 03-13-2007 All rights reserved