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'```� u CERTIFICATE OF LIABILITY INSURANCE <br />DATEIMW2D/YYYTI <br />Oi/29/2019 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED <br />ORDER THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BE THE ISSUING <br />R(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certitcate holder is an ADDITIONAL INSURED, the pollcy(iss) must he ADDITIONAL INSURED provisions be <br />Or endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies <br />licies may require an endorsement. A statement <br />on <br />this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). <br />PRODUCER <br />SCdk�?i'r3Y.fdP <br />° ER OL HASSAN <br />NAME_ _ <br />EROL HASSAN <br />PHONECN. 31054b-6579 rAC No: 310546-6821 <br />3540 HIGHLAND AVE <br />E-MAIL --'-- <br />-ADDRESS: <br />' MANHATTAN BEACH, CA 90266 <br />INSUItER(SI AFFORDING COVERAGE <br />NAIC P <br />wsuREa A: State Farm General Insurance Company <br />25151 <br />-- <br />WsuRED <br />INSURER B: State Farm Fire and Casualty Company <br />25143 <br />CUFFORD, SUSAN SAXE DR <br />INSURER C:INSURER <br />A PROFESSIONAL CORPORATION 16530 VENTURA BLVD <br />— D: <br />STE 203 <br />— <br />INSURER-E: <br />ENCINOCA 91436 <br />INSURER F: <br />COVERAGPS rcorm.nw.�... •....'..._ <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE <br />NUMBER: <br />BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT <br />OR OTHER <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE <br />DOCUMENT WITH RESPECT <br />TO WHICH THIS <br />POLICIES DESCRIBED HEREIN IS SUBJECT <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN <br />TO ALL THE TERMS, <br />REDUCFD BY PAID CLAIMS. <br />INTN DI —"' —" <br />TYPE OF INSURANCE AUSV POLICYEFF POLICY EEP <br />POUCYNV UER MM1DDlYYYY MWID W <br />UNITS <br />COMMERCIAL GENERAL LIABILITY <br />LAIMS-MADE OCCUR <br />'bhCH—MADETSRENYEE <br />$ 1,000,000 <br />PREMISES Eeo <br />3 300,000 <br />--- Y N <br />MEDEXP(ALr enan) <br />s 5,000 <br />92-92-2679-2 04/i B/2018 04/18/2019 <br />JGN'LAGGREGATE <br />PERSONAL B ADV INJURY <br />S <br />UMIT"(PLIE""��S PER:GENERAL <br />JEC <br />LOCR: <br />AGGREGATEY <br />LI <br />PRODUCTS-COMP/OPAGG <br />S 2,000,000 <br />BILE LABILITY <br />COMR NED BINDLE LI 1 <br />ANY AUTO <br />1'eemlaenq <br />t <br />BODILY INJURY (Per Person) <br />8 <br />OVMEO SCHEDULED <br />AUTOS ONLV AUTOS <br />HIRED NON-ONNED <br />BDUUYINJURY(Peramia.n,) <br />t <br />AUTOS ONLY AUTOS ONLY <br />p �aween-AGE <br />--'— <br />S <br />UMBRELLA LAB <br />OCCUR <br />EYCESSUAB <br />CIAIMS.4IAOE <br />EACHOCCIIRRENCE <br />C <br />AGGREGATE <br />3 <br />TIED i RETENTIONS <br />—' <br />COMPS A <br />3 <br />B <br />AND EMPS LIABILITY <br />ILIT <br />AND EMPLOVERS'LIABIUTY YIN <br />ANY PROPRIETORIPARTNER:EAECUTIVE <br />STATUTE ERtI <br />E.L. EACH ACCIDENT <br />-- <br />s 1,000,000 <br />OFFICERAIEMSEREXCWDE09 Y <br />NIA <br />N � <br />92-LH-2103-0 <br />07/01/2018 <br />07/01/2019 <br />IhlYeetltlIPTIO opal <br />E.L. CISEASE-EA EMPLOYE <br />g T,OOQOOD <br />OhSCRiPTiON OF OPERATIONS bHav <br />EA- DISEASE - POLICY UMIT <br />i <br />i 1,000,000 <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD tut, AtlGNanel Remarks Schedule, may be aaacbe0lf mom sW ce Is requirotl7 <br />PsycOlogieal Services <br />CERTIFICATE HOLDER .....__.. "_._._ <br />CITY OF SANTA ANA <br />60 CIVIC CENTER PLAZA <br />SANTA ANA. CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS, <br />WZEDMREPRRE,SENTATIVE <br />—,,. wname aria Togo are registered marks Of ACORD <br />All rights <br />1W1486 132849.12 P&10-2016 <br />/,v'PG%er✓�c /�Otic� frF�TS �EQ S D� �,QF�/'�.i� <br />�r��. S'D,c'�.t�so�✓ <br />