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Francine R. Digitally signed by Frzntlne R. Villareal Villareal Date: 2021.11.1816:0434-01TOO ACC>Ro CERTIFICATE OF LIABILITY INSURANCE DATE IMr DNYYY) 11/09/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: IT the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. B SUBROGATION IS WANED, subject to the terms and conditions Of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of auch andomemar a), PRODUCE0. NAME: TIM FRANZ $fatefdRll TIM FRANZ- AGENT WCNE -559-251-3777 FAx e59. No : 5251-0653 = SUITE A ADORE , TIM.FF NZ.B9HMCSTATEFARM.COM 5534 E KINGS CANYON RD NSURE S AFFORDING COVERAGE twcs FRESNO CA 93727 INSURER t State Farm General Insurance Company 25151 INSURED INSURER B: State Farm Mutual Automobile Insurance Company 25178 INSURER C : HALCYON BEHAVIORAL LLC INSURER D: 1080 W SHAW AVE STE 105 INSURER E: FRESNO CA 93711 INSURER F: COVERAGES CERTIFICATE NUNRERe DFVISION NUMRFR. THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR TYPE OF INSURANCE IADDLSUBR POLICY NUMBER POIJCYEFF fMwDDNYYY1 POLICYEXP IMMIDONY170Ulna q CONMERCIALOENERAL LIABILITY CLAMS -MADE © OCCUR Y Y 9D-C3-N18S-SG 12/09/2020 12/09/2022 EACHOCCURRENCE S 2,000.000 PREMISESIEs S 300,000 MED EXP(My are pae0n $ 6,000 I PERSONAL RAW INJURY S GENT AGGREGATE LIMIT APPLIES PER: POLICY JET LOC OTHER GENERALAOGREOATE $ 4,000.000 PRODUCTS-COAPIOPAGG S 4,000.000 S B AUTOIgBa LIABILITY ANY AUTO OWNED � M OS ONLY "CH ALT HIRED NONOWNED AUTOS ONLY AUTOS ONLY Y 4621262-C74-55 09/14/2021 09114/2022 Ea de s 2,000,000 BODILY INJURY (Par pawn) $ BODILYINJURY(Pereetldmt) S PROPERTYCAMAGE emhlent s S UMBRELLALMB EXCESS LIAR OCCUR CIAIMSMADE EACHOCCURRENCE $ AGGREGATE $ DED 1 1 RETENTIONS $ A WORKERS COMPENSATION AND ENPLOYERS' WBIIJTY 0Y�GyM� TMD�ECU� Y (Mwdatery In NH) n yyes, deacriDe uMer DMMd TON OF OPERATIONS bete. NIA Y 90-EO-M970-5 09/1712021 09,17,2022 I P R OTH- STATU E ER E.L EACH ACCIDENT $ 1.000,ODO E.L DISEASE. EA EMPLOYE $ 1,000,000 E.L DISEASE -POLICY LIMIT $ 1,000,000 T- DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 401, AdGItbnH Remark* 6cfadda, may Oa at wN mera war la r"untd) Please see attached endorsements CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana AU 10112Fn REPRESENTATIVE Risk Management Division 20 Civic Center Plaza (M-30) Completed by an aut to Farm tative. B signature Sara Ana CA 92702 Is required, please a State F O 1988.2015 ACORD C ACORD 25 (2016103) The ACORD name and logo arc registered marks of ACORD a RWeMMagl»umiDiviskin oI %..E^M� CCREVIEWED6'PR VED Bv/: R. AP aE7L 1 T Risk Management Analyst