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Entry Properties
Last modified
8/1/2018 1:01:45 PM
Creation date
8/1/2018 12:08:46 PM
Metadata
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Contracts
Company Name
ILLUMINATION FOUNDATION
Contract #
A-2018-133-02
Agency
COMMUNITY DEVELOPMENT
Council Approval Date
5/15/2018
Expiration Date
6/30/2019
Insurance Exp Date
9/15/2018
Destruction Year
2024
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CERTIFICATE OF LIABILITY INSURANCE <br />DATR(MM/pDIYYYY) <br />1/2/2018 <br />THIS CERTIFICATE 19 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTCR THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(% AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CCRTIPICATE HOLDER, <br />IMPORTANT; If the certificate holder Is an ADDITIONAL INSURED, the polloy(Inti must have ADDITIONAL. INSURED provisions or be endorsed, <br />If SUBROGATION IS WAIVED, subject to the terms and Conditions of the Palley, certain policies may require an endorsement. A statement on <br />this certificate does not Confer rl hts to the CartlflCate heldar In Ilea Of such undo mementls . <br />PRODUCER <br />EXPLICXTY INSURANCE SERVICES <br />9851 Irvine Center Drive <br />N� 1A cl'(949) 7765353 <br />CARE <br />Irvine, CA 92618 <br />---- <br />IN$UAUA�FFORDING COVanAOa NAZCA <br />INSURERA: State CCny"Eatti On 7.n8L1.ranco 5'Und <br />INSURED <br />INSURER E :.Mmm• ,... <br />INSURER C: <br />THE ILLUMINATION )FOUNDATION <br />2691 Richter Ave., SLtite 107 <br />Irvine, CA 92606 <br />INSURER D: <br />INSURER E: W <br />INSURER : <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER; <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LI9TEO BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE. MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SVBJEOT TO ALL. THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SOON POLICIES, LIMIT$ SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />NIS.rnR <br />TYPE OF INSURANGEI <br />s <br />POLICY NUMBER <br />D Yri <br />M Y <br />LIMITS _.._ <br />CON MaIMAL OUNCRA4 UARLITY <br />CLAIMS -MADE 0 OCCURT_ <br />EACH OCCURRENCE <br />$ <br />MIS 8 me <br />�,~�._................ <br />$ <br />PERSONAL&ADVINJURY <br />$ <br />OCNIT AGGREGATE LIMIT AIPPI'P''L19j6 PER: <br />POLICY l.._..I rcc r L.J LOC <br />DINER: <br />GENERAL AGGREGATE <br />$ <br />PRODUCTS - COMPIOP AGO <br />$ <br />$ <br />AUTOM0011,E <br />LIASIIJTY <br />ANYAUTO <br />ApWNEDBDWEDULED <br />AUT08PNLY AUTOS <br />HIRED M NON.OWNFD <br />AUTCS ONLY AUTQS ONLY <br />COMBINED SINGLE LIMIT$ <br />Ea ar,�ltlentl <br />BODILY INJURY (Pet person) <br />_ <br />$ <br />DODILYINJURy(Peracddeni) <br />$ <br />per acal an m.W <br />$ <br />$ <br />UMBRELLA LIAR <br />EXCE88 LAS <br />OCCUR <br />CLAIMS•MA05 <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DEP I RETENTION$ <br />A <br />ORKVRS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY I'ROpnIaTORIPAnTNava%eouTive /I <br />OFEIaeNMEM9EFl aXCWDC-n7 47 <br />IMendmorYinNNI <br />I(yyetlaeadba Ondel <br />DES8 CRIPTION OF OPERATIONS bCIOW <br />NIA <br />9040950-2018 <br />1/1/18 <br />1/1/19 <br />%C TATUTE ER m,,, <br />E.L. EACH ACCIDENT <br />$ 110001000 <br />E. L. D19FASE - EA FNIPLOY(S <br />1,000,090 <br />S.L. DISEASE -POLICY LIMIT <br />$ 1,000,--, � 00 <br />�,,,,,Q <br />DESCRIPTION OF OPERATION81 LOCATIONS IVEHICLCS (ACORD 109, Addlllonal Remarks 80hedule, may be gnashed If more apace in squired) ...µ.. \ �. <br />LnGlprp®mentsa 30 days written cancel notice (10 days for non payment of premium), /1n <br />CITY OF SANTA ANA <br />20 Civic Center Plaza, <br />Santa Ana, CA 92701 <br />6th Flr,, <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 />ACORD26(204103) The ACORD name end logo are registered marks of ACORD <br />
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