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YSI9oedbFFnntloeP <br />2nCInE . Vt dI� Me:20 <br />ort:xoxl.at.zotiea:agoaao <br />4`� CERTIFICATE OF LIABILITY INSURANCE <br />DATE <br />11/202YYY <br />1/11/2021 <br />THIS CERTIFICATE IS 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 ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endomement(s). <br />PRODUCER <br />Bowermaster & Associates <br />10805 Holder St <br />Ste 350 <br />Cypress CA 90630 <br />NAME T Liz Orozco <br />PHONE FAX <br />M. No. Eau. 714-733-6248 ac No): <br />EXFDp4ss: lorozco bowennaster.com <br />INSURER(SI AFFORDING COVERAGE <br />NAICS <br />INSURER.: Philadel hfa Indemni Insurance <br />INSURERS: Redwood Fire & Casual Insurance <br />18058 <br />11673 <br />INSURED ILLUFOU-01 <br />n <br />Illumination Foundation <br />INSURER C: Non roots' Insurance Alliance of California <br />LifeArk Community and LifeArk El Monte LLC <br />1091 N. Batavia Street <br />Orange CA 92867 <br />INSURERD: <br />INSURER E: <br />NSURER F: <br />— -----^• •" KMVI*IUIN NUMtlt:R: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED <br />ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED <br />WITH RESPECT TO WHICH THIS <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />HEREIN IS SUBJECT TO ALL THE TERMS, <br />ILTR TYPEOFINSURANCE AODL SUB POUCYNUMBER IAMIDO EFF PNIJDDYE%P <br />LIMITS <br />C X COMMERCUILGENERALLIABILITY Y 2020-24712 9/15202D 9/152021 <br />CLAIMS -MADE OCCUR <br />EACH OCCURRENCE $1,000,000 <br />X <br />PREMISES Ea oarr venr» $500,000 <br />Prd UabiRv <br />NED EXP(Anyane person) $20,000 <br />PERSONAL&ADVINJURY $1.000,000 <br />GENL AGGREGATE LIMIT APPLIES PER <br />X POLICY PRO -CT ❑ <br />JELOC <br />GENERALAGGREGATE $3,OOD,OoO <br />PRODUCTS-COMP/OP AGO $3.000,000 <br />OTHER: <br />E <br />C <br />AUTOMOBILELIABILITY <br />2020-24712 <br />9/152020 <br />9/15/2021 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$1.000,000 <br />X <br />ANY AUTO <br />BODILY INJURY (Par Person) <br />$ <br />OWNED SCHEDULED <br />AUTOS ONLYMAUTOS <br />BOOTEE INJURY (Per accident) <br />$ <br />X <br />AUTOS OHIRED NLY AUTOS ONLY <br />Parr sWid,mtl GE <br />E <br />C <br />X <br />UMBRELLA UAB <br />X <br />OCCUR <br />202-24712-UMB <br />9/152020 <br />9/152021 <br />EACH OCCURRENCE <br />$7.000,000 <br />EXCESS UAR <br />CLAIMS -MADE <br />AGGREGATE <br />$7,000,000 <br />OED RETENTIONS <br />S <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ILWCI0TBB7 <br />1/12021 <br />1112022 <br />X PER OTH- <br />$ <br />ANYPROPRIETOWPARTNERI ECUTIVE YIN <br />OFFICER MBEREXCWDED9 ❑ <br />NIA <br />STATUTE ER <br />EL. EACH ACCIDENT <br />$1,000,000 <br />IMandatory in NH) <br />Iryou, descdbeurgar <br />E.L. DISEASE - EA EMPLOYEE <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS be. <br />E1. DISEASE - POLICY LIMIT <br />$1.000,000 <br />A <br />C <br />Commercial Sl Cal Conduct <br />Improper Sexual Canducl <br />PHSDI575498 <br />9/152020 <br />9/15/2021 <br />Agg:$3,000,000/Each <br />$1,000.000 <br />2020-24712 <br />9/152020 <br />W15/2021 <br />A99: E1,000,0G0/Eatlt <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Addltloned Remarks Schedule, may be altachad N more apace le required) <br />City of Santa Ana, it's officers, employees, agents, and volunteers are Additional Insured With respects to General <br />Liability per attached endorsement form; <br />Primary and Non -Contributory wording applies per attached endorsement form. <br />30-day notice of cancellation is provided per policy provisions. <br />r CIDTIelrarc unr nv. <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th Fir <br />Santa Ana CA 92702 <br />USA <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 />01988.2015 ACORD <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />RENEWED&APFROVEDBy: <br />Fufr ; e R, (!:,(.,Aa <br />Risk Management Analyst <br />