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DigUally signed by Francine 2 Francine R. Villareal villareal CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 10/412021 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: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, 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 such endorsement(s). PRODUCER Bowermaster & Associates 10805 Holder St Ste 350 Cypress CA 90630 INSURED Illumination Foundation 1091 N. Batavia Street Orange CA 92867 COVERAGES CERTIFICATE NUMBER: 1394503630 REVISION NUMBER: 18058 11673 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. INSR LTR TYPE OF ADDLSUBR POLICYNUMBER POLICY EFF MWDO POLICY EXP MMI DfYYYYI LIMITS C X COMMERCIAL GENERAL LIABILITY CLAIMSMADE .' OCCUR V 2021-24712 9/15/2021 9/15/2022 EACH OCCURRENCE $1,000,000 DAMAGE TORENTE nence PREMISES Ea accu $500,000 X MED EXP (Any one person) $ 20,000 Prof Liability PERSONAL &ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER RI - POLICY ❑ JECT PRO LOG GENERALAGGREGATE $3.000,000 GEN'L X PRODUCTS-COMPIOP AGO $3,000,000 IS OTHER: C AUTOMOBILE LIABILITY 2021-24712 9/15/2021 9/15/2022 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS Per accdent ) BODILY INJURY i $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident) $ O X UMBRELLA LIAB X OCCUR 2021-24712-UMB 9/15/2021 9/15/2022 EACH OCCURRENCE $7,000,000 AGGREGATE $7.000.000 EXCESS LIAB CLAIMS -MADE DEO I I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBEREXCLUDED? N/A ILWC209336 1/1/2021 1/1/2022 X : PER OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000.000 (Mandatory in NH) If yes, descrbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000.000 A C Commercial Other Liability Improper Sexual Conduct PHSD1575498 2021-24712 9/15/2021 9/15/2021 9/15/2022 9115/2022 Agg:$3,000,0001Each Ag9:$1,000,0001Each $1,000,000 $1.000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required( Re Location: 1815 Carnegie Avenue, Santa Ana, CA 92705 Certificate Holder is Additional Insured as respects to General Liability per attached endorsement form. Coverage applies on a Primary basis per attached endorsement form. Excess/Umbrella coverage is follow form over the primary General Liability. City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE Fot�'.o wlt mosgaRMRt utMeum cRENEWED&APPROV®BY: Risk Management Analyst