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Digitally signed by Francine R. <br />Francine R. Villareal Villareal <br />A� �® CERTIFICATE OF LIABILITY INSURANCE <br />DATE jMWDDNYYY) <br />2 <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(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms 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 endorsement(s). <br />PRODUCER <br />Bowermaster & Associates <br />Holder St <br />CONTACT <br />NAME: LlZette OrOZCD <br />PHO10805 <br />MC, Ne an- 714-733-6248 AIC No: <br />Ste 350 <br />ADDRESS: lorozco bowermaster.com <br />Cypress CA90630 <br />INSURERS AFFORDING COVERAGE <br />NAICN <br />INSURERA: Philadelphia Indemnity Insurance <br />18058 <br />_ <br />INSURED ILLUFOU-01 <br />Illumination Foundation <br />1091 N. Batavia Street <br />INSURERS: Redwood Fire &Casualty Insurance <br />11673 <br />INSURERC: Nonprofits' Insurance Alliance of California <br />11384 <br />1 INSURER D: <br />Orange CA 92867 <br />INSURER E <br />NSURER F: <br />COVERAGES CERTIFICATE NUMBER: 1394503630 REVISION NUMBER - <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN 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 SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDLSUSR <br />POLICY NUMBER <br />POLICY EFF <br />MMIDD <br />POLICY EXP <br />MM/D <br />LIMITS <br />C <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />2021-24712 <br />9/15/2021 <br />9/15/2022 <br />EACH OCCURRENCE <br />$1,000,000 <br />CLAIMS -MADE I -XI OCCUR <br />DAMAGE ToRENTED <br />PREMISES Eaeceunence <br />$500,000 <br />X <br />MED EXP (Any one person) <br />$ 20,000 <br />Prof Liability <br />PERSONAL &ADV INJURY <br />$1,000,000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$3.000,000 <br />X <br />POLICY PRO- <br />JECT ❑ LOC <br />PRODUCTS - COMPIOP AGG <br />$3.000,000 <br />$ <br />OTHER: <br />C <br />AUTOMOBILE <br />LIABILITY <br />2021-24712 <br />9/15/2021 <br />9/15/2022 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$1,000,000 <br />ANY AUTO <br />BODILY INJURY (Per person) <br />S <br />IX <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY accident) <br />$ <br />X <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />Per actldent <br />$ <br />C <br />X <br />UMBRELLA LIAR <br />X <br />OCCUR <br />2021-24712-UMB <br />9/15/2021 <br />9/15/2022 <br />EACH OCCURRENCE <br />$7,000.000 <br />AGGREGATE <br />$7,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I I RETENTION$ <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANYPROPRIETOR/PARTNERIEXECUTIVE <br />OFFICER/MEM BER EXCLUDED? <br />NIA <br />ILWC209336 <br />1/1/2021 <br />1/1/2022 <br />X STATUTE ERH <br />E.L. EACH ACCIDENT <br />IS11000,000 <br />E.L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />(Mandatary, In NH) <br />If yes, deserts under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />A <br />C <br />Commercial Cyber Liability <br />Improper Sexual Conduct. <br />PHSD1575498 <br />2021-24712 <br />9/15/2021 <br />9/15/2021 <br />9/15/2022 <br />9/15/2022 <br />Agg:$3,000,WWEach <br />Ag9:$1.000,000/Each <br />$1,000,000 <br />$1,000.000 <br />DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Re Location: 1815 Carnegie Avenue, Santa Ana, CA 92705 <br />Certificate Holder is Additional Insured as respects to General Liability per attached endorsement form. Coverage applies on a Primary basis per attached <br />endorsement form. <br />Excess/Umbrella coverage is follow form over the primary General Liability. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br />Risk Management Division <br />20 Civic Center Plaza AUTHORgED REPRESENTATIVE <br />Santa Ana CA 92701 �- <br />o Risk MeagemenEDivision <br />REve&ED & APpRovEDBY: <br />©1988-2015 ACORD C F4,NrdN.[ R. VjJAWAt <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD' Risk Management analyst <br />THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE <br />