Laserfiche WebLink
Francine R. Digitally signed by Francine <br />R. Villareal <br />i� II; ) Date: 202101.27 17 24A8 <br />'�� o® CERTIFICATE OF LIABILITY INSURANCE 'area <br />°Av a s/zozz <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 />10805 Holder St <br />CONTACT <br />NAME: Lizette Orozco <br />PHONE 714-733-6248 FAX <br />No: <br />E-MAIL <br />ADoaess, lorozco@bowermaster.com <br />Ste 350 <br />Cypress CA 90630 <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURER A: Philadelphia Indemnity Insurance <br />18058 <br />INSURED ILLUFOU-01 <br />The Illumination Foundation <br />1091 N. Batavia Street <br />INSURER B: Nonprofits' Insurance Alliance of California <br />11384 <br />INSURER C: Cypress Ins Co <br />10855 <br />INSURER D <br />Orange CA 92867 <br />INSURER E <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 1919030540 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 <br />ADDLSUBR <br />POLICYNUMBER <br />POLICY EFF <br />tMMIDDNYYYI <br />POLICY EXP <br />(MMIDDIYYYY <br />LIMITS <br />B <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CL41MS-MADE FxIOCCUR <br />y <br />2021-24712 <br />9/15/2021 <br />9/15/2022 <br />EACH OCCURRENCE <br />$1,000,000 <br />U RENTED <br />Ea cccurmnce <br />$500,000 <br />X <br />Any one person) <br />$ 20,000 <br />Prof Liability <br />L&AOV INJURY <br />$1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />X POLICY jEa LOG <br />AGGREGATE <br />ro <br />$3,000,000 <br />S-COMP/OP AGG <br />$3,000,000 <br />$ <br />OTHER: <br />B <br />AUTOMOBILE <br />LIABILITY <br />2021-24712 <br />9/15/2021 <br />9/15/2022 <br />SINGLELIMIT <br />t <br />$1,000,000 <br />X <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY Per accident <br />$ <br />X <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />B <br />X <br />UMBRELLA LIAB <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 />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY YIN <br />ILWC310553 <br />1/1/2022 <br />1/1/2023 <br />X I PER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$1.000,000 <br />ANYPROPRIETOWPARTNERIEXECUTIVE ❑ <br />OFFICERIMEMBEREXCLUDED9 <br />NIA <br />E.L. DISEASE - EA EMPLOYEE <br />$1.000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE LIMIT <br />$1.000,000 <br />A <br />B <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 />A9g:$3,00g0001Each <br />A99:$1,000,OOMS& <br />$1,000,000 <br />$1.000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if mare space is required) <br />RE: HPRP Contract#A-2021-046, A-2021-228 <br />City of Santa Ana, their officers, employees, agents, volunteers and representatives are Additional Insured with respects to General Liability per attached form; <br />Primary and Non -Contributory wording applies per attached form. <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 <br />Santa Ana CA 92701 AUTHOR EDREPRESENTATRE <br />USA <br />rs RIA M-29-a EDilision <br />4 REVIEWTD& APPROVED BY: <br />©1988-2015 ACORD C FµWZ" P, VtlL1W1 <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Risk Management Anaryel <br />THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE <br />