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4 <br />ILLFOU -001 SNSH <br />4` °RO' CERTIFICATE OF LIABILITY INSURANCE <br />oA1015/2012 <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER (688) 625 -4322 <br />Bowermaster&Associates <br />P.O. Box 6026 <br />10805 Holder Street - Suite 350 <br />Cypress, CA 90630 <br />GNAW Sneddon <br />Pwc °NO Ea;714- 733 -6251 ac No: 714- 252 -8253 <br />E -MAIL <br />ADDRESS: ssneddon@bowermaster.com <br />INSURER(S) AFFORDING COVERAGE <br />NAIC# <br />INSURER A:Non rofits' Insurance Alliance of California <br />LIMITS <br />INSURED Illumination Foundation <br />2691 Ritcher Avenue <br />Suite 107 <br />Irvine, CA 92606- <br />INSURER B: <br />INSURER C: <br />INSURER D: <br />INSURER E: <br />$ 1,000,000 <br />INSURER F: <br />X COMMERCIAL GENERAL LIABILITY <br />r.()VFRAr:FS CERTIFICATE NUMBER: 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 />IN SR <br />D <br />POLICYNUMBER <br />POLICY EFF <br />MMIDDIYI•YY <br />POLICY EXP <br />MMIDDIVY <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />X <br />201224712NPO <br />911512012 <br />9/15/2013 <br />PREMISES Ea occurrence <br />$ 500,000 <br />CLAIM &MADE F7X OCCUR <br />MED EXP (Any one person) <br />$ 20,000 <br />PERSONAL& ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 3,000,000 <br />GENT AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMPIOP AGG <br />$ 3,000,000 <br />$ <br />X POLICY PRO LOG <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accitlenl <br />$ 1,000 ,000 <br />BODILY INJURY(Per person) <br />$ <br />A <br />X ANY AUTO <br />201224712NPO <br />9115/2012 <br />911512013 <br />BODILY INJURY (Per accident) <br />$ <br />ALL OWNED SCHEDULED <br />AlJT05 AUTOS <br />NON -OWNED <br />X HIRED AUTOS X AUTOS <br />TO <br />RM <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />1111PRO�ED <br />L'A <br />UMBRELLA LIAR <br />EXCESS LIAB <br />OCCUR <br />CLAIMS -MADE <br />L <br />LISA E• <br />TORCK <br />ttorn <br />Y <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DE. RETENTION $ <br />$ <br />WORKERS COMPENSATION <br />ANO EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNERIEXECIrTIVE Y� <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory In NH) <br />NIA <br />Y <br />WC STATU- OTH- <br />TORY LIMITS ER <br />E. L. EACH ACCT DENT <br />$ <br />E.L. DISEASE-EAEMPLOYE <br />$ <br />If yes, describe ,rder <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />• <br />Professional Liability <br />201224712NPO <br />911512012 <br />9115/2013 <br />Occurrence /Aggregate 1,000,000 1$3,000,00 <br />• <br />Improper Sexual Conduct <br />201224712NPO <br />911512012 <br />9/1512013 <br />Each Claim /Aggregate $250,0001$250,000 <br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, ifmore space is required) <br />RE: HPRP Contract #A- 2009 -137 Homeless Prevention and A- 2009 -137A Rapid Re- Housing <br />City of Santa Ana, their officers, officials, employees, agents and volunteers are Additional Insureds per attached #CG2026 endorsement with <br />primary wording per policy form CG00010798. <br />City of Santa Ana <br />20 Civic Center Plaza, M -25 <br />Santa Ana, CA 92701- <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 />AUTHORIZED REPRESENTATIVE <br />©1988 -2010 <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />