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<br />CERTIFICATE OF LIABILITY INSURANCE DATa1MMID`1014 )
<br />1z/29rzo1a
<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 be endorsed. If SUBROGATION I5 WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this cenlPoceto does not confer rights to the
<br />certificate holder In lieu of such endorsement(s).
<br />PRODUCER (888) 825 -4322
<br />Bowermaster &Associates
<br />P.O. Box 6026
<br />10605 Holder Strout -Stilts 360
<br />Cypress, CA 90630
<br />Npp,7EACT
<br />N�
<br />Andrea Thurmond
<br />FIO
<br />o 1;714. 733.6208 Aic Ne: 714. 252.8253
<br />E-MAIL
<br />ADDRESS:
<br />athurmond EAboWermaster,com,
<br />-,_
<br />INSURERS AFFORDING COVE RAGE
<br />NAIC#
<br />INSURERA:Nonprofits' Insurance Alliance of California
<br />GENERAL LIABILITY
<br />INSURED Illumination Foundation
<br />2691 Ritcher Avenue
<br />Su [to 107
<br />Irvine, CA 92606-
<br />INSURERS:Wost American Insurance
<br />_
<br />44393
<br />INSURERC:State Compensation Insurance Fund
<br />INSURERD:
<br />EACH OCCURRENCE
<br />INSURER E:
<br />A
<br />INSURERF:
<br />X
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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 />_ _
<br />9R
<br />TYPE OF INSURANCE
<br />Santa Ana, CA 92701 -
<br />POLICYNUMBER
<br />MM /�OYEFF
<br />POD C
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ff] OCCUR
<br />X
<br />201424712NPO
<br />911512D14
<br />9/512015
<br />ppEMlses Eao
<br />5 500,000
<br />MED RAP (Any ono person)
<br />$ 20,000
<br />PERSONAL A ADV INJURY
<br />$ 1,000,000
<br />_
<br />GENERAL AGGREGATE
<br />$ 3,000,000
<br />GEWL AGGREGATE
<br />LIMIT APPLIES PER:
<br />PRODUCTS •CCMP /OP AGG
<br />$ 3,000,000
<br />X POLICY
<br />PR0. LOC
<br />_
<br />$
<br />AUTOMOBILE
<br />LIABILITY
<br />N CgMBIN ❑ EL T
<br />Ea ecddaent
<br />.g_ 'I,000,OD0
<br />B
<br />X
<br />ANYAIITO
<br />BAWS6316571
<br />911512014
<br />9/1512015
<br />BODILY INJURY (Par Parson)
<br />S
<br />ALLOWNED SCHEDULED
<br />AUTOS AUT'Oa
<br />aODILY INJURY Par acddgnl
<br />{' )
<br />X
<br />AIRED AUTOS X NON-OWNED
<br />AUTOS
<br />PROPERTY DAMAGE
<br />Per eaddent
<br />$
<br />$
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />DED RETENTION S
<br />$
<br />C
<br />AND EMPLOYERV LIABILITY
<br />WORKERS COMPENSATION RT
<br />ANY PROPAIETORIPANEREXECUOVE YIN
<br />OFFICERIMEMIER EXCLUDED?
<br />(Mandatory In NHj
<br />OEeORIPTIION pf OPERATIONS bOUW
<br />NIA
<br />90409502015
<br />11112015
<br />1/1/2016
<br />WCSTATU OTR -��
<br />T
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE• EA EMPLOYE
<br />6 1,000,000
<br />11, OISEASC, POLICY LIMIT
<br />S 1,000,000
<br />•
<br />Professional Liability
<br />201424712NPO
<br />9/15/2014
<br />9/1512015
<br />Occurrence(Aggragatel,0o0,e00 /$3,000,000
<br />•
<br />Improper Secual Conduct
<br />201424712NPO
<br />9115/2014
<br />9/1512015
<br />OccurrencelAggregato $250,0001$250,000
<br />DESCRIP 'rIONOFOPERATIONSILOCATIONSJV HICLES (Aileen ACORD 101, Additional Remarks Schedule, If more space Is required)
<br />RE; HPRP Contract #A2009.137 Homeless Prevention and A2009- 137ARapid 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 polloy form CG0001 0798, 1
<br />\V
<br />J
<br />CERTIFICATE HOLDER CANCELLATION �-
<br />0 1988,2010 ACORO CORPORATION. All rights reserved.
<br />ACORD 25 (2010106) The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City Of Santa Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />20 Civic Center Plaza, M -25
<br />Santa Ana, CA 92701 -
<br />AUTHORIZED REPRESENTATIVE
<br />0 1988,2010 ACORO CORPORATION. All rights reserved.
<br />ACORD 25 (2010106) The ACORD name and logo are registered marks of ACORD
<br />
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