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ILLFOU -001 HE
<br />CERTIFICATE OF LIABILITY INSURANCE D 2tzs12o 4
<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 />PRODUCER (888) 825 -4322 NAME :" Andrea Thurmond
<br />Bowermaster & Associates PAN /ONE
<br />P.O. Box 6026 E -MAE„t.714.733.6208 ac,Nm; 714.252.8253
<br />IL
<br />10805 Holder Street - Suite 350 ADDRESS: athurmond @bowermaster.com
<br />Cypress, CA 90630 INSURER ai AFFORDING COVERAGE NAIL #
<br />INSURER A: Nonprofits' Insurance Alliance of California
<br />INSURED Illumination Foundation INSURER B:West American Insurance 44393
<br />2691 Ritcher Avenue INSURERC:State Compensation Insurance Fund
<br />Suite 107 INSURER D: _
<br />Irvine, CA 92606- INSURER E
<br />INSURER F
<br />COVERAGES 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 ADDL SU POLICY EFF POLICY EXP
<br />LTR TYPE OF INSURANCE iry POLICY NUMBER MM /DD ODtYYYY LIMITS
<br />GENERAL LIABILITY
<br />Santa Ana, CA 92701 -
<br />EACHOCCURRENCE $ 1,000,00
<br />A X COMMEERCLAL GENERAL LIABILITY Y
<br />N
<br />201424712NPO 911512014 9/15/2015 PREMI,E8 Ea ocrurzem_e' 3 500,00
<br />CLAIMS MADE IX-1 OCCUR
<br />MED EXP (Any one pe son) $ 20,00
<br />PERSONAL & ADV INJURY $ 1,000,00
<br />GENERAL AGGREGATE $ 3,000,060
<br />GENT AGGREGATE. LIMIT APPLIES PER:
<br />PRODUCTS- COMPIOPAGG $ 3,000,000
<br />X POLICY PRO- LOC
<br />$
<br />AUTOMOBILE LIABILITY
<br />COMBINED SINGLE LIMIT Eaccldent 1,666,666
<br />a _,
<br />B X ANY AUTO N
<br />N
<br />DAWS6316571 9115/2014 9/15/2015 BODILY INJURY (Per person) $
<br />ALL OWNED SCHEDULED
<br />BODILY INJURY (Per accident) $
<br />AUTOS AUTOS
<br />NON -OWNED
<br />PROPERTY DAMAGE
<br />X HIRED AUTOS X AUTOS
<br />PER ACCIDENT
<br />UMBRELLA UAB OCCUR
<br />EACH OCCURRENCE $
<br />EXCESS LAG CLAIMS -MADE
<br />AGGREGATE $
<br />DED RETENTION $
<br />$
<br />WORKERS COMPENSATION
<br />OCCY5LAMTIU- OLTH-
<br />AND EMPLOYERS' LIABILITY YIN
<br />- --
<br />C ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />N
<br />90409502015 1/1/2015 1/1/2016 E.L. EACH ACCIDENT $ 1,000,000
<br />OFFICEWMEMBER EXCLUDED? NIA
<br />(Mandatory in NH)
<br />E.L. DISEASE - EA EMPLOYEI $ 1,000,000
<br />If yes, describe under'
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE- POLICY LIMIT $ 1,000,000
<br />• Professional Liability N
<br />N
<br />201424712NPO 9115/2014 9/15/2015 Occurrence /Aggregate $1,000,0001$3,000,000
<br />• Improper Secual Conduct N
<br />N
<br />201424712NPO 9115/2014 9/15/2015 Occurrence /Aggregate $250,000/$250,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more 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 whh
<br />primary wording per policy form CGO0010798.
<br />RevieweAi 1 of 16
<br />CERTIFICATE HOLDER CANCELLATION
<br />ACORD 25 (2010/05)
<br />O 1988.2010 ACORD CORPORATION. All rights reserved.
<br />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 />20 Civic Center Plaza, M -25
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana, CA 92701 -
<br />AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2010/05)
<br />O 1988.2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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