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ILLUFOU-01 ITIVATIOTIll , li.i ° CERTIFICATE OF LIABILITY INSURANCE �--''�- TE MMIDDIYYYY) oA11/09/2017 11/09/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BYTHEPOLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # 0079613 NRMJJ CT Bowermaster & Associates Insurance Agency, Inc. 10805 Holder Street, Suite 350 Cypress, CA 90630 PHONE 714 733.6200 FAX (A/C, No, E,b ( ) (AIC, No):(714) 252-8253 ADDRIESS: INSURERS AFFORDING COVERAGE NAIC# X INSURER A:Philadelphia lndemnit Insurance 18058 PHPK1712176 09/15/2017 09/15/2018 INSURED INSURER B: Illumination Foundation 2691 Richter Avenue INSURER C: 100,000 100'000 Suite 107 INSURER D INSURER E: Irvine, CA 92606 INSURER F: COVERAGES CERTIFICATE NIIMRF_R- RFVISION KIHMRFP- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDLSUBR INSD MDPOLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE ® OCCUR X PHPK1712176 09/15/2017 09/15/2018 EACH OCCURRENCE $ 1,000'000 ESO RENTED PREMISES 100,000 100'000 MED EXP (Any oneperson) 5'000 PERSONAL &ADV INJURY $ 1'000'000 AGGREGATE LIMIT APPLIES PER: POLICY jE0 E LOC GENERAL AGGREGATE $ 3'000'000 GEN'L X PRODUCTS-COMPIOP AGG $ 3'000'000 OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 _bEaAdegentl BODILY INJURY Per personL $ X ANYAUTO PHPK1712176 09/15/2017 09/15/2018 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ OPERTY AMAGE acadenl _ $ HIRED ONLY NON-OWNED AUTOSer A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1'000'000 EXCESS LIAB CLAIMS -MADE PHUB600483 09115/2017 09/15/2018 AGGREGATE 1.000'000 DED X RETENTION$ 10,000 WORKERS COMPENSATIONPER ANDEMPLOYERS'LIABILITY YIN OTH- STATUTE OFFICRfOOiIMEIMBERIEXCLUEWE ECUTIVE ❑ (Mantlatcry in NH) If yes, describe under NIA E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT A Improper Sexual Cond PHPK1712176 09/1512017 09115/2018 Per Occurrence 1,000,000 A Professional Liab PHPK1712176 09/15/2017 09115/2018 Agg:$3,000,000 /Each 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: Emergency Solutions Grant program The following endorsements apply in favor of the City of Santa Ana, their officers, officials, employees, agents and volunteers to the extent required by a written contract: General Liability: Additional Insured perform PIGLDHS1011. Primary and Non -Contributory wording applies perform PIGL0050712. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cit of Santa Ana City THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza, M-25 Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD