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DATE(MWDD/YYYY) <br />CERTIFICATE OF LIABILITY INSURANCE 1/2/2018 <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 pollcy(les)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 />PRODUCER NAME:, _ <br />EMPLICITY INSURANCE SERVICES PHONE FAX <br />9851 Irvine Center Drive A/ No X NON,:( ) <br />MAIL <br />Irvine, CA 92618 ABORES$ <br />INBUftaR181 AFFORDING COVERAGE NAIGfl <br />INSURED <br />THE ILLUMINATION FOUNDATION <br />2691 Richter Ave., Suite 107 <br />Irvine, CA 92606 <br />rnVFRAnP.q CERTIFICATE NUMRBRREVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANGE 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 />LTRR <br />TYPE OF INSURANCE <br />3 <br />POLICY NUMBER <br />EFF <br />MOLICY YYY <br />M DIY EAP <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />T':01AIM1 MADE OCCUR <br />EACH OCCURRENCE <br />$ <br />PREMISES Ee oacurrenca <br />_ <br />$ <br />MED EXP (Any one person) <br />$^ <br />PERSONAL a ADVINJURY <br />$ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY ,EcO C LOC <br />OTHER: <br />GENERAL AGGREGATE <br />$ <br />PRODUCTS -COMPIOP AGO <br />$ <br />$ <br />AUTOMOBILE LIABILITY <br />ANYAUTO <br />OWNED SCHEDULED <br />AUTOS ONLYAUTOS <br />HIRED NOWOWNED <br />AUTOS ONLY AUTOS ONLY <br />QUNNINHU <br />eccldent <br />$ <br />BODILY INJURY (Par parson) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident] <br />$ <br />$ <br />UMBRELLA LIAR <br />EXCESS IIAB <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE ^� <br />$ <br />DED RETENTION$ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PIN <br />ROPRIETORIPARTNEWEXECUTIVE r� <br />OFFICERMEMDER EXCLUDED? tt <br />(Mandatory In Ne <br />H yaa describe under <br />DE SCRIPTION OF OPERATIONS below <br />NIA <br />9040950-2018 <br />1/1/7.9 <br />1/1/19 <br />STATUTE ER <br />EL EACH ACCIDENT <br />$_ 1, 0_00, 000 <br />E.L.DISEASE• EA EMPLOYE <br />$ 1,000,000 <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addliional Remarks Schedule, may be attached If more space is required) <br />V� <br />Endorsements: 30 days written cancel notice (10 days for non payment of premium). <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 />20 Civic Center Plaza, 6th F1r., 11 <br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE <br />CORPORATION. <br />ACOR025(2096/03) The ACORD name and logo are registered marks of ACORD <br />