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+ �bol CERTIFICATE OF LIABILITY INSURANCE <br />8DATE <br />0/2017 Y) <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 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 />this certificate does not confer rights to the certificate holder In lieu of such ondorsernont(s). <br />PRODUCEAct <br />R <br />EMPLICITY INSURANCE SERVICES <br />raD0TY­F7Pr'-- <br />MMID t)IYVYY <br />Sn,Hoar:-"'- 4 9) 716 - 5 353 <br />9551 Irvine Center Drive <br />Irvine, CA 92618 <br />WC No Gu. _—.LLA'c Nyl;.(9 <br />— <br />E. AIL <br />ADDRESS, <br />INSURER(i AFFORDING COVERAGE <br />NAWO <br />_ <br />INBURCItA.State Compensation Insurance Fund <br />INSURED <br />INSURER B <br />INSURER C. <br />THE ILLUMINATION FOUNDATION <br />INSURER 0, <br />2691 Richter Ave., Suite 107 <br />INSURER ee <br />— <br />Irvine, CA 92606 <br />----....---_----- <br />INSURER F <br />—' <br />CLAIMS-MADE OCCUR <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 'PERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID Cl <br />Pan LTR <br />TYPE QP INSURANCE <br />AW <br />Dan <br />Wool <br />WVO <br />Poll NUMBER <br />(MMfODfYYYYj_ <br />raD0TY­F7Pr'-- <br />MMID t)IYVYY <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE. <br />$ <br />1:1 <br />"TTA ACJOmrRTE- <br />- <br />CLAIMS-MADE OCCUR <br />PREMPCS__(LMGuurnat <br />$_- <br />MED ERP (Any one person) <br />$ <br />PERSONAL ft ADV INJURY _ <br />IS <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />GENERAI. AGGREGATE <br />$ <br />POLICY I_J JECT L._ ' UC <br />PRODUCTS � COMPtOP AGO <br />$ <br />...._ <br />01___ <br />AUTOMOBILE LIABILITY"CFAIItFl@l5RuiR23CFLTi'vi.T <br />fa eCdltlent <br />$ <br />_ <br />ANYAUTO <br />BODILY INJURY (Per parson) <br />$� <br />OWNEDSCHEDULEDBODILY <br />INJURY (Par accident' <br />$ <br />AUTOS ONLY AUTOS <br />— HIRED ev. NON -OWNED <br />P2'Ttl`�"IJAFIA[ <br />AUTOS ONLY AUTOS ONLY <br />secltleY¢}� <br />$ <br />UMBRELLA i..- <br />_ <br />OCCUR <br />EACH OCCURRENCE___ <br />EXCESS LIAR <br />CLAIMS -MADE <br />AGGREGATE <br />5 <br />.^ <br />OEp <br />ftETENi'ION$ <br />$ <br />WORKERS COMPENSATION <br />Xjj - <br />f_9TATUTE FR <br />--II <br />A <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIEOWPARTNENE%ECUTIVE <br />OFFICERIMEMBER EXCLUOED9 ❑ <br />iMeeAOlory In Ni <br />NIA <br />9040950-2017 <br />1/1/17 <br />1/1/18 <br />EL. EACH ACCIDENT <br />"t <br />EL. DISEAASE- EA EMPLOYEE <br />$ 1,000,000 <br />1,000,000 <br />If yyas, dasoribe under <br />0SCRIP-HONOPOPERATIONS E.faw <br />— <br />EI. DISEASE -POLICY LIMIT <br />$_1,000,000 <br />�~ <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VE.HICLEG (ACORD 101, Additional Remarks Schedule, ri be attached if mare spare is required) <br />J IT" <br />Endorsementst 30 day's written cancel notice (10 days for non Payment of Premium . <br />i <br />CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 Civic Center Plaza, 6th F1r. ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENHl <br />0 1998-2015 ACORD CORPORATION. A rights reserved. <br />ACORD25(2016703) The ACORD name and logo are registered marks of ACORD <br />