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<br />Francine R. Villareal W-1
<br />Dma xo1,01.2017e4:w40W
<br />�® CERTIFICATE OF LIABILITY INSURANCE
<br />°AT,/`/zo2, YY
<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 endorsement(s).
<br />PRODUCER
<br />Bowermaster & Associates
<br />10805 Holder StINC.No)
<br />Ste 350
<br />CONTACT
<br />NAME: Liz Orozco
<br />PHONE 714 733-6248 FAX
<br />ADDRIESS: lorozco@bowermaster.com
<br />Cypress CA 90630
<br />INSURER 3 AFFORDING COVERAGE
<br />NNCe
<br />INSURER A: Philadelphia Indemnity Insurance
<br />18058
<br />INSURED ILLUFOU-01
<br />IIIUmination Foundation
<br />LifeArk Community and LifeArk El Monte LLC
<br />INSURER B: Redwood Fire & Casualty Insurance
<br />11673
<br />INSURER C : Nonprofits' Insurance Alliance of California
<br />INSURER D:
<br />1091 N. Batavia Street
<br />Orange CA 92867
<br />INSURER E:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 1108026962 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 />INTR
<br />TYPE OF INSURANCE
<br />ADDLSUBR
<br />POLICYNUMBER
<br />POLICY EFF
<br />MM/OOIYVYY
<br />POLICY EXP
<br />MWDD
<br />LIMITS
<br />C
<br />TCOMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE � OCCUR
<br />V
<br />2020-24712
<br />9/15/2020
<br />9/15/2021
<br />EACH OCCURRENCE
<br />$1,000,000
<br />DAMAGESTO
<br />(RENTED
<br />PREMISES Ea oxumence
<br />$500,000
<br />MED EXP (Any one person)
<br />$ 20,000
<br />Liability
<br />PERSONAL&ADV INJURY
<br />$1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />X POLICY PEQFLOC
<br />GENERA -AGGREGATE
<br />$3,000,000
<br />PRODUCTS-COMP/OP AGG
<br />$3,000.000
<br />$
<br />OTHER:
<br />C
<br />AUTOMOBILE
<br />LIABILITY
<br />2020-24712
<br />9/15/2020
<br />9/15/2021
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$1,000,000
<br />BODILY INJURY IPerpersen)
<br />$
<br />IANYAUTO
<br />OWNED SCHEDULED00DILY
<br />AUTOS ONLY AUTOS
<br />INJURY P
<br />(er accident)HIRED
<br />X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />Per aecitlent
<br />$
<br />C
<br />X
<br />UMBRELLALIAB
<br />X
<br />OCCUR
<br />202-24712-UMB
<br />9/15/2020
<br />9/15/2021
<br />EACH OCCURRENCE
<br />$7,000,000
<br />AGGREGATE
<br />$7.000.000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DEO RETENTION$
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ILWC107887
<br />1/1/2021
<br />1/1/2022
<br />X STATUTE ERH
<br />E.L. EACH ACCIDENT
<br />$1.000,000
<br />ANYPROPRIETORIPARTNEMEXECUTIVE ❑
<br />OFFICER/MEMBEREXCLUDEDi
<br />N/A
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,000,000
<br />(Mandatary In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS be.
<br />E.L. DISEASE -POLICY LIMIT
<br />$1,000,000
<br />A
<br />Commercial Cyber Liability
<br />PHSD1575498
<br />9/15/2020
<br />9/15/2021
<br />AN:$3,000,000fEach
<br />$1,000,000
<br />C
<br />Improper Sexual Cmducl
<br />2020-24712
<br />9/15/2020
<br />9/15/2021
<br />AN:$1P00,000IEach
<br />$1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS f VEHICLES (ACORD 101, Additional Remarks Schedule, maybe aUached if more space is required)
<br />City of Santa Ana, it's officers, employees, agents, and volunteers are Additional Insured With respects to General Liability per attached endorsement form;
<br />Primary and Non -Contributory wording applies per attached endorsement form.
<br />30-day notice of cancellation is provided per policy provisions.
<br />CERTIFICATE HOLDER
<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 />Risk Management Division
<br />20 Civic Center Plaza, 4th Fir
<br />Santa Ana CA 92702 AUTHORI ED REPRESENTATIVE
<br />USA
<br />rs
<br />RENEWED&APPROVED BY:
<br />1988.2015 ACORD C(',�',he Z Vl(4waf
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORDRisk Management Amly,t
<br />
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