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ILLUMINATION FOUNDATION (19)
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ILLUMINATION FOUNDATION (19)
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Entry Properties
Last modified
4/8/2025 5:26:01 PM
Creation date
10/12/2021 11:44:44 AM
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Contracts
Company Name
ILLUMINATION FOUNDATION
Contract #
A-2021-175
Agency
Community Development
Council Approval Date
9/7/2021
Expiration Date
9/7/2021
Insurance Exp Date
12/1/2025
Destruction Year
2029
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Digitally signed by Francine R. <br />Francine R. Villareal Villareal <br />AC")? CERTIFICATE OF LIABILITY INSURANCE DATE(MMID 21wY) <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 enciorsement(s). <br />PRODUCER <br />Bowermaster & Associates <br />10805 Holder St <br />Ste 350 <br />Cypress CA90630 <br />CONTACT <br />NAME: Llzette Orozco <br />PHONE 714-733-6248 FAX <br />No: <br />ADDRIESS• lorozco bowermaster.com <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURERA: Philadelphia Indemnity Insurance <br />18058 <br />INSURED ILLUFOU-01 <br />Illumination Foundation <br />1091 N. Batavia Street <br />INSURER B: Redwood Fire & Casualty Insurance <br />11673 <br />INSURERC: Nonprofits' Insurance Alliance of California <br />11384 <br />INSURER D <br />Orange CA 92867 <br />INSURER E : <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 1394503630 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 />MEN <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUER <br />POLICY NUMBER <br />POLICY EFF <br />MM/DDIYYYY <br />POLICY II <br />MM/DD/YYYYI <br />LIMITS <br />C <br />X <br />COMMERCIALGENERAL LIABILITY <br />CLMMS-MAOE El OCCUR <br />Y <br />2021-24712 <br />9/15/2021 <br />9/15/2022 <br />EACH OCCURRENCE <br />$1,000,000 <br />CXVAGET -RENTED <br />PREMISES Ea occurrence <br />$500,000 <br />X <br />MED EXP (Any one parson) <br />$2Q000 <br />Prof Liability <br />PERSONAL A ADV INJURY <br />000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERA -AGGREGATE <br />000 <br />POLICY PRO- ❑ LOC <br />X JECT <br />PRODUCTS - COMP/OP AGG000 <br />OTHER <br />C <br />AUTOMOBILE <br />LIABILITY <br />2021-24712 <br />9/15/2021 <br />9/15/2022 <br />COMBINED SINGLE LIMIT <br />F3,O <br />000EaaccldentX <br />BODILY INJURY (Per person)OWNED <br />ANV AUTO <br />SCHEDULED <br />ONLY AUTOS <br />BODILY INJURY Per accidentAUTOS <br />( )X <br />HIRED X NON'WNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />Per occident <br />C <br />X <br />UMBRELLALIAB <br />X <br />I OCCUR <br />2021-24712-UMB <br />9/15/2021 <br />9/1512022 <br />EACH OCCURRENCE <br />$7,000,000 <br />ri <br />AGGREGATE <br />$7,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I I RETENTION$ <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ILWC209336 <br />1/1/2021 <br />1/1/2022 <br />X PER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />ANYPROPRIETORPARTNEREXECUTIVE ❑ <br />OFFICERIMEMBEREXCLUDED'! <br />NIA <br />E.L. DISEASE - EA EMPLOYEE <br />$1,000,000 <br />(Mandatory in NH) <br />f yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />A <br />C <br />Commercial Cyber Liability <br />Improper Sexual Conduct <br />PHSDI575498 <br />2021-24712 <br />9/15/2021 <br />9/15/2021 <br />9/15/2022 <br />9/15/2022 <br />Agg:$3,000, 0001Each <br />Agg:$1.000,000IEach <br />$1,000,000 <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) <br />Re Location: 1815 Carnegie Avenue, Santa Ana, CA 92705 <br />Certificate Holder is Additional Insured as respects to General Liability per attached endorsement form. Coverage applies on a Primary basis per attached <br />endorsement form. <br />Excess/Umbrella coverage is follow form over the primary General Liability. <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 AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92701 <br />NnF RiskManagEmentDit'iebn <br />Y <br />REVIEWED&APP,RIOVSr.a P, S <br />©1988-2015 ACORD C s �`' Ff".e .�" <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Risk Management Analyst <br />THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE <br />
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