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Francine R. Digitally signs by Francine <br />R. Villareal <br />I Date: 2022.01.2717.24:48 <br />A� �® CERTIFICATE OF LIABILITY INSURANCE <br />DA?f48IDOfTi <br />11/2022 <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 St <br />Ste 350 <br />Cypress CA 90630 <br />CONTACT <br />NAME: Llzette Orozoo <br />PHONE 714-733-6248 ac No <br />Ef4R�Lss, lorozco bowefmaster.com <br />INSURERS AFFORDING COVERAGE <br />NAIL# <br />INSURERA: Philadelphia Indemnity Insurance <br />18058 <br />INSURED ILLUFOU-01 <br />The Illumination Foundation <br />1091 N. Batavia Street <br />INSURERS: Nonprofits' Insurance Alliance of California <br />11384 <br />INSURER C: Cypress Ins Cc <br />10855 <br />INSURER D: <br />Orange CA 92867 <br />NSURERE: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 1919030540 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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADOL <br />SUBR <br />POLICYNUMBER <br />POLICY EFF <br />MMIDDfYYYY) <br />POLICY UP <br />IMMUDDINY'li <br />LIMITS <br />B <br />X <br />COMMERCIALGENERAL LIABILITY <br />OCCUR <br />Y <br />2021-24712 <br />9/15/2021 <br />9/15/2022 <br />EACH OCCURRENCE <br />$1,000,000 <br />D <br />RAMACLAIMS-MADE1XI <br />ET E. baba <br />PREMISES <br />PREMISES Ea ocanenca <br />$500,000 <br />X <br />MED UP (Any one parson) <br />$20,000 <br />Prof Uability, <br />PERSONAL&ADV INJURY <br />$1,000.000 <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY PRO- LOG <br />JECT <br />GENERALAGGREGATE <br />$3,000.000 <br />GEN'L <br />X <br />PRODUCTS-COMP/OP AGG <br />$3,000,000 <br />$ <br />OTHER: <br />B <br />AUTOMOBILE <br />LIABILITY <br />2021-24712 <br />9/15/2021 <br />9/15/2022 <br />COMBINED SINGLE UNIT <br />Ea eccitlent <br />$1,000,000 <br />X <br />BODILY INJURY (Per parson) <br />$ <br />ANY AUTO <br />OWNED SGHEDULED <br />AUTOS ONLY AUTOS <br />I <br />INJURY ) BODILY <br />(Per accitlent <br />$ <br />X <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />Par eccitlent <br />$ <br />B <br />X <br />UMBRELLALU\B <br />X <br />OCCUR <br />2021-24712-UMB <br />9/15/2021 <br />9/15/2022 <br />EACH OCCURRENCE <br />$7,000,000 <br />AGGREGATE <br />$7,000,000 <br />EXCESS LIAR <br />CLAIMS -MADE <br />DIED I I RETENTIONS <br />$ <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ILWC310553 <br />1/1/2022 <br />1/1/2023 <br />X STATUTE ERH <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />ANYPROPRIETOILPARTNEWEXECUTIVE <br />OFFICEWMEMBEREXCLUDED? <br />N/A <br />E.L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />(Mandatory In NH) <br />If yes, cornice under <br />E.L. DISEASE -POLICY LIMIT <br />$1.000,000 <br />DESCRIPTION OF OPERATIONS below <br />A <br />e <br />Commercial Cyber Liability <br />Improper Sexual Conduct <br />PHSDIS75498 <br />2021-24712 <br />9/15/2021 <br />9/15/2021 <br />9/15/2022 <br />9/15/2022 <br />Agg:$3000,0c0/Each <br />Agg:$1P00.W0/Each <br />$1,000,000 <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) <br />RE: HPRP Contract #A-2021-046, A-2021-228 <br />City of Santa Ana, their officers, employees, agents, volunteers and representatives are Additional Insured with respects to General Liability per attached form; <br />Primary and Non -Contributory wording applies per attached form. <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 <br />Santa Ana CA 92701 AUTHOR EDREPRESENTATIVE <br />USA rol's <br />RinkMwgamml:Dh6lan <br />RiEvew D&APPROVED BY. <br />©1988-2015 ACORD C Fes"P, V:(Gc4a4[ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Risk Management Analyst <br />THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE <br />