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ILLUMINATION FOUNDATION (42)
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ILLUMINATION FOUNDATION (42)
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Last modified
12/9/2025 8:17:17 AM
Creation date
4/29/2025 9:24:58 AM
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Contracts
Company Name
ILLUMINATION FOUNDATION
Contract #
A-2021-175-01A
Agency
Community Development
Expiration Date
5/1/2027
Insurance Exp Date
1/1/2026
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712/8/2025 <br /> E(MM/DD/YYYY) <br /> A�" CERTIFICATE OF LIABILITY INSURANCE <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 CONTACT <br /> NAME: Jeff Davis <br /> Marsh &McLennan Agency LLC PHONE FAX <br /> Marsh &McLennan Ins.Agency LLC vC No Ext: 949-544-8481 vc,No: <br /> E-M1 Polaris Way#300 ADDRESS: jeff.davis@marshmma.com <br /> Aliso Viejo CA 92656 INSURER(S)AFFORDING COVERAGE NAIC# <br /> License#:OH18131 INSURERA: QBE Specialty Insurance Company 11515 <br /> INSURED ILLUMFOUND INSURERB: Redwood Fire and Casualty Insurance Co 11673 <br /> Illumination Health + Home <br /> 2871 Pullman St INsuRERc: Berkshire Hathaway Specialty Ins Co 22276 <br /> Santa Ana, CA 92705-5713 INSURERD: Underwriters at Lloyd's London 55555 <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:542651510 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR INSD WVD POLICYNUMBER MM/DD MM/DD <br /> A X COMMERCIAL GENERAL LIABILITY 140002207 12/1/2025 12/1/2026 EACH OCCURRENCE $2,000,000 <br /> CLAIMS-MADE OCCUR PREMISES DAMAGE TO <br /> PREMISES Ea occurrence) <br /> ccurrence $50,000 <br /> MED EXP(Any one person) $5,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 <br /> POLICY PRO ❑ LOC PRODUCTS-COMP/OP AGG $3,000,000 <br /> X El JECT <br /> OTHER: $ <br /> B AUTOMOBILE LIABILITY 01APM06426901 12/1/2025 12/1/2026 COMBINED SINGLE LIMIT $1,000,000 <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED X SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> UMBRELLALIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> C WORKERS COMPENSATION ILWC613770 1/1/2025 1/1/2026 X PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $1,000,000 <br /> OFFICE R/M EMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 <br /> A PROFESSIONAL LIABILITY 140002207 12/1/2025 12/1/2026 EACH CLAIM/AGGREGAT $2M/$2M <br /> D SEXUAL ABUSE&MOLESTATION B0621PILL0001325 12/1/2025 12/1/2026 EACH CLAIM/AGGREGAT $1M/$1M <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) <br /> Waiver of Subrogation applies to General Liability,Auto Liability,and Workers Compensation,where required by written contract,per the attached <br /> endorsements. Digitally signed by <br /> Tran Iran Tu Tran Nguyen <br /> Date:2025.12.08 <br /> Nguyen 14:56:46-08'00' <br /> APPROVED <br /> JBy Tu Tran Nguyen at 2:56 pm,Dec 08,2025 <br /> �] <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> City of Santa Ana <br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE <br /> Santa Ana CA 92701 <br /> @ 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />
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