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OCAMPO, KARINA MORALES 3
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OCAMPO, KARINA MORALES 3
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Last modified
6/22/2020 10:42:38 AM
Creation date
9/26/2018 12:14:29 PM
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Contracts
Company Name
OCAMPO, KARINA MORALES
Contract #
N-2018-078-01
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Expiration Date
6/30/2018
Insurance Exp Date
12/31/2018
Destruction Year
2024
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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 2018.35 <br />CERTIFICATE OF INSURANCE <br />SPECIAL EVENT LIABILITY PROGRAM <br />PRODUCER <br />PUBLIC ENTITY (ADDITIONAL INSURED) <br />Alliant Insurance Services, Inc, in conjunction with <br />City of Santa Ana <br />Apex Insurance Services <br />20 Civic Center Plaza <br />P. 0. Box 6450 <br />Santa Ana, CA 92701 <br />Newport Beach, CA 92658 N_2018-078-01 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />EVENT INFORMATION: <br />Karina MoralesOcatupo <br />TYPE: Dance <br />9772 Santiago Blvd -L20) -7 _ l / <br />DATE(S): 2/08718-1213UI$ <br />Villa Park, CA 92867 <br />LOCATION: Santa Anita Center <br />*Liquor Liability Yes ❑ No <br />"Liquor Liability after 12 am ends before 2 am <br />This is to certify that the insurance policy listed below has been issued to the above insured named (event holder) for the policy <br />period indicated. The insurance described herein is subject to all the terms, exclusions and conditions of such policy(ies) unless <br />amended as described in Special Conditions. <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: SEP41026 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2018 EXPIRATION: JANUARY 1, 2019 <br />COMMERCIAL GENERAL LIABILITY <br />OCCURRENCE FORM <br />DEDUCTIBLE: NONE <br />General Aggregate Limit S 2,000,000 <br />Products & Completed Operations 1,000,000 <br />SPECIAL CONDITIONS: <br />Personal & Advertising Injury 1,000,000 <br />The following endorsements attached to <br />Each Occurrence Limit I,Oo0,000 <br />the Master Policy do not apply to this <br />Damage To Promises Rental To You (Any One Premises) 100,000 <br />Certirmse Of Insurance: <br />Medical Payments (Any One Person) 5,000 <br />MEGL643 <br />Liquor Liability (Ifpurchased) 1,000,000 <br />Optional Limits Purchased <br />Q $1,000,0001S3,000,000 <br />❑ $210001000/$2,000,000 <br />Damage To Property (If purchased) <br />The limits of insurance apply separately to each event insured by this policy as if a separate policy of insumace has been issued rot that event. <br />OTHER ADDITIONAL INSUREDS <br />:E <br />CANCELLATION Should the above described policy be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy <br />rovisions. <br />AUTHORIZED REP?ESENTA <br />DATE ISSUED: <br />G <br />(bxP SP�P��`� <br />91? <br />
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