MARISCAL, PATRICE 1 - 2003 - Laserfiche WebLink

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EVANSTON INSURANCE COMPANY CERTIFICATE NO.: CERTIFICATE OF INSURANCE EXCLUDES COVERAGE FOR NOMINEE EVENTS, SEE SEPARATE APPLICATIONS FOil NOMINEE EVENTS. SPECIAL EVENT LIABILITY PROGRAM PRODUCER: ' PUBLIC ENTITY (ADDITIONAL INSURED) DriverAlliantlnsurance Serv/c~s City of Santa Aha P.O. Box28323 20 Civic Center Plaza, M-28 SantaAna, CA 92799-8323 P.0. Box 1988 (949)660-8163 Santa Aha, GA 92702 License No: OC 36861 NASd[ED INSURED (ETM HOLDER): EVENT INFORMATION: TYPE: Self Improvement patriCe MariScai~ ~I ..~ (~.f~c[ DATE(S): 1/14/04 - 12/51/04 LOCATION: S.A. Jaii This is to certify that the policies of insurance listed below have been issued to the insured named above for the policy period /ndidatcd. Notwithstanding any rexltti~ments, tm or conditions of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the reruns, exclusions and conditions of such policies. Limits shown may have been reduced by paid claims. INSURANCE CARRIER: Evanston Insurance Company MASTER POLICY NUMBER: IMSEP1000001 MASTER POLICY DALES: EFFECTIVE: JANUARY I, 2004 EXPIRATION: JANUARY 1, 2005 COMMF~RCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE O~nmml Aggregate Limit $ 2,000,000 Products & Compl~ll~d Operations 1,000,000 Pcmonal & Advertising Injury 1,000,000 Each Occunence Limit 1,000,000 Fire Damage (Paly One Fire) 50,1)00 Medical Payments (Any One Person) 5,000 The bruits of insurance apply separately to *ach event insured by this pohcy ~s ~f a ~eparate pohcy of m~urar?e has be~t i$s[l~d for that event. after the event holder ceases to be a tenant itt tha~,p~nises. OTHER ADDITIONAL INSUREDS ~ Should the above described policy to mncelled before ti~ expiration date the, mmf, the issuing company will mail 30 days written notice to DATEISSUED: January 14, 2004