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HAUK, CAROLYN 1
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INACTIVE CONTRACTS (Originals Destroyed)
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G-H (INACTIVE)
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HAUK, CAROLYN 1
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Entry Properties
Last modified
5/28/2015 10:13:14 AM
Creation date
11/16/2004 10:03:08 AM
Metadata
Fields
Template:
Contracts
Company Name
Carolyn Hauk
Contract #
N-2004-132
Agency
Police
Expiration Date
1/1/2006
Insurance Exp Date
12/31/2006
Destruction Year
2010
Notes
Amends N-2004-132-01
Document Relationships
HAUK CAROLYN 1A
(Amended By)
Path:
\Contracts / Agreements\ INACTIVE CONTRACTS (Originals Destroyed)\G-H (INACTIVE)
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FVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: - <br />CERTIFICATE OF INSURANCE <br />EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. <br />SPECIAL EVENT LIABILI'T'Y PROGRAM <br />PRODUCER. <br />PUBLIC ENTITY (ADD[ I ZONAL INSURED) <br />City of Santa Ana <br />Driver Alliant Insurance Services in conjunction with <br />20 Civic Center Plaza, M -28 <br />Apex Insutanee Services <br />Santa Ana, CA 92701 <br />P O. Box 28323 <br />Santa Ana, CA 92799 -8323 <br />(949)660 -8163 <br />License Nu: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />EVEN 'P INFORMATION. <br />Carolyn Hank N - ,Rco y_13of -0 <br />TYPE: htstructional /Self - Improvement <br />DATE(S): January 1 - December 31, 2006 <br />LOCATION: Santa Ana Jail <br />This is in ecrtify that the policies of insurance listed below have been issued to the insured named above for the policy period <br />indicated. Notwithstanding any requirements, terms or conditions 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 />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER. 04SEP100000I <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2006 EXPIRATION: JANUARY 1, 2007 <br />COMMFINJAL OLNERAL I IAR1I I Y <br />OCCURRENCP DORM <br />DLDUCTIBI.F. NONL <br />General Aqpmgvte Llmrt $ 2,000,01111 <br />Products& Completed Operations 1,1104000 <br />Personal & Advertising Injury 1 0011,000 <br />Each Ocnatencn Limit 1000,000 <br />Piro Dmuagc (Any (uc Fire) 50,000 <br />Medical Papmmnts (Any One Person) 5,000 <br />I limits of insurance apply separately w each event insured by this policy as ifa separate policy In Insurance has been Issued for that event <br />`Who is insured is amended to inolude, as an insured, the persun or orcran7 tion shown in this schedule, but only wah respect to hi hilily al i.in,, nut of the <br />ownership Inaimmnance rot Use uRhe premises used by the named insured (eventholdeq Th,s Insuraneedocs not apply to'. Any `occurrence' which takcaplzcc <br />alter drc event hold r wmec nt be a LenwII in tltat prentisas. <br />OTHER ADDITIONAL INSUREDS <br />CAN( 'I!I I I'ION Should the ebnvc dc.mbed policy m cantalled before the nxpilhiuo dMe thereof, the issumg company will mail 30 days written notice to the <br />esniocatc holder and addlnunnl lnwreds listed <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: <br />% 7 <br />-E ltl�tll <�f �f)I'H all _L:C13 PE <br />
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