Reyes, Juan 1 - Laserfiche WebLink

Home Browse Search

EVANSTON INSURANCE COhwr ANY CERTIFICATE NO.: .Ww CERTIFICATE OF INSURANCE SPECIAL EVENT LIABILITY PROGRAM PRODUCER: PUBLIC ENTITY (ADDITIONAL INSURED) City of Santa Ana Driver Alliaat Insurance Services 1/ 20 Civic Center Plaza, M -28 P. O. Box 28323 Santa Ana, CA 92701 Santa Ana, CA 92799 -8323 (949) 660 -8163 ri License No: OC 36861 NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: Juan Reyes TYPE: Instructional — Softball 2521 W. Sunflower, #N5 DATE(S): _01/03 — 6/30/03 Santa Ana, CA 92704 LOCATION: Various Parks in Santa Ana This is to certify that the policies of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirements, terms 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 terms, exclusions and conditions of such policies. Limits shown may have been reduced by paid claims. INSURANCE CARRIER: Evanston Insurance Company MASTER POLICY NUMBER: 02SEP100000I MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2003 EXPIRATION: JANUARY 1, 2004 COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE General Aggregate Limit $1,000,000 Products & Completed Operations 1,000,000 Personal & Advertising Injury 1,000,000 Each Occurrence Limit 1,000,000 Fire Damage (Any One Fire) 50,000 Medical Payments (Any One Person) 5,000 The limits of imuraoce apply separately to each event insured by this policy as if a separate policy of insumme has been issued for that event. "Who is insured° is amended to include, as an insured, the person or organization shown in this schedule, but only with respect to liability arising out of the owner ship, maintenance or use of the premises used by the named insured (event Iwlder} This insurance does not apply to: Any "occurrence" which takes place after the event holder ceases to be a tenant in that premises. OTHER ADDITIONAL INSUREDS CANCELLATION: Should the above described policy to cancelled before the expiration date thereo4 the issuing company will mail 30 days written notice to the certificate holder and additional insureds fisted. A?i1IW , Eo AS TO FOIE_ AUTHORIZED REPRESENTATIVE: DATE ISSUED: