ROBLES, DENISE 1A - 2008 - Laserfiche WebLink

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EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 2008-08 CERTIFICATE OF INSURANCE EXCLUDES COVERAGE FOR NOMINEE EVENTS- LIABILITY TE APPLICATIONS FOR NOMINEE EVENTS. SPECIAL EE .. ..nch.rmrr-v iAiairi -T -ir �rvul.irvaurcrir�r n PRODUCER: rin . San City of f Santa Ana Alliant Insurance Servic es, Inc. in conjunction with 20 Civic Center Plaza, M -28 Santa Ana, CA 92701 Apex Insurance Services P. O. Box 6450 Newport Beach, CA 92658 (949) 660 -8135 License No: OC 36861 NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: TYPE: Aerobics Denise Robles D March 2008 — December 2008 12591 Westminster Ave. #212 LOCATION: Center LOCATION: SYes Garden Grove, CA 92843 *Liquor Liability Yes ❑ No [ * *Li uor LiabilitV after 12 am ends before 2 am ❑ This is to certify that the policies of insurance listed below have been issued to the insured named above for the policy period document with respect to which this indicated. Notwithstanding any requirements , terms or conditions of any contact or other be issued or may the insurance afforded by the policies described herein is subject to all the terms, certificate may pertain, exclusions and conditions of such policies. Limits shown may have been reduced by paid claims. INSURANCE CARRIER: Evanston Insurance Company MASTER POLICY NUMBER: 04SEPID000014 MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2008 EXPIRATION: JANUARY 1, 2009 COMMERCIAL GENERAL I.IABILrrY OCCURRENCE FORM DEDUCTIBLE: NONE Gcneral Aggregate Limit $ 2,000,000 1,000,000 Produces & Cornpleted Operations Personal & Advertising Injury 1,000,000 Each Occurrence [.unit 1,000,000 50,000 Fire Damage (Any One Fire) Medical Paymcnts (Any One Person) 5,000 Liquor Liability (If purchased) i'mo,000 The Innits of insurance apply separately to each event insured by this policy es if a separate policy of insurance has been issued for that event "Who is insured" is amended to include, n an insured, the person or organisation shown in this schedule, but only with respect ro liability arising out of the ownership, mauntcnance or use of 0te promises used by the named insured (event holder). This insurance does not apply to: Any "occurrence" which takes place after the event holder ceases to be a tenant in that prorcim. THER ADDITIONAL INSUREDS L LLATION: Should the above described policy to cancelled before the expiration date thereof, the issuing company will mail 30 days written notice m the te holder and additional insureds listed. AUTHORIZED REPRESENTATIVE: DATE ISSUED: 3 L >te_.0