SEHUAME, RUDY R. 1d - Laserfiche WebLink

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I VANSTON INSURANCE COMPANY t: ERTIFICATE NO.: 2009 -09 CERTIFICATE OF INSURANCE EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. SPECIAL EVENT LIABILITY PROGRAM PRODUCER: PUBLIC ENTITY (ADDITIONAL INSURED) City of Santa Ana Thant Insurance Services, Inc. in conjunction with 20 Civic Center Plaza ^• pex Insurance Services Santa Ana, CA 92701 1`_ 0. Box 6450 1, ewpon Beach, UA 92658 •1491 660-8135 to --nse No: OC 36861 \`ANIED INSURED (EVENT HOLDER): EVENT INFORMATION: R.udv Seltuame TYPE: Karate Class .1424 1V. First Street, Space 133 DATE(S): Jan. 12 - Dec. 31 Santa Ana, CA 92703 LOCATION: Santa Anita Park *Liquor Liability Yes ❑ No W "Liquor Liability after 12 am ends before 2 am ❑ I'his is to certify that the policies of insurance listed below have been issued to the insured named above for the policy period nd cated. Notwithstanding any requirements, terms or conditions of any contract or other document with respect to which this c.rtificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, �: xclusions and conditions of such policies. Limits shown may have been reduced by paid claims. IN'SURANCF. CARRIER: Evanston Insurance Company NIASTER POLICY NUMBER: 04SEP1000001 -5 >1ASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2009 EXPIRATION: JANUARY 1, 2010 OMIvtERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE i eneral Aggregate Limit $ 2,000,000 ?roclucts & Completed Operations 1,000,000 °ersonal & Advertising Injury 1,000,000 Ciach Occurrence Limit 1,000,000 Fire Damage (Any One Fire) 50,000 Vecical Payments (Any One Person) 5,000 Liquor Liability (If purchased) 1,000,000 ] he limits of insurance apply separately to each event insured by this policy as if a separate policy of insurance has been issued for that event. I 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 w iership, maintenance or use of the premises used by the named insured (event holder). This insurance does not apply to: Any "occurrence" which takes place a fter the event holder ceases to be a tenant in that premises. OTHER ADDITIONAL INSUREDS u AW 1,-1.f.ATION: Should the above described policy to cancelled before the expiration date thereof, the issuing company will mail 30 days written notice to the c _rt:flcate holder and additional insureds listed. ,( TfiOKILND REPRESENTATIVE: 1).',Tt. ISSUED