ROBLES, DENISE 1B - 2009 - Laserfiche WebLink

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EVANSTON INSURANCE COMPANY CERTIFICATE NO_: 2010 -014 � - �O o 7 -O3 i -C�3 CERTIFICATE OF INSURANCE EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. SPECIAL EVENT LIABILITY PROGRAM PRODUCER PUBLIC ENTITY (ADDITIONAL INSURED) Alliant Insurance Services, Inc. in conjunction with Clty of Santa Ana Apez Insurance Services 20 Civic Center Plaza P. O. Box G450 Santa Ana, CA 92701 Newport Beach, CA 92658 License No: OC 368G1 NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: Denise Robles TYPE: Aerobics 10672 Claussen Street DATE(S): February 2010 — December 2010 Garden Grove, CA 92840 LOCATION: Salado Center •Liquor Liability Yes Q No •�Li uor Liabilit after 12 am ends before 2 am Q 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: 1 OSEP1000001 MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2010 EXPIRATION: JANUARY 1, 201 I C'OMMERCIA I_ GENERAL LIAL3ILITY OCCURRENCE FORM DEDUCTIBLE: NONE Generel Aggregntc Limit E 2,000,000 Products 8e Completed Operations 1.000,000 Personal � Advertising Injury 1,000,000 L-ach Occurrence Limit 1,000,000 Fire Damage (Any One Fire) SO,000 Medical Payments (Any One Person) 5,000 Liquor Liability (lf purchased) 1.000.000 The limits of irnuraneo apply separately to each event insured by this policy as if a separate policy of insurance has been issued for that event. "Who i5 insured" is amrnded to include, as an insured, the person or organi]alion shown in this schedule, but only ,vith respect to liability arising oui of the ownership, maintenance or use ofthe premises used by the named insured (event holder). This insurance does rtot apply to: Any "occurrence" which lakes place after the event holder erases 10 be a tenant in that premises - OTHER ADDITIONAL INSUREDS Hortencia Nunez LANCE ATION- Should the above described policy be cancelled Ix fore the expiration date thereof, the issuing company will mail 30 days a.rinen notice to the certificate holder and additional insureds listed. AUTHORIZED REPRESENTATIVE: �� 'C DATE ISSUED: February 8. 2010 BriTa Morales