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MONTELONE, SUE 1 - 2009
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MONTELONE, SUE 1 - 2009
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Last modified
10/21/2013 11:32:15 AM
Creation date
9/29/2009 9:22:21 AM
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Contracts
Company Name
MONTELONE, SUE
Contract #
N-2009-108
Agency
COMMUNITY DEVELOPMENT
Expiration Date
6/30/2010
Insurance Exp Date
1/1/2011
Destruction Year
2015
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f? - 2C?C?G -1 O <br />EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.e 2010-056 <br />CERTIFICATE OF INSURANCE 1? ?,?p?? ? ? ?.3 <br />EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APP A `YI''bb FO NOMINEE EVENTS. <br />SPECIAL EVENT LIABILITY PROGRAM .._rA ANA <br />CITY G'i -_- <br />PRODUCER PUBLIC ENTITY AL'-1 <br />Alliant Insurance Services, Inc. in conjunction with City of Santa Ana <br />Apex Insurance Services 20 Civic Center Plaza <br />P. O. Box 6450 Santa Ana, CA 92701 <br />Newport Beach, CA 92658 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: <br />Sue Montelone TYPE: Resume WorKshoa/Self Improvement <br />19918 Paseo Lorenzo DATE(S): September 15, 2010 -December 31.2010 <br />Yorba Linda, CA 92886 LOCATION: WorK Center <br /> *Liquor Liability Yes ? No <br /> **Li uor Liabili after 12 am ends before 2 am <br />This is to certify 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: lOSEP1000001 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2010 EXPIRATION: JANUARY 1, 2011 <br />COMMERCIAL GENERAL LIABILITY -OCCURRENCE FORM DEDUCTIBLE:NONE <br />General Aggregate Limit $ 2,000,000 <br />Products 8c Completed Operations 1,000,000 <br />Personal Rc Advertising Injury 1,000,000 <br />Each Occurrence Limit 1,000,000 <br />Fire Damage (Any,One Fire) 50,000 <br />Medical Payments (Any One Person) 5,000 <br />Liquor Liability (If purchased) 1,000,000 <br />The 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. <br />"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 <br />ownership, maintenance or use of the premises used by the named insured (event holder). This insurance does not apply to: Any "occurrence" which takes place <br />after the event holder ceases to be a tenant in that premises. <br />OTHER ADDITIONAL INSUREDS <br /> <br />CANCELLATION: Should the above described policy be cancelled before the expiration date thereof, the issuing company will mail 30 days written notice to the <br />certificate holder and additional insureds listed. <br />AUTHORIZED REPRESENTATIVE: ?? ? ??? <br />DATE ISSUED: September 15, 2010 by Briza Morales _..?nAV£D ?'? ?®_?? M <br />Assistant City
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