VALENCIA, GERALDINE 1C - 2007 - Laserfiche WebLink

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EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 2011-11 CERTIFICATE OF INSU NgXN2U PM 3' COVERAGE EXCLUDED FOR NOMINEE EVENTS SEE SEPAR E APPLICATIONS SPECIAL EVENT LIABILIT6r""AM -- O4 FOR NOMINEE EVENTS. P,NA ,—it PRODUCERPUBLI I '1' (ADD7 I NAL INSURED) Alliant Insurance Services, Inc. in conjunction with City of Santa Ana Apex Insurance Services 20 Civic Center Plaza P. O. Box 6450 Santa Ana, CA 92701 Newport Beach, CA 92658 License No: OC 36861 NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: Geraldine Valencia TYPE: Gvmnastics 13100 Chapman Ave., Apt. 3-108 DATE(S): 01/19/11 — 12/31/11 Garden Grove, CA 92840 LOCATION: Jerome Center 1V c7 *Liquor Liability Yes 0 No **Liquor Liability after 12 am ends before 2 am This is to certify that the insurance policy listed below has been issued to the above insured named (event holder) for the policy period indicated. This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate docs not affirmatively or negatively amend, extend or alter the coverage afforded by the policy listed and it does not constitute a contract between the insurance carrier, authorized representative, producer and certificate holder. The insurance described herein is subject to all the terms, exclusions and conditions of such policy(ies). INSURANCE CARRIER: Evanston Insurance Company MASTER POLICY NUMBER: 11SEP1000001 MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2011 EXPIRATION: JANUARY 1, 2012 COMMERCIAL (IENERAI. I-IA1311-11Y OCCURRENCE FORM DEDUCT 1131E: NONE General Aggregate Limit $ 2,000,000 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 Liquor Liability (If purchased) 1,000.000 The limits of insurance apply separately to each event insured by this policy as ira separate policy of insurance has been issued for that event. "Who is ins—ed" is amended to include, as an insured, the person or orgam,aiion shown in this schedule, but only with respect to liability arising out ofthe ownership, maintenance or use or the premises used by the named insured (event holder)_ This insurance does not apply to Any "occurrence" which takes place alter the event hold,, ceases to be a tenant in that premises. OTHER ADDITIONAL INSUREDS CANCELLATION- Should the above described policy be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions. F_very effort will be made to deliver 30 days written notice to the certificate holder and additional insu,ed(s) listed. AUTHORIZED REPRESENTATIVE: DATE ISSUED: January 19, 201 1 by Briza Morales