Laserfiche WebLink
IWMN 9 <br />1. ; 0 0 - . <br />CERTIFICATE OF INSURANCE <br />SPECIAL EVENT LIABILITY PROGRAM <br />PRODUCER <br />PUBLIC ENTITY (ADDITIONAL INSURED) <br />. .. ......... <br />Alliant Insurance Services, Inc. in conjunction with <br />. ....... <br />City of Santa Ana <br />Apex Insurance Services <br />P. 0. Box 6450 <br />Newport Beach, CA 92658 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />. . ................. . . . . .......... . ..... <br />EVENT INFORMATION: <br />Laura Ramirez <br />TYPE: BaHet <br />14221 Edward Street, Ap,t. 91 <br />DATE(S): 01/0412012 - 12/1912012 <br />Westminster, CA 92683 <br />LOCATION: Memorial Center <br />C� <br />a c�_,;) <br />*Liquor Liability <br />ty Yes No F1 <br />**Liquor Liabilityafter 12 am ends before 2 am El <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 gnsurance Comipany <br />. .. . . ............. . . . ............ ... . . — <br />MASTER POLICY NUMBER: 12SEP1000001 <br />. ............... ­ <br />MASTER POLICY DATES: EFFECTIVE: January 01, 201:2 EXPIRATION: January 01, 2013 <br />COMMERCIAL GENERAL LIABILITY <br />OCCURRENCE FORM <br />DEDUCTIBLE: NONE <br />General Aggregate Limit $ 2,000,000 <br />Products & Completed Operations 1,000,000 <br />Personal & Advertising Injury 1,000,000 <br />Each Occurrence Limit 1,000,0w <br />Fire Darnage (Any One Fire) 50,000 <br />Medical Payments (Any One person) 5,000 <br />Liquor Liability (If purchased) 1,0D00,000 <br />The limfts of insurance apply separately to each event insured by this policy as if a separate policy of rnsumncc has been issued for that event, <br />"Who is insured" is amended to include, as an insured, the person or organi7ation shown in this schedule, but on9y with respect to liability arising out ofthe <br />ownership, maintenance or we 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 />CAkLCE.1J,A_TJQN,-, Should the above described policy be cancelled before the expiration date thereof, the issuing company will mail 30 days Witten notice to the <br />Lcertificate holder and additional insureds listed. <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: 01103/2012 <br />