ROBLES, DENISE 1D - 2011 - Laserfiche WebLink

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EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 63427938967118028'1 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 City Of Santa Ana Apex Insurance Services P. O_ Box 6450 Newport Beach, CA 92658 N- 2007 -05'1 License No: OC 36861 _04 NAMED INSURED (EVENT HOLDER): DenlSe RObleS EVENT INFORMATION: � TYPE: Aerobics 10672 Claussen Street DATE(S): 0'1/03/20'1'1 - 06/30/20'11 Garden Grove. CA 9 ?840 LOCATION: Salgado Community Center *Liquor Liability Yes � No Q * *Li uor Liabili after 12 am ends before 2 am � 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 ail 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: 'I'ISEP�00000'I MASTER POLICY DATES: EFFECTIVE• January 01, 20'1'1 EXPIRATION: January 01, 20'12 COMMERCIAL GENERAL LIABILI'T'Y Grneral Aggregate Limit $ 2,000,000 OCCURRENCE FORM DEDUCTIBLE: NONE Products 8c Completed Operations 1,000,000 Personal 8• Advertising Injury 1,000,000 Each Occurrence Limit 1,000,000 Fire IYemage (Any One Fire) 50,000 Medical Payments (Any One Person) 5,000 Liquor Liability (If purchased) 1,000,000 - The limits of insurance a ly se arately to each event insured by [his olicy as if a s arate policy of insurance has been issued for that event. "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 ownership, maintenance or use of the premises used by the named insured (event holder). This insurance does no[ apply to: Any "occurrence" which takes place after the event holder ceases to be a tenant in that premises. OTHER ADDITIONAL INSUREDS Hortencia Nunez ^.PF'RUV�;I) AS .TO FC_)�::. —�� - t, a u r - -- -- - -- �s,tstant City Actorn�y AN r I ATION� Should the above described policy be cancelled before the expiration date thereof, the issuing company will mail 30 days writtrn notice to the certificate holder and additional insureds listed. �� [.` AUTHORIZED REPRESENTATIVE: DATE ISSUED: