ILKCAGLA, FELICE 1H - 2011 - Laserfiche WebLink

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EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 2012-07 CERTIFICATE OF INSURANCE SPECIAL EVENT LIABILITY PROGRAM PRODUCER .. . ..... PUBLIC ENTITY (ADDITIONAL INSURED) . . ..... Alliant Insurance Services, Inc, in conjunction with City of Santa Ana Apex Insurance Services 20 Civic Center Plaza P. 0. Box 6450 Newport Beach, CA 92658 Santa Ana, CA 92701 License No: OC 36861 NAMED INSURED (EVENT HOLDER): . . . . . ............ EVENT INFORMATION: Felice 11kcagla TYPE: Self Improvement 3436 S. Taurus Lane DATE(S).- 01/03/12 —12/31/12 Santa Ana, CA,9270'4 LOCATION: Santiago Lawn Bowling Clubhouse o c'� *Liquor Liaty Yes El No Z "Liquor Liability after era ends before 2 am E] -1. 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 does 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: 12SEPIOOOOOI MASTER POLICY DATES: EFFECTIVE.- JANUARY 1, 2012 EXPIRATION: JANUARY 1, 2013 COMMERCIAL GENERAL LIABIL17FY OCCURRENCE FORM DIEDUCT113LE: NONE General Aggregate Limit $2,000,000 Products & Completed Operations 1,000,000 Personal & Advertismg Injury 1,000,000 Each Occurrence Limit 1,000,000 Fire Damage (Any One Fire) 100,000 Medical Payments (Any One Person) 5,000 Liquor Liability (if purchased) 1,000,000 Optional Limits Purchased $1,000,0001$3,000,0,00 S2,000,00052,000,000 The limits offfisurance apply separately to each event insured by this policy as of separate 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 ofthe ownership, maintenance or use ofthe premises used by the named insured (event hoider). This insurance does not apply to: Any "occurrence" which takes place after the event holder ceases to beta tenant in that premises, OTHER ADDITIONAL INSUREDS CANCELLATIOL4: Should the above described policy be cancelled before the expiration date thereof, notice wall be delivered in accordance v4th the policy provisions, AUTHORIZED REPRESENTATIVE: DATE ISSUED: 01/03:/-j!—b r.z.a Morales y JU ............