GOMEZ, MAGDA 1B - 2012 - Laserfiche WebLink

Home Browse Search

I EVANSTON INSURANCE COMPANY CERTIFICATE NO-: 2012-17 CERTIFICATE OF INSURAN(, , F 2:3 � 3 AN6 SPECIAL EVENT LIABILITY PRO/�M PRODUCER PUBLIC ENZIbC (ADDITION4L a.N�ljLjj�,D) Alliant Insurance Services, Inc. in conjunction with City of San i�Ana Apex Insurance Services 20 Civic Center Plaza P. O. Box Newport Beach, CA 92658 Santa Ana CA 92701 License No: OC 36861 NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: Magda Gomez TYPE: Active 207 S. Cypress Ave- DATE(S): 01/10/12 —12/31/12 Santa Ana, CA 92701 LOCATION: Memorial Center �^1 Z4t--> *Liquor Liability Yes 0 No CK **Liquor Liabili 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 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: 12SEP1000001 MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2012 EXPIRATION: JANUARY 1, 2013 COMMEB RCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE General Aggregate Limit $ 2,000,000 Products& Completed Operations 1,000,000 i3P P1Zvvl=_.1J Personal & Advertising Injury 1,000,000 Each Occurrence Limit 1,000,000 Fire Damage (Any One Fire) 100,000 Medical Payments (Any One Person) 5,000 --'--"`-'--- "'- LiquorLiability (If purchased) 1,000,000 Optional Limits Purchased $1,000,000/$3,000,000 $2,000,0()0/$2,000,000 lite limits of insurance apply separately to each event insured by this olicy as if a 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 of the 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 after the event holder 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 rovisions. AUTHORIZED REPRESENTATIVE: DATE ISSUED: 01/10/12 by Briza Morales