Laserfiche WebLink
EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 2012-16 <br />CERTIFICATE OF INSURANCE <br />SPECIAL EVENT LIABILITY PROGRAM <br />PRODUCER <br />PUBLIC ENTITY (ADDITIONAL INSURED) <br />Alliant Insurance Services, Inc. in conjunction with <br />City of Santa Ana <br />Apex Insurance Services <br />Civic Center Plaza <br />P. O. Box <br />Newport Beach, CA 92658 <br />Beach, <br />S20 <br />Santa Ana , CA 92701 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />EVENT INFORMATION: <br />Maria Vigil <br />TYPE: Zumba <br />308 Columbia Street <br />DATE(S): 01/05/12 —12/31/12 <br />Newport Beach, CA 92663 <br />LOCATION: Jerome Center <br />1 �7� _ ,1 <br />** Liquor Liability Yes 0 K-023 <br />**Liquor <br />Liability after 12 am ends before 2 am 0 <br />This is to certify that the insurance policy listed below has been issued to the above insured named (event holder) for the policy <br />period indicated. This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This <br />certificate does not affirmatively or negatively amend, extend or alter the coverage afforded by the policy listed and it does not <br />constitute a contract between the insurance carrier, authorized representative, producer and certificate holder. The insurance <br />described herein is subject to all the terms, exclusions and conditions of such policy(ies). <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: 12SEP1000001 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2012 EXPIRATION: JANUARY 1, 2013 <br />COMMERCIAL GENERAL LIABIL= <br />OCCURRENCE FORM DEDUCTIBLE: NONE <br />General Aggregate Limit S2,000,000 <br />Products &: Completed Operations 1,000,000 <br />Personal & Advertising Injury 1,000,000 <br />Each Occurrence Limit 1,000,000 <br />Fire Damage (Any One Fire) 100,000 <br />Medical Payments (Any One Person) 5,000 <br />Liquor Liability (If purchased) 1,000,000 <br />Laura tir:tt Sneed <br />Optional Limits Purchased <br />$1,000,000/$3,000,000 <br />E] $1,000,000/$3,000,000 <br />y <br />0 $2,000,000/$2,000,000 <br />The limits of insurance apply separately to each event insured by this policy as if a separate policy of insurance has been issued for that event. <br />"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 <br />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 <br />after the event holder ceases to be a tenant in that premises. <br />OTHER ADDITIONAL INSUREDS <br />CANCELLATION, Should the above described policy be cancelled before the expiration date thereof, notice will be delivered in accordance with the <br />policy <br />provisions - <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: 01/05/12 by Briza Morales <br />