WILSON, LORA 1B-2011 - Laserfiche WebLink

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EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 2012 -21 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. O. sox 6aso p�- 2011 - 021 -002 Santa Ana, CA 92701 Newport Beach, CA 92658 License No: OC 36561 NAMED INSURED (EVENT HOLDER): - EVENT INFORMATION: Lora Wilson TYPE: Dance (Variousl 1918 E. 19`h Street DATE(S): 02/16/12 — 12/31/12 Santa Ana, CA 92703 N -201 1- 021 LOCATION: Jerome Center -001 •Liquor Liability Yes � No '�Li uor 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 certiFcate 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 COMMERCIAL GENERAL LL4B[L77'Y OCCURRENCE FORM DEDUCTIBLE: NONE General Aggregate Limit $ 2,000,000 Products � Completed Operations 1,000,000 _ Personal � Advertising Injury 1,000,000 , •la p... . 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 51,000,000/53,000,000 I:� \' ' � i :: � [ � 52,000,000/52,000,000 The limits of insurance apply separately to each evrnt insured by [his policy 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 organim[ion shown in [his schedule, but only with respect to liability arising out of [he ownership, maintenance or use of the premises used by the named insured (even[ 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 CANCELLATION- Should the above described policy be cancelled before [he expiration date [hereof, notice will be delivered in amordance with the policy rovisions. /..�.�r _ Q -CGS._ AUTHORIZED REPRESENTATIVE: DATE ISSUED: 02/16/12 by Briza Morales