ZAPATA, MICHAEL 1 -2013 - Laserfiche WebLink

Home Browse Search

EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 2013-41 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. Box 6450 Santa Ana, CA 92701 Newport Beach, CA 92658 License No: OC 36861 NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: Michael Zapata TYPE: Martial Arm 2130 S. Lewis Street DATE(S): 08114/13-12/31/13 Anaheim, CA 92802 LOCATION: Santa Anita Center *Liquor Liability Yes ❑ No El *'*Li uor Liability 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 poticy(ies). INSURANCE CARRIER: Evanston Insurance Company MASTER POLICY NUMBER: SEP41011 MASTER POLICY DATES: EFFECTIVE: JANUARY 1,2013 EXPIRATION: JANUARY 1,20t4 COMMERCIAL GENERAL LIABILITY OCCURRENCE FOWA DEDUCTMLE: NONE General Aggregate Limit. $ 2,000,000 Products& Completed Operations 1,000,000 Personal & Advertising thinly-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 ❑ $1,000,00053,000,000 ❑ S2,000 00012,000,000 Tic limits of insurance apply separately to each eventinsured by this policy as if a separate policy of insurance has been issued ler that event. "Who is insured" is amended to include, as an insured, the Peron or organization shown in this schedule, but only with respect to liability arising out of file ownership, maintenance or use of the promises used by the named insured (event holder). 'this insurance does not apply to: Any "occurrence" which takes place after the event holder ceases to be a tenant in that premises. OTHER ADDITIONAL INSUREDS — Geraldine Val.enaia CANCELLATION, Should the above described policy be cancelled before the expiration date thereat. notice will be delivered in accordance with the policy provisions, a'a ..p., AUTHORIZED REPRESENTATIVE: DATE ISSUED: Au ua st14,2013b BtizaMorales Revised 9/3/13 to add additional insured. B.M. APPROVED AS TO FORM LISA E. STORCK — +$ ,Assistant City Attorney /jt