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MARTINEZ, KARINA M. 2 - 2015
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MARTINEZ, KARINA M. 2 - 2015
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Last modified
3/25/2020 11:28:51 AM
Creation date
6/16/2015 2:00:47 PM
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Contracts
Company Name
MARTINEZ, KARINA M.
Contract #
N-2015-101
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Expiration Date
7/1/2017
Insurance Exp Date
12/31/2017
Destruction Year
2022
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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 2015-23 <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 />20 Civic Center Plaza <br />P. 0, Box 6450 <br />Santa Ana, CA 92701 <br />Newport Beach, CA 92658 <br />License Nru OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />EVENT INFORMATION: <br />Karina Morales Martinez <br />TYPE: Ballet <br />9772 Santiago Blvd. <br />DATE(S): 02/18/15 — 12/31/15 <br />Villa Park, CA 92867 <br />LOCATION: Santa Anita Center <br />*Liquor Liability Yes ❑ No <br />- - <br />"Liquor Liability after 12 am ends before 2 am ❑ <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. The insurance described herein is subject to all the terms, exclusions and conditions of such policy(ies) unless <br />amended as described in Special Conditions. <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: SEP41017 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2015 EXPIRATION: JANUARY 1, 2016 <br />COMMERCIAL GENERAL LIABILITY <br />OCCURRENCE FORM <br />DEDUCTIBLE: NONE <br />General Aggregate Limit $ 2,000,000 <br />Products at Completed Operations 1,000,000 <br />SPECIAL CONDITIONS: <br />Personal & Advertising Injury 1,000,000 <br />The tollowing endorsements attached to <br />Each Occurrence Limit 1,000,000 <br />the Master Policy do not apply to this <br />Damage To Premises Rented To You (Any One Premises) 100,000 <br />Certificate Of Insurance: <br />Medical Payments (Any One Person) 5,000 <br />Liquor Liability (If purchased) 1,000,000 <br />Optional Limits Purchased <br />0 $1,000,00053,000,000 <br />❑ $2,000,00032,000,000 <br />Damage To Property (It purchased) <br />The limits of insurance apply separately to each event insured by this policy as us separate policy of insurance has been issued for that event. <br />OTHER ADDITIONAL INSUREDS <br />CANCELLATIOM Should the above described policy be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy <br />provisions. <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: <br />b, ' <br />Cuevas <br />p 'GSN A <br />
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