Laserfiche WebLink
EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO,: 635745534902216823 <br />CERTIFICATE OF INSURANCE <br />SPECIAL EVENT LIABILITY PROGRAM <br />PRODUCER PUBLIC ENTITY (ADDITIONAL INSURED) <br />Alliant Insurance Services, Inc. in conjunction with City Of Santa Ana <br />Apex Insurance Services <br />P. 0. Sox 6450 <br />Newport Beach, CA 92658 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: <br />Theresa Robertson TYPE: Dance (Various) <br />16889, Nichols Street #D DATE(S): 09/01/2015 - 12/31/2015 <br />Huntington Beach, CA 92647 LOCATION: Southwest Senior Center <br />*Liquor Liability YesC) Noe <br />**Li nor L,iabilit after 12 am ends be#ore 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; IANUARY 1, 2016 <br />COMMERCIAL GENERAL LIABILITY General OCCURRENCE FORM DEDUCTIBLE: NONE <br />Aggregate Limit $ 2,000,000 <br />Products & Completed Operations 1,000,000 SPECIAL CONDITIONS: <br />Personal & Advertising Injury 1,000,000 The following endorsements attached to <br />Each Occurrence Limit 1,000,000 the Master Policy do not apply to this <br />Damage To Premises Rented To You (Any One Premises) 100,000 Certrficate Of Insurance: <br />Medical Payments (Any One Person) 5,000 <br />LIquorLiability (Ilpurchased) 1,000,000 edb <br />Optional Limits Purchased PaV\P,� LI' <br />11 $1,000,000/$3,000,000 Ls <br />El$2,000,000/$2,000,000Property Damage (If purchased) v`aS <br />No Property Damaga Coverage d�\\C\ <br />The limits of irista-mae apply separately t reach event insured by this policy as if a separate policy of ina�u c ras been issued for that event. <br />—4 <br />OTHER ADDITIONAL INSUREDS <br />.0 LA"IIQIy; Should the above described policy be o rmelled before the expiration date thereof, notice will be delivered in accordance with the policy <br />provisions, <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: <br />