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ROMO, JOSE L. 5 - 2016
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ROMO, JOSE L. 5 - 2016
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Last modified
5/26/2017 11:34:26 AM
Creation date
4/1/2016 9:33:35 AM
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Contracts
Company Name
ROMO, JOSE L.
Contract #
N-2016-039
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Expiration Date
5/31/2016
Insurance Exp Date
5/1/2016
Destruction Year
2021
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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: - <br />CERTIFICATE OF INSURANCE <br />SPECIAL EVENT LIABILITY PROGRAM <br />Alliant Insurance Services, Inc. in conjunction with <br />Apex Insurance Services <br />P. O. Box 6450 <br />Newport Beach, CA 92658 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />City of Santa Ana <br />P O Box 1988 <br />Santa Ana, CA 927092 <br />INSURED) <br />TYPE: Cinco De Mayo Festival <br />DATE(S): April 29, 30, 2016 and May 1, 2, 2016 <br />LOCATION: Downtown City of Santa Ana <br />*Liquor Liability Yes® No ❑ <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: SEP41020 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2016 EXPIRATION: JANUARY 1, 2017 <br />COMMERCIAL GENERAL LIABILPI'Y <br />OCCURRENCE FORM <br />DEDUCTIBLE: NONE <br />General Aggregate Limit $ 2,000,000 <br />Products & Completed Operations 1,000,000 <br />SPECIAL CONDITIONS: <br />Personal & Advertising Injury 1,000,000 <br />The following 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 />❑ $1,000,00053,000,000 <br />❑ $2,000,0002,000,000 <br />Damage To Property (If purchased) <br />The limits of insurance apply separately to each event insured by this policy as if separate policy of insurance has been issued for that event, <br />OTHER ADDITIONAL INSUREDS <br />Liquor Liability applies on to April 30, 2016 and May 1, <br />Bobby Nava <br />2016 <br />Jose Romo <br />CANCION, Should the above described policy be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy <br />provissions.ions. <br />IGst <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: <br />`J\% -N <br />V� <br />
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