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ROMO, JOSE L. 6 - 2016
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ROMO, JOSE L. 6 - 2016
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Last modified
2/14/2018 3:17:34 PM
Creation date
9/1/2016 2:14:59 PM
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Contracts
Company Name
ROMO, JOSE L.
Contract #
N-2016-131
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Expiration Date
9/30/2016
Insurance Exp Date
9/12/2016
Destruction Year
2021
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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 6360-89316060261613 <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 />P. O. Box 6450 <br />Newport Beach, CA 92658 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />EVENT INFORMATION: <br />City of Santa Ana <br />TYPE: Fairs And Festivals <br />20 Civic Center Plaza, M-28 <br />DATE(S): 09109/2016 - 09/12/2016 <br />Santa Ana, CA 92701-1988 <br />LOCATION: Downtown Santa Ana <br />*Liquor Liability YesG) NoC) <br />I "Liquor Liabihty 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 al I 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 01, 2016 EXPIRATION: January 01, 2017 <br />COMMERCIAL GENERAL LIABILITY General <br />OCCUIZRENCE FORM <br />DEDUCTIBLE: NONE <br />Aggregate Limit $2,000,000 <br />Products & Completed Operations 1,000,000 <br />SPECIAL CONDITIONS: <br />Personal & Advertising In3ury 1,000,000 <br />The foHowing endorsements attached to <br />Each Occurrence Limit 1,000,000 <br />the Master Policy do not apply to this <br />Damage To Premises Dented 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 />e <br />F-1 $1,000,00053,000,000 <br />1:1 $2,000,000/$2,000,000 <br />Property Damage (if purchased) <br />011110� <br />No Property Damage Coverage'0 <br />0 °f\ "tom <br />- <br />The limits of insurance apply separately to each event insured by this pohey as if separate policy ofmsurance�lt' $&hTssued for that event. <br />OTHER ADDITIONAL INSUREDS <br />Santa Ana Business Council <br />Jose Manuel <br />Jose Roma <br />Garcia <br />Bobby Nava K- - <br />Raul Martinez yA <br />CANCELLATION- Should the above described policy be cancelled before the expiration date thereof, notice vJ11 be delivered in accordance with the policy <br />provisions. <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: 09/08/2016 <br />
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