Laserfiche WebLink
EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 2017-20 <br />CERTIFICATE OF INSURANCE <br />SPECIAL EVENT LIABILITY PROGRAM <br />rPRODUCER <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. O. Box 6450 <br />Santa Ana, CA 92701 <br />Newport Beach, CA 92658 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: <br />Sonia Miskulin- Academy of International Dance TYPE: Dance <br />2025 S Main St. DATE(S): 1/11/17 - 12/31/17 <br />Santa Ana, CA 92707 LOCATION: Jerome, Salgado & El Salvador Center <br />I �') C*Liquor Liability Yes [-] No <br />\H <br />j -- 1-*- � � (t, - \ **Liquor <br />. Liability after 12 am ends before 2 amE:1 <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 ofsuch policy(ies) unless <br />amended as described in Special Conditions, <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: SEP41023 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2017 EXPIRATION: JANUARY 1, 2018 <br />COMMERCIAL GENERAL UABILITY <br />OCCURRENCE FORM <br />DEDUCTIBLE: NONE <br />I General Aggregate Linut S2,000,000 <br />Product,, & Completed Operations 1,000,000 <br />SPECIAL, CONDITIONS; <br />Personal & Advertising Injury 1,000,000 <br />The following endorsements attached to <br />Hach Occurrence I Arnit 1,000,00o <br />the Master policy do not: apply to this <br />Damage To Premises Rented ToYou (Any Oue Premises) 100,000 <br />Certificate Of Insurance: <br />Medical Payments (Any One Person) 51000 <br />Liquor Liability (If purchased) 1,000,000 <br />Optional Limits Purchased <br />M SI,000,000/$3,000,000 <br />El 52,0,00,000/$2,000,000 <br />Damage To Property (If purchased) <br />........... <br />The limits of insurance apply separately to each event insured by this policy as if a separate <br />policy of insurance has been issued <br />for that event. <br />OTHER ADDITIONAL INSUREDS <br />CANCELLATION: Should the above described policy be cancelled before the expiration date thereof, notice will be delivered'' NS0Z+ wit he policy <br />provisions." gE�Ite � 2. <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: January 5, 2017 by Stella Fajardo <br />