Laserfiche WebLink
EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 2017-07 <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. O. Box 6450 <br />Santa Ana, CA 92701 <br />Newport Beach, CA 92658 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />EVENT INFORMATION: <br />Maria Del Carmen Bustos Gutierrez <br />TYPE: Zumba <br />1222 S Ross St. <br />DATE(S): 1/01/17-12/31/17 <br />Santa Ana, CA 92707 <br />LOCATION: Memorial Center & S/W Senior Center <br />�� <br />*Liquor Liability Yes ❑ No Z <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: SEP41023 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2017 EXPIRATION: JAN'UARY 1, 2018 <br />COMMERCIAL GENERAL LIABILITY <br />OCClnRRENCE 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) 1.00,000 <br />Certificate Of lnsurancc: <br />Medical Payments (Any One Person) 5,000 <br />Liquor 1.aiability (If purchased) 1,000,000 <br />Optional Limits Put -chased <br />, `w <br />❑ $1,000,000/$3,000,000 <br />[:1$2,000,00052,000,000 <br />V <br />Damage To Property (If purchased) <br />The limits Of insurance apply separately to each event insured by this policy as if a separate policy of insura , as bee �ssu e 'enL <br />OTHER ADDITIONAL INSUREDS t ,e <br />CANCELLATION: 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: December 20 2016 by Stella Fajardo <br />