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OSEGUERA, DESIREE - 2017
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OSEGUERA, DESIREE - 2017
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Last modified
7/8/2020 11:11:39 AM
Creation date
10/24/2017 3:45:14 PM
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Contracts
Company Name
OSEGUERA, DESIREE
Contract #
N-2017-218
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Expiration Date
9/30/2018
Insurance Exp Date
12/31/2018
Destruction Year
2023
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EVANSTON INSURANCE COMPANY <br />CERTIFICATENO.: 2017-40 <br />CERTIFICATE OF INSURANCE <br />SPECIAL EVENT LIABtu'ry PROGRAM <br />PRODUCER <br />PUBLICENTIT-Y (ADDITIONAL INSURED) <br />Inc. invanjunction,wrth <br />City ufSautaAna <br />Apex ,litsuranate.Seyvices., <br />20,0vir Center Plaza <br />P.;0. 113ex £x450 <br />Santa Ann, CA 92701 <br />Newport Beach, CA YZ455,8 <br />UieQnse No:,0C 3,6861 <br />NAMED INSURED (EV ENT ,H('YuDER): <br />EVENT INFORMATION: <br />Desinve0scguera <br />TYPE: Martin] Arts <br />1613E.Anbutus,St. <br />DATE(S): Novetaber'.01, 2`047— December 31JI17 <br />Anaheim, CA 92805 <br />LOCATION: Garfield Center <br />Liquor Liability YesEl No! <br />**LigLIT)TLiabilityafter [2amoTtdstbefom2ani ,[:] <br />This .is to certify.dratho intsuranac pedicy listed below has boemissudlo theAbove.itisured namadji(c.vortzholder) -far the policy <br />poriodindicated. Tfreinsivance describod,hlimbi .is sujectlo all the terrrrs,,"dus%ccrusand cendiiit)ns,cg:s.uchpollcy(iius),,unlcig <br />amended as described in Speridl,'Cwiditiartg. <br />INSURANCE CARRIER : E-vanstcalinsuranceCon1parry <br />NIAS.TF,,RPGL,I,,CYINUILVIBER: SEP41023 <br />AIAST fR POLICY -MTF S: EFFECTIVE: JANUARY' 1, 2017 IEXPIRAT.ION. JANUARY 1, 20.18 <br />Y <br />OCCURRENCE FORM <br />DED.UlCTBLE: NONE <br />$210001DOO, <br />1,00MOO <br />SPECIAL COKRITIOVS. <br />Personni & Advanism9dogury 11000.000 <br />'fhc following vidorsenctits attaofid to <br />12101,0=11jrrwoc Uimit I M)0.0110 <br />the Nlxswr[Poflcy.do not apply rto this <br />Amidge l© Piccriiis Rontud ToYmi(AxpOiteftnusos) x100;000 <br />Curtificsic OFIEsumacc: <br />fvjudnafl NTYIIAOIJESI(Any�DIse F!23on) 5;000 <br />Uquor'Liabkfity (Ifpurclhased) 1000x00 <br />Optional LiwitsPumhasad <br />Damage To Property (If purchased) <br />7he insumd hY this pulley as it asuparatepplizy afinsuat=cbas bounjissutsdiforthatewnt <br />'OTHE R ADDIII-ONAL INSURERS <br />C:A ENMA 5 ,Palicy be,cmuolled ireare the expiratiou data 1hLrear, notiocWill be del mortodinac 1 6 policy <br />provisivils. <br />wqo- VO <br />00�ki <br />C 3� <br />AUTHORIZED RE ARF SENTATI V E: <br />BATE ISSUED: Oclober 23, 20;17 by Stellafaiardo <br />
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