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RUFFIN, DON AND ARLENE
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RUFFIN, DON AND ARLENE
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Last modified
4/4/2022 4:06:00 PM
Creation date
6/20/2019 4:29:23 PM
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Contracts
Company Name
RUFFIN, DON AND ARLENE
Contract #
N-2019-108
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Destruction Year
2025
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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 2019-10 <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 Ann <br />Apex Insurance Services <br />20 Civic Center Plaza <br />P. 0. Box 6450 <br />Santa Ann, CA 92701 <br />Newport Beach, CA 92658 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />EVENT INFORMATION: <br />Arlene B. Ruffin <br />TYPE: Tennis <br />28 Grant <br />a © <br />DATE(S): 01/01/2019-12/31/2019 <br />Irvine, CA 92620 <br />LOCATION: Neal Machander Tennis Center, Santn <br />Ana Hiah School <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: SEP41028 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2019 EXPIRATION: JANUARY 1, 2020 <br />COMMERCIAL GENERAL LIABILITY <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 follovnng 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[nsurance: <br />Medical Payments (Any One Parson) 5,000 <br />MEGL641 <br />Liquor Liability (If purchased) 1,000,000 <br />Optional Limits Purchased <br />Q $1,000,00033,000,000 <br />$2,000,000/$2,000,000 <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 insurance has been issued for that event, <br />OTHER ADDITIONAL INSUREDS <br />Don Ruffin <br />'�11 <br />CANCELLATION Should the -above described polic�be_cancelled.befgre_the expirgNottdatethereof, notice will to §' a _.�.SGRa�jdanc�th thgpoli_cy_------ _----- __. <br />rovisions. CCAA <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: December 21 2018 Risk Management FRV <br />
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