Laserfiche WebLink
Page I of Certificate o .Insur'ance <br />Special Events <br />Name Insured: Named Additional Insured: <br />Yvette Isabel Ramirez SANTA ANA CITY OF -INDEPENDENT CITIES <br />717 North Nancita Street RISK MANAGEMENT (SPECIAL EVENT) <br />Anaheim, CA 92801 20 Civic Center Plaza M-28 <br />SANTA ANA, CA 92701 <br />Certificate Term 9/2/2019 to 10/31/2019 Certificate # COSA18-0009 <br />Coverage CITY OF SANTA ANA Special Event Policy Company: New Hampshire Insurance Company <br />Commercial General Liability Per Master Policy4 010-624315 <br />Master Policy Effective Date:1 I/I/2018 to expiration <br />Limits $2,000,000 General Aggregate / $1,000,000 Each Occurrence / $1,000,000 Products & Completed operations / <br />$1,000,000 Personal & Advertising Injury/$300,000 Damage to Rented Premises/ Medical Payments Excluded <br />Deductibles <br />$50,00 Premium (Fully Earned) <br />$0.00 Taxes (Fully Earned) <br />$40.00 Certificate Fee (Fully Earned) <br />REVIEWED & APPROVED <br />TRIA By Risk MANAGEMENT DIVISION <br />$90.00 Total Amount �VILLAREAL <br />Terms & I Premium and All fees are fully earned. No Cancellations Allowed. Conditions 2. Hazard Class: l 711 <br />FRANCINE R. <br />3. Event Location: El Salvador Community Center <br />4. Event Description: Instructor- Tiny Tots <br />5. Total Attendance: 3 Vendors: None <br />6. Attachments: Limited Contractual Endt., Designated Premises, Classification Limitation Endt. <br />7. Event Date: 9/2/2019 to 10/31/2019 <br />8. NO LIQUOR LIABILITY COVERAGE PROVIDED. <br />9. THIS POLICY DOES NOT PROVIDE COVERAGE FOR BODILY INJURY TO PERFORMERS OR <br />PARTICIPANTS AS A RESULT OF THEIR PARTICIPATION. <br />Department Parks, Recreation and Community Services <br />Exclusions Assault & Battery; Total Pollution; Asbestos; Lead Contamination; Animals; Nuclear; Employment Related <br />Practices; Liquor Liability; Cross Suits; Independent Contractors; Communicable Disease; Subsidence; Non- <br />Owned/Hired Auto; New Entities; Unscheduled activities or Events; Athletic Participants; Fireworks and Explosives; <br />Punitive Damages; Professional Liability; Voluntary Labor (For a complete list of the forms, conditions and <br />exclusions of the policy, refer to Master Policy.) <br />The insurance afforded under the specified policy above is subject to all terms, conditions, and exclusions of such <br />policy. (A copy of the policy is available upon written request.) This coverage applies only to the contractor or event <br />noted above and does not extend to any other activities or work performed by the holder. <br />MERRIWETHER & WILLIAMS INSURANCE SERVICES, Inc. should be notified at once of any claim arising <br />from your operation. Call 1-800-420-0555 and a claims representative will assist you in the reporting process. <br />Coverage is primary and not contributing with any insurance maintained by the above public entitiy. The limits of <br />insurance apply to each event. If more than one named insured for any one event it will not increase the total limits <br />of liability available for that event. <br />550 Montgomery St., Suite 550 San Francisco, CA 94111 800.420,0555 415.986.3999 fax 415,986,4421 License# 0001378 <br />www,imwis.com <br />