HARVEY, WILLIAM C. 1-2006 - Laserfiche WebLink

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I ;r/h~ ;&~.t m~l ' L,iJ-< rd'u EVANSTON INSURANCE COMPANY CERTIFICATE NO.: CERTIFICATE OF INSURANCE EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. SPECIAL EVENT LIABILITY PROGRAM PRODUCER: PUBLIC ENTITY (ADDfrrONAL INSURED) City of Santa Ana, California Driver A1liant Insurance Services in conjunction with 20 Civic Center Plaza, P.O. Ball: 1988 Apex Insurance Services M-28 P. O. Box 28323 Santa Ana, CA 92702 Santa Ana, CA 92799-8323 (949) 660-8163 License No: OC 36861 NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: William C. Harvey dba Language Services Institute TYPE: Cultural Diversity Traininl! 2905 Palau PI., P.O. Box 3402 DATE(S): 4 session between 3/6/06 & 6130/06 Costa Mesa, CA 92628-3402 LOCATION: Santa Alia Police Admin. & Holdinl! Facility This is to certify that the policies of insurance listed below have been issued to the insured named above for the policy period . indicated. Notwithstanding any requirements, tenns or conditions of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to a\1 the terms, exclusions and conditions of such policies. Limits shown may have been reduced by paid claims. INSURANCE CARRIER: Evanston Insurance Company ,MASTERPOLlCY NUMBER: 04SEP1000001 MASTER POLlCY DATES: EFFECTIVE: JANUARY I, 2006 EXPIRATION: JANUARY I, 2007 COMMERCIAL GENERAL LIABILITV OCCURRENCE FORM DEDUCTIBLR NONE General Aggregate Limit $ 2,000,000 Products & Completed Operations 1,000,000 Personal & Advertising Injury 1,000,000 Each Occurrence Limit 1,000,000 Fire Damage (Any One Fire) 50,000 Medical Payments (Any One Person) 5,000 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. "Who is insured" is amended to include, as an insured, the person or organization ShOWTI in this schedule, but only with respect to liability arising out of the ownership, maintenance or use of the premises used by the named insured (event holder), This insurance does not apply to: Any "occurrence" which takes place after the event holder ceases to be a tenant in that premises. OTHER ADDITIONAL INSUREDS ,.q-, , CANCELLATION: Should the above described poli,~v fo p.lmf',....11prllw_forp t},,,,, p.-~nil':'ltinn l1::tte thereof, the issuing company will mail 30 days written notice to the certificate holder and additional insureds listed. / ~ ~ AUTHORIZED REPRESENTATIVE: ./" ,:/ .7' --\,1- ". /./-/ ---'_~_:_" i 1/,--- /