VALENCIA, GERALDINE - 2013 - Laserfiche WebLink

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EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 2014-15 CERTIFICATE OF INSURANCE SPECIAL EVENT LIABILITY PROGRAM PRODUCER PUBLIC ENTITY (ADDITIONAL INSURED) Alllant Insurance services, Inc. in conjunction with City of Santa Ana Apex Insurance Services 20 Civic Center Plaza P, 0. Box 6450 Santa Ana, CA 92701. Newport Beach, CA 92658 License No: OC 36861 NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: Geraldine Valencia TYPE: Gymnastics 3939 W. EI Prado Ave„ Apt. D DATE(S): 01/07/14 —12131/14 Orange, CA 92868 LOCATION: Jerome Center *Liquor Liability Yes ❑ No **Liquor Liability aier 12 am ends before 2 ant This is to certify that the insurance policy listed below has been issued to the above insured named (event holder) for the policy period indicated. This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not affirmatively or negatively amend, extend or alter the coverage afforded by the policy listed and it does not .constitute a contract between theinsurance carrier, authorized representative, producer and certificate holder. The insurance described herein is subject to all the terms, exclusions and conditions of such policy(ies). INSURANCE CARRIE& Evanston Insurance Company MASTER POLICY NUMBER: SEP41014 MASTER POLICY DATES: EFFECTIVE: JANUARY I, 2014 EXPIRATION: JANUARY 1, 2015 COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE.: NONE. General Aggregate Limit $ 2,000,000 Products & Comphsad Operations 1,000,000 Personale& Advertising Injury 1,000;000 Each Occurrence Limit 1,000,000 Fire Damage (Any One Fire) 100;000 Medical Payments (Any One Person) 5,000 Liquor Liability, (If purchased) 1,000,000 Optional Limits. Purchased. 11 $1100010001$3;000,000 ❑ $2,000000/S2,000,000 PropertyDamage (If purchased) 0 Limit $90,000 Deductible $500 El Limit $100,000 Deductible $1,000 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, "Wird is insured" is amended to include, as an insured, the.person 0e organraation shown in this schedule,. but onlywith respect to liability arising on, ofthe ownership, maintenance. or use of the premises used by the named. insured (event. holder) This insurance does not apply to: Any "occurrence" whichtakesplace atter the event holder ceases to be a tenant m that premises. OTHER ADDITIONAL INSUREDS CANCELLMIQNt Should the above described policy bescancelled behave. the expiration date thereof, notice will be delivered in accordance with the policy. revisions. /^7 y, . Cr AUTHORIZED REPRESENTATIVE: DATE ISSUED; January 7 2014 by Briza Morales