Laserfiche WebLink
EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 2017-33 <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 Ana <br />Apex Insurance Services <br />20 Civic Center Plaza <br />P. O. Box 6450 <br />Santa Ana, CA 92701 <br />1 <br />Newport Beach, CA 92658 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />EVENT INFORMATION: <br />Salamon Rivera <br />TYPE: Dance (Various) <br />709 S Parton St. <br />DATE(S): 2/27/17 — 12/31/17 <br />Santa Ana, CA 92701 <br />LOCATION: Southwest Senior Center <br />*Liquor Liability Yes El No <br />"Liquor Liability after 12 am ends before 2 amE] <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(ics) unless <br />amended as described in Special Conditions. <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: SEP41023 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2017 EXPIRATION: JANUARY 1, 2018 <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 />SPE( ' 'lAl, CONDITIONS: <br />Personal & Advertising Injury 1,000,000 <br />The following endorsements attached to <br />Each Occurrence Limit l'oo0,000 <br />the Master Policy do not apply to dais <br />Damage'To Premises Rented To You (Any One Premises) 100,000 <br />Certificate 01'Insurance: <br />Medical Payments (Any One Person) 5,000 <br />Liquor Liability (If purchased) 1 '000,000 <br />Optional Limits Purchased <br />bY'. <br />F-1 $1,000,0001$3,000,000 <br />Re'JleNN <br />d <br />[] $2,000,000/$2,000,000 <br />' <br />Damage To Property (If purchased) <br />well� <br />Av <br />w. <br />up,\Ja <br />The limits of'insurance apply separately to each event insured by this policy as ifa paratep0liCy0finSUranoRgs Aa TA, evern. <br />OTHER ADDITIONAL INSUREDS <br />CANCELLATION: Should the above described policy be cancelled before the expiration date thereof', notice will be delivered in accordance with the policy <br />provisions. <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: February 27, 2017 By Stella Fajardo <br />