HomeMy WebLinkAboutBillmeyer, Donna; 2022-02-08;EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 2022-283 CERTIFICATE OF INSURANCE SPECIAL EVENT LIABILITY PROGRAM
PRODUCER PUBLIC ENTITY (ADDITIONAL INSURED)
Alliant Insurance Services, Inc. in conjunction with Apex Insurance Services P. O. Box 6450 Newport Beach, CA 92658 License No: OC 36861
City of Carlsbad 1200 Carlsbad Village Dr. Carlsbad, CA 92024
NAMED INSURED (EVENT HOLDER): Donna Billmeyer - Instructor 1566 Maritime Drive Carlsbad, CA 92011
EVENT INFORMATION: TYPE: I DATE(S): 01/01/2022 – 01/01/2023 LOCATION: Carlsbad Senior Center *Liquor Liability Yes No **Liquor Liability after 12 am ends before 2 am
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. The insurance described herein is subject to all the terms, exclusions and conditions of such policy(ies) unless amended as described in Special Conditions. INSURANCE CARRIER: Evanston Insurance Company
MASTER POLICY NUMBER MKLV7PBC000935
MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2022 EXPIRATION: JANUARY 1, 2023
COMMERCIAL GENERAL LIABILITY General Aggregate Limit Products & Completed Operations Personal & Advertising Injury Each Occurrence Limit Damage To Premises Rented To You (Any One Premises) Medical Payments (Any One Person) Liquor Liability (If purchased) Optional Limits Purchased $1,000,000/$3,000,000 $2,000,000/$2,000,000 Damage To Property (If purchased)
$ 2,000,000 1,000,000 1,000,000 1,000,000 100,000 5,000 1,000,000
OCCURRENCE FORM
DEDUCTIBLE: NONE SPECIAL CONDITIONS: The following endorsements attached to the Master Policy do not apply to this Certificate Of Insurance: MEGL643
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.
OTHER ADDITIONAL INSUREDS
CANCELLATION: Should the above described policy be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions.
AUTHORIZED REPRESENTATIVE: DATE ISSUED: 12/10/2022