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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: <br /> <br /> CERTIFICATE OF INSURANCE <br />EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. <br />SPECIAL EVENT LIABILITY PROGRAM <br /> <br />PRODUCER: PUBLIC ENIIrY (ADDITIONAL 1NSUR~D) <br />DfiverAlliant Insurance Services City of Santa Ana <br />P.O. Box28323 20 Civic Center Plaza, M-28 <br />SantaAna, CA 92799-8323 P,O. Box 1988 <br />(949)660-8163 Santa Aha, GA 92702 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HoLDF-'P'): EVENT INFORMATION: <br />~ -,~I'X- ~'&~ TYPE: Self Improvement <br />Ateja~dro. B~lnes /d ,9~( ~ _ ~&~' : DATE(S): 1/14/04 - 12/31/04 <br /> LOCATION: S.A. Jail <br /> <br />~ is to cerdfy that the policies of insurance listed below have been issued to the insured named above fo/the policy p~riod <br />indicated_ Notwithstanding any requiremanls, terms or conditions of any contract or other doctm~nt with respect to winch this <br />certificate may be issued ur may pertain, the insurance afford~l by th~ policies described herein is subject to all the terms, <br />cxclusiurm and conditions of such policies. Lindts shown may have been reduced by paid clamas. <br />INSURANCE CARRIER: Evanston inma'ance Corapany <br />MASTER POLICY NUMBER: 04SEP1000001 <br />MASTER POLICY DATES: EI~FECTIVE: IANUARY I, 2004 EXPIRATION: JANUARY 1, 2005 <br /> <br />COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE <br />Gmeral Aggregate Limit $ 2,000,000 <br /> <br /> OTHER ADDITIONAL INSUREDS <br /> <br />DATEISSUED: January 14, 2004 <br /> <br /> <br />