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<br />r <br /> <br />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: <br /> <br />PUBLIC ENTITY (ADDITIONAL INSURED) <br /> <br />¡v ./)-002 -\ 2- <6 <br />\'"'" L. (X>'z.- - ()u..~ <br />Driver Allia¡lt InsuranCe Services P v '2-co 1-\ --oq v <br />P,O.Box28323 .. J , ':>. ~I <br />Santa Ana, CA 92799-8323 - - ;t-O;:) v - ~ <br />(949) 660-8163 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOIDER): <br /> <br />C);tlj 06 Sa.YLta Ana. <br />20 C,¿v.i.c. CentVL P.i.a.za., M-28 <br />Sa.nta. Ana., CA 92701 <br /> <br />I <br /> <br />EVENT INFORMATION: . ,__0 .01 <br />TYPE: I/I,6,t1u¡c.-UoT"""'-S,,-,,-u <br />DATE(S): I/U6/U':J - lZ/jl/U':J <br />LOCATION: S,A. JaM:. <br /> <br />ImpltOvement <br /> <br />Va.IÚe.t Ac.ha.:tz <br /> <br />This is to certifY tbat the policies of insurance listed below have been issued to the insured named above for the policy period <br />indicated. Notwithstandú1g any req¡h,ç-ut.. terms or conditions of any contract or other document with respect to which this <br />certificate may be issued or may pertain, the insurance afforded by the policies descn"bed herein is subject to all the terms, <br />exclnsions and conditions of such policies. Limits shown may have been reduced by paid claims, . <br />INSURANCE CARRIER: Evanston Insurance Company <br /> <br />MASTER POLICY NUMBER: 05SEP1000oo1 <br /> <br />MASTER POLICY DATES: EFFECTIVE: JANUARY I, 2005 <br /> <br />EXPIRATION: JANUARY 1,2006 <br /> <br />COMMERCIAL GENERAL UABIUfY <br />General Agpplc Umit <br />Products '" Complclcd Operations <br />Personal '" Advatisin¡ InjUl1' <br />Each Occum:ncc Limit <br />Fito Damosc (Any One Fire) <br />Medical Payments (Any One Penon) <br /> <br />OCCURRENCE FORM <br /> <br />DEDUCTIBLI!: NONE <br /> <br />S 2.000.000 <br />1.000,000 <br />1.000.000 <br />1.000.000 <br />so,ooo <br />s.ooo <br /> <br />The limits of insurance apply scøantely to each event insuRd by mis policy as if a separate policy of insunmcc hu been issued for lhat event. <br />'"Who is insured" is amended to include, as lID insured, the pc:I'St1I1 or orpnizatiœ shown in 1bis schedu~ but only with respect to liability arising out ofttle <br />ownership, mainlalance or use of the premises used by the named insumI (ov..t holdel'~ This insuranœ does not apply to: Any"occum:ncc" which lakes p10ee <br />.ftcrthe event holder ceases tObe a tenant in that premises. <br />OTHER ADDmONAL INSUREDS <br /> <br />. <br /> <br />CANCEUA TION: Should the above dc:sçrjbcd policy to c:anceJled before the expiration date thereof, the issuing company win mail 30 days written notiœ: to the <br />certificate holder and additional in- listed, <br /> <br />AUTIIORIZED REPRESENTATIVE: <br /> <br />~~~ <br /> <br />1.1. . <br />~! ' . <br />.:/"L- 1.....-t/ (~ ¡,.vi I <br />.... . / <br /> <br />DATE ISSUED: <br /> <br />Ja.nu.aJLlj 6, 2005 <br />