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<br />r <br /> <br />EVANSTON INSURANCE COMPANY <br />CERTIF1CATE NO.: <br /> <br />CERTIF1CATE OF INSURANCE , <br />EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. <br />SPECIAL EVENT LIABILITY PROGRAM <br /> <br />PRODUCER: fV ./).-60'1.-\ 2- <6 PUBLIC ENTITY (ADDffiONAL INSURED) <br /> \'.-I' L, 092- - [)\{~ <br />Driver Allia¡¡t Insurance Services P v '2-00 1.\ -oq V Calf 06 Sa.n.ta. Ana. <br />P.O.Box28323 f'J :2 '3 CA-I 20 C.¿vic. Cen.teJL Plaza., M-28 <br />Santa Ana, CA 92799-8323 - c-o~ - Sa.YLta. Ana., CA 92701 <br />(949) 660-8163 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOWER): I EVENTINFO~TIm: . na1. ei¡\ <br /> I TYPE: fÚ> c..ü.o - S ImpfWvemen.t <br />Va.n.i.d Ac.ha;tz DATE(S): I/Uó/U~ no! /U~ <br /> LOCATION: S.A. J aA.L <br />This is to certifY that the policies of insurance listed below bave been issued to the insured named above for the policy period <br />indicàÌed. Notwithstandmg any requh~""'JIts, tenns or conditions of any contract or other ,w,,"""Dt with respect to which this <br />certificate may he issued or may pertain, the insurance afforded by the policies descnèed herein is subject to all the tenns, <br />exclusions and conditions of such policies. Limits shown may have been reduced by paid claims. <br />INSURANCE CARRIER: Evanston Ins\lI8Dce Company <br />MASTER POLICY NUMBER: 05SEP1000oo1 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY I, 2005 EXPIRATION: JANUARY 1,2006 <br />COMMERCIAL GENERAL UABIUfY OCCURRENCE FO)(M DEDUCTIBLE: NONE <br />General Agpga1c Umit S 2,000,000 <br />Products &: Completed Opcratioo. 1,000,000 " <br />PenonaI &: Advortisins InjUl)' 1,000,000 <br />Each Occum:ncc [jmit 1,000,000 <br />Fire Damasc (Any One Fire) SO,OOO <br />Medical Payments (Any One Penon) 5,000 <br /> , <br />The limits of insurance apply separately to each event insured by dJis policy as if a separate policy of insurance has been issued for that event <br />'"Wbo is insured" js .mended to include, as an insured, the pa'5CIJ or orpnizatiœ shown in this schodule, but only with respect to 1iability Irisin. out of the <br />ownenbip. maintenance or use ofthc premises used by tbc named insured (event bo1der). This insurance does n.ot apply to: Any "occurraace" which tabs place <br />.ftcrthe event holder ceases to'bc a tenant in that pmnises. <br /> OTHER ADDmONAL INSUREDS <br /> , <br /> , <br />CANCEUA TION: Should 1be above described policy to amce11ed before the expiration date thereof. the issuing company win mai1 30 days written notiee to the <br />œrtificate holder and additional insureds listed. <br /> <br />AUTIIORIZED REPRESENTATIVE: <br /> <br />~;Z~ <br /> <br />1...../,/". <br />/;.:.'7,-<; , /Ì-(í <br />,.,. .. ./ <br /> <br />DATE ISSUED, <br /> <br />Ja.nuaJtlf 6, 2005 <br />