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<br />SANTA ANA RISK MGMT. <br /> <br />Fax:714-647-5311 <br /> <br />Mar 82006 11:22 <br /> <br />P.04 <br /> <br />EVANSTON INSURANCE COMPANY <br />CERTIF1CATE NO.: <br /> <br />CERTIFICATE OF INSURANCE <br />EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPAoRATE APPLICATIONS FOR NOMINEE EVENTS. <br />SPECIAL EVENT LIABILIlY PROGRAM <br /> <br />PRODUCER: PUBLIC ENITTY (ADDffiONAL INSURED) <br /> City of Santa Ana <br />Driver AJliant Insurance Services in cor\iunction with 20 Civic Center Plaza, M-28 <br />Apex Insurance Services Santa Ana, CA 92701 <br />P. O. Box 28323 <br />Santa Ana, CA 92799-8323 <br />(949) 660-8163 <br />License No; OC 36861 <br />NAMED INSURED (EVENT HOLDER): /V-;;!DO.J.-O'IK EVENTlNFORMATlON: <br />Daniel Achatz Ai - ;).Do;). - /..28' TYPE: InstructionallSelf-Iwprovement <br /> tJ. d.a:)j. /)7/ DATE(S): Januarv 1 - December 31. 2006 <br /> N _ J.oO'f - tJ90 LOCATION: Santa Ana Jail <br /> N-~cA. -rYl,;'- 0/ <br />This is to certify that the policies of insurance listed below have been issued to the insmed ~d above for the policy period <br />indicated. Notwithstanding any requirements, terms or conditions of any contract or other document with respect to which this <br />certificate may be issued or may pertain, the insmance afforded by the policies described herein is subject to all the terms, <br />exclusions and conditions of such policies. Limits shown may have been reduced by paid claims. <br />INSURANCE CARRIER: Evanston Insurance Coropauy <br />MASTERPOLlCYNUMBER: Q.4SEP10OOOOl <br />MASTER POLICY DATES: EFJ!'l!:CTIVE: JANUARY I, 2006 EXPIRATION: JANUARY 1,2007 <br />COMMERCIAL GENIWAlllABIUTY OCCUlU\ENCEFOl\M DEDUCTlIlLJO, NONE <br />General Aggregate Limit $ ~,OOQ.OOO <br />Products & Completed Operations 11000,000 <br />Personal & Advertising Injury 1,000,000 <br />Each Occurrence Limit ) ,OOO,OOQ <br />Fire Damage (Any Ont: FiTt:) 50,000 <br />Medical Payments (.Any One P~son) 5,000 <br />Th~ limits of iosuranct: apply :;cparately to each event insured by this policy as if .II. .s~te policy of insUt'aIJ.c;c has been issued for that event. <br />"Who is mSl,1fedTJis a.rnended to include, as Brl insured} the person or organiz;ation shown in this schedule. but Qnly with respect to liability mlsing Ollt of the <br />ownership, maintenance or u.se of the premise$ used by the n;i.med insured (event holder). This insurance does not apply tQ: Any "occwrencc" which takes ?lace <br />a~ tbe event holder ceases to be a tenant in that premises. <br /> OTllER ADDITIONAL INSUREDS <br />CA NrF.T I A nON: Sbovld the aboVC' described policy to cancelled before the expiration date tbaeof, thi:! issuing company wilt mail 30 days written notice to the <br />certificate holder and additional insureds listed, <br /> <br />~/~ <br /> <br />A'.i:: '::'~~I.~::: "'/ .f,.:..: ,1.':"__' <br /> <br />AUTHORIZED REPRESENTATIVE: <br /> <br />.,~ <br />~~,~...~ ..'~ ," '. ,". <br />__ '.....M.._... <br />r. '~,:;~szc _~_ 1_.>: :,' t:.,;': ,>. ,\ : <br /> <br />DATE ISSUED: Januarv 20. 2006 <br /> <br />\l. ' <br />