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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 LIABLLITY PROGRAM <br /> <br /> P~RODUCER: PUBLIC EN'I1TY (ADDITIONAL INSURED) <br /> Driver Al~ant Insurance Sendces City of Santa Aha <br /> P.O. Box28323 20 Civic Center Plaza, M-28 <br /> SanmAna, CA 92?99-8323 P.O. Box 1988 <br /> (949) 660-8163 Santa Ana, CA 92702 <br /> License No: OC 36861 <br /> NAMED INSURED (EVENT HOLDER): c EVENT INFORMATION: <br /> fO - ,'~ ~(('~ c~ 1V TYPE: Self Improvement <br /> Chri~ CoWper. ~ - 5~0~- f~ DATE(S): 1/~4/04 - 12/31/04 <br /> ]~' - f.~C~:~ - I I I LOCATION: S .A. Jail <br /> <br />This is to certify that the policies of insurance listed below have been issued to the insured named above for thc policy poriod <br />indieatcd. Notwithstanding any requirements, terms or conditions of any contract or other document with respect to which this <br />t certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the torn~, <br />exclusions and conditions of soch policies. Limits shown may have been reduced by paid claims. <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: 04SEPI000001 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY I, 2004 EXPIRATION: JANUARY 1, 2005 <br /> <br /> COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE <br /> General Aggtegat~ Limit $ <br /> Products & Comp]¢~ Operations 1,000,000 <br /> Personal & Advgrfising Inju~ 1,0fl0,000 <br /> Each Oc¢orrencc Limit 1,000,000 <br /> Fire Damage (Any One Fire) 50,000 <br /> Medical Paymen~ (Any On~ Person) <br /> <br /> The limits of insurance apply separately to each event tosu~,d by this policy as ifa sc~ra~e poli~'y of insurance ha~ been iszued for t~at event. <br /> "Who is insurexl" is amended to inglud~, as an insured, thc p~-son or orgonization sl~own in this schedol¢, but only with resider to liability arisin~ out of the <br /> ownership, maintenance or uzc oftbe premlse~ ~ by thc named insured (e~:nt holder). This insurance d~ not apply to: Any "occun'cncc" which ~akes p]ac~ <br /> aftgr thc event holder ceases to be a tenant in that p~¢mi~.,,, <br /> OTHER ADDITIONAL INSUREDS <br /> CANCELLATION: Should the abo¥¢ d~cri~ policy to ~nc~ll*d befo~'¢ th~ ~xpirati~ dat~ ~of, the i~uing company will mail 50 day~ .arritt~-~ notice to the <br /> c~ifica~ holder ~nd eddi6onal in~a~l~ li~ted. <br /> <br />AUTHORIZED tLEPKESENTATIVE: <br /> <br />DATE ISSUED: January 14, <br /> <br />2004 <br /> <br /> <br />