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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: - <br />CERTIFICATE OF INSURANCE <br />EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. <br />SPECIAL EVENT LIABILITY PROGRAM <br />PRODUCER: <br />PUBLIC ENTITY (ADDITIONAL INSURED) <br />Driver Alliant Insurance Services <br />City ob Santa Ana <br />P. O. Box 28323 <br />20 Civic CenteA P.Paza, M -28 <br />Santa Ana, CA 92799 -8323 <br />Santa Ana, CA 92701 <br />(949) 660 -8163 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />EVENT INFORIANION: <br />In6.tw ti.onaC -Se 6 Improvement <br />f� <br />Ron Wtae2 <br />TYPE: <br />DATE(S): IlUbIO5 - <br />LOCATION: <br />This is to certify that the policies of insurance listed below have been issued to the insured named 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 insurance 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 Company <br />MASTER POLICY NUMBER 05SEP1000001 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2005 EXPIRATION: JANUARY 1, 2006 <br />COMMERCIAL GENERAL LIABILITY <br />OCCURRENCE FORM <br />DEDUCTIBLE: NONE <br />General Agregaae I3mit S 2,000,000 <br />Products & Conyleted Operations 1,000,000 <br />. <br />Persotwl & Advertising Injury 11000,000 <br />Each Occurtawro Lbrdt 1,000,000 <br />Fire Damage (Any One Fire) 50,000 <br />Medial Payments (Any One Person) 5,000 <br />The limits of insurance apply separsittly, to cash event insured by this policy as if a separate policy of insurance has been issued for that event. <br />"Who is insured" is amended to include, as an insured, the person or organization shown in this schedule, but only with respect to liability arising out of the <br />ownership, maintenance or use of the premises used by the ruined inured (evert holder} This insurance does not apply to: Any "oeemrence" which takes plea <br />alter the event holder cases sdbe a tenant in that premises. <br />OTHER ADDITIONAL INSUREDS <br />CANCELLATION: Should the above desrnbed policy to cancelled before the expiration date thereof, the issuing cornpany will mail 30 days written notice to the - <br />certificate holder and additional insureds listed. <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: Janua&y 6, 2005 <br />i <br />