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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: N� _ <br />PUBLIC ENTITY (ADDITIONAL INSURED) <br />N- ?mss -C-5 <br />Driver Alliant Insurance Services PJ - 2-13p2 — �) y <br />City o U Santa Ana <br />P. O. Box 28323 Yl� 1 <br />t T?i7 <br />20 Civic CenteA Haza, 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 INFORIVIpN: <br />In6tJUtcti.onat -Se2b Imphavement <br />TYPE: <br />Tony DeXgado <br />DATE(S): - <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. Notwdbsmodmg 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 Congmy <br />MASTER POLICY NUMBER 05SEPI000001 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2005 EXPIRATION: JANUARY 1, 2006 <br />COMMERCIAL GENERAL LIABILITY OCCURRENCEFORM <br />DEDUCTIBLE: NONE <br />General Aggregate limit f 2,000,000 <br />Products & Completed Operations 1,000,000 <br />Personal & Advertising injury 11000.000 <br />Each Occa mice Limit _ 11000,000 <br />Fite Damage (Any One Fire) 50,000 <br />Medical Payments (Any One Person) 5,000 <br />The limits of insurarce apply separately to each event insured by this policy as if a separate policy of insurance has been issued for tlmt event <br />"Who is msumd" is amended to include, as an insured, the person or otgmiratim shown in this schedule, but only with respect to liability arising out of the <br />ownership, msintenarce or use of the Pmarises used by the named insured (event holder} This insurance does not apply to: Any "oeeuemce" which takes place <br />after the event holder ceases td be a tenant in that pmmisea. <br />OTHER ADDITIONAL INSUREDS <br />CANCELLATION: Should the above described policy to cancelled before: the expiration date thereof, the issuing company will mail 30 days written notice to the <br />certificate holder and additional insureds listed. <br />AUTHORIZED REPRESENTATIVE:" ' <br />DATE ISSUED: JanuaAy 6, 2005 <br />