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<br />EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: <br /> <br />CERTIFICATE OF INSURANCE , <br />EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE E"W'''''''' <br />SPECIAL EVENT LIABILITY PROGRAM . <br /> <br /> - <br />PRODUCER: PUBUC ENTITY (ADDITIONAL INSURED) <br />Driver Alliapt Insurance Services C.uy 0 n Santa. Ana . <br />p, O. Box 28323 20 C~V~~ Cent~Ptaza, M-28 <br />Santa Ana, CA 92799-8323 Santa. Ana, CA 92701 <br />(949) 660-8163 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDE13i . EVENT INFORMATION; <br />Alnftedo AtvMado tJ, ~~ (I') TYPE: Il'L6tJLuc.aonat - Gtll/lnat>üCh <br />1419 S. SyeamOfte, #6 IV --'2ÞQ'3 -u 3 -q DATE(S): 1/01/05 - 12/31 /05 <br />Santa. Ana, CA 92701 LOCATION: lohnm() C'.rn:tPJt <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 />indicàted. Notwithstanding any requirements, terms or conditinns 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: 05SEPlOOOOOI <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1,2005 EXPIRATION: JANUARY 1,2006 <br />COMMERCIAL GENERAL L1ABIUTY OCCURRENCE FORM DEDUCTŒLE: NONE <br />General Aggreptc Limit $ 2,000,000 <br />Produeta & Completed Operaricms 1.000.000 <br />p.....,.¡ & Advel1i,;ng Injury 1.000,000 <br />Each Occum:ncc Limit 1,000,000 <br />Fire Damage (Any One Fire) ~O,OOO <br />Medical Payments (Any One Person) ~,ooo <br />The limits of insurance apply separately to each event insured by this policy as if a scp8I'Ite policy of insurance has been issued for that event <br />"Who is insured" is amended to inc1ude, as an insured, lite person or organization shown in this schedu1e. but only with respect to liabiiity arising out of the <br />ownership, maintenance or use oftbe premises used by the named insured (event holder). This insurance docs not apply to: Any "occurrence" which takes place: <br />atœr the event holder ceases to'be a tenant ìn that pmmses. <br /> OTHER ADDmONAL INSUREDS <br /> , <br />CANCELLATION: Should the: above dcscnòed policy to cancelled befon:: the expiration date thereof, the issuing company will mail 30 d8)S written notice to the <br />certificate holder and additional insureds listed. <br /> <br />AUTHORIZED REPRESENTATIVE: <br /> <br />~/~ <br /> <br />~~ <br /> <br />DATEISSUED:--12/28/04 <br />