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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: <br />N -goo mil— 03-I-) <br />CERTIFICATE OF INSURANCE <br />EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. <br />SPECIAL EVENT LIABILITY PROGRAM <br />PWAWCER: <br />PUBLIC ENTITY (ADDITIONAL INSURED) <br />'Atvtr Alliant Inswance Services <br />City of Santa Ana <br />P, 0 Box 28321 <br />20 Civic Center Plaza, M-28 <br />Santa Ana. CA 92" 99-8323 <br />P.O. Box 1988 <br />(949)W4163 <br />Santa Ana, CA 92702 <br />License Nw OC 36861 <br />TAMED INSURED (EVENT HOLDER). <br />EVENT IWO"TION: <br />sae'ofyttot <br />TYPE: <br />DATE(S): Da <br />709 S. Patiton Stkeet <br />LOCAT10N- <br />Santa Ana, CA 92701 <br />1 <br />This is to certify that the policies of insurance listed below have been issued to the insured named above for the policy penod <br />indicated. Notwithstanding any requirements, terms or conditions of any contract or other document with respect to winch 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. 04SEPI00000I <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2004 EXPIRATION: JANUARY 1, 200.5 <br />COMMERCIAL GENERAL LIABILITY OCCURRENCE K)RM <br />NONE <br />fim mm I Aggnptc Umil s2mlwl <br />PnWvc ;s & (;.r'rnplcu:d OpmteoaC )Ao(L(M <br />i^r MAI & AdItun,MS injury InonoXi <br />(Leah (kcw7coce Limit 1,owr)(0 <br />Ffm LkAuNtW;AT1y Doc F-re? �%'" <br />Mcdow payrm:'L' jk,y ()" Perron) <br />o "W"ncr 4p;uy stparsitly to each cY tc iusumd by des policy " ji-a s4paratt POI=Y Df uu,a=e <br />J= luten isutod i M that tycto, <br />'Wh" {s insuted" 45 alm"'dod to utitutit, 2$ an wwrtd, ft ronunt or orperstion shttwn in this W;lWdUIC6 but only with mp= W Imbility arutifty, out it( the <br />"uTmOlp' nountmovow or D of tit P �-sft w;W by the um insured (e,tsit Wilts). This instustrice dm not apply to: Any "mcurunwe" wtucb takes p1wc <br />'avr ihe cwni hQkta crux n to be a trnaut ut thaprentim, <br />OTHER ADDITIONAL INSUREDS <br />------- --- <br />----- <br />- - ----- ---- - — ------ ----- — ---------- <br />C KN1`,1LLS:tYQN, Shwki the ttbo•: detembed policy t,; cancelled Wbot as, expiration date dmwf, the issuing corripany will mail 30 days written notice W the <br />0,3alf"W ihada ow Addiijunki Insutaft lawd. <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: <br />4107104 <br />