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<br />,-- <br /> <br />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 LIABILITY PROGRAM <br /> <br />PRODUCER: f'). ~2cD° - ~ T . <br /> <br />. -J- þcP3-~5 <br />Driver Allia¡J.t Insurance Services r--> - 2a::>1- - II t.( <br />P.O,Box28323 >11.1 -~.-ct1' <br />Santa Ana, CA 92799-8323 . r- <br />(949) 660-8163 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOIDER): <br /> <br />Tontj Ve..f.ga.do <br /> <br />PUBLIC ENTITY (ADDITIONAL INSURED) <br /> <br />Catj 06 Sa.nta. AM <br />20 C'¿vÙ, Ce.n.tVL Plaza., M-28 <br />Sa.nta. AM, CA 92701 <br /> <br />, <br /> <br />EVENT INFORMA.TION: , . ^ 01 <br />TYPE: I Yll>Vw.c;Uona1.-S""'-u <br />DATE(S): IIUbIU~ - IZ/~IIU~ <br />LOCATION: S.A. JIU..{. <br /> <br />Imp.lt.Ov eme.n.t <br /> <br />This is to certify tbat the policies of insurance listed below have been issued to the insured uamed above for the policy period <br />indicated. Notwitbstaoding 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 descn"bed herein is subject to all the tenDs, <br />exclusions and conditions of such policies. Limits shown may have been reduced by paid claims. <br />INSURANCE CARRIER: Evanston Insw:ance Company <br /> <br />MASTER POLICY NUMBER: 05SEPlOOOOOI <br /> <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1,2005 <br /> <br />EXPIRATION: JANUARY 1,2006 <br /> <br />COMMERCIAL GENERAL UABIUTY <br />Gencn¡1 Agpep" Umil <br />Products &: Completed Opcntions <br />Personal &: AdYertisins Injury <br />Each o.:c:un.nc. Limit <br />Fùo Domagc (Any One Fire) <br />Medical Payments (Any One Person) <br /> <br />OCCURRENCE FORM <br /> <br />DEDUCTffiLE: NONE <br /> <br />$ 2,000,000 <br />1,000,000 <br />1,000.000 <br />1,000,000 <br />SO,OOO <br />s,ooo <br /> <br />The limits of insurance apply separately to each event insured by this policy as if a separate policy of jnsurancc hu been issued for that event <br />"Who is insured" is amended to include, as an insured. the person or ocpnization shown in this schedule. but only with respect to 1¡ability arisinS out of the <br />ownership, main....... or uoe of the pn:mises UJed by !be oamcd insured (eveolllol",,). This insurance does not apply to: Any "QCÇurtaK:C:" whieh talc.. ploee <br />after the event holder ceases to'be a tenant in that premises. <br />OTHER ADDrnONAL INSUREDS <br /> <br />CANCP.T I A TION: Should the above described policy to cancelled before the expiration date thereof. the lssuing cOJJ1W1Y witl mail 30 days written notice to the '- <br />wtificatc h~der and additional insureds listed. <br /> <br />AUTIIORIZED REPRESENTATIVE: <br /> <br />~;Z~ <br /> <br />, ; "'d,~ (: /;~~, <br /> <br />)" <br /> <br />DATE ISSUED: <br /> <br />Ja.nUiVLtj 6, 2005 <br /> <br />~y <br />"i':~},>I~>:,:,;,:" ';.>"-'" !'," <br />