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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 />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: January 6, 2005 <br />PRODUCER: PUBLIC ENTITY (ADDITIONAL INSURED) <br />Driver Alliant Insurance Services City o6 Santa Ana <br />P. O. Box 28323 20 Civic CenteA Pkaza, M -28 <br />Santa Ana, CA 92799 -8323 Santa. Ana CA 92701 <br />r�' ' <br />(949) 660 -8163 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: <br />In t/ tonak -Se25 Impuvement <br />Carolyn Nauh TYPE: <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. 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 05SEPI000001 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2005 EXPIRATION: JANUARY 1, 2006 <br />COMMERCIAL GENERAL LIABILITY ORM DEDUCTIBLE: NOME <br />General Aggregate Limit <br />Products & Completed Operations <br />=2.000,000 <br />Personal & Advertising Injury <br />Each Occunawc limit <br />Fire Damage (My One Fire) <br />Medial Payments (Any One Person) <br />The limits of insurance apply separately to each event insured by this policy as if a separate policy of insurance has been issued fa that "ML <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 named insured (event bolder). This insurance does not apply to: Any ••aeaurence" which rakes place <br />after the event holder ceases to be a tenant in that prandses. <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 wriaen notice to the <br />certificate holder and additional insureds; listed. <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: January 6, 2005 <br />