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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: <br />PUBLIC ENTrfY (ADDITIONAL INSURED) <br />Driver Alliant Insurance Services <br />City ob Santa Ana <br />P. O. Box 28323 <br />20 Civic CenteA Ptaza, 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 INFORTTIpN: <br />Inatlu�cti,onae -Sett Impn.ovement <br />!� <br />Ron Ib2aet <br />TYPE- <br />DATE(S): - <br />�" <br />LOCATION: S.A. Jatt <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 petfain, 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 05SEP100000I <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2005 EXPIRATION: JANUARY 1, 2006 <br />COMMERCIAL GENERAL LIABILITY <br />OCCURRENCE FORM <br />DEDUCTIBLE: NONE <br />General Aggregate Limit S 2,000,000 <br />Products & Completed Operations 1.000.000 <br />. <br />Personal & Advertising Injury 11000,000 <br />Each Occurrence Limit 11000,000 <br />Fire Damage (Any One Fire) 50,000 <br />Medical Payments (Any One Person) SAM <br />The limits of insurance apply separately to each event insured by this policy as if a separate policy of insurance has been issued for that event <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 prendses used by the named insured (event holder} This insurance does not apply to: Any "oceorrrarce' which takes place <br />after the event holder roses to be a tenant in that penises. <br />OTHER ADDITIONAL INSUREDS <br />CANCELLATION: Should the above desmbed 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: Janua'y 6, 2005 <br />