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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: _ <br />EXCLUDES COVERAGE FOR NOMINEE EVENTS SEE SEPARAU TAE APPLICATIONS FOR NOMINEE EVENTS. <br />SPECIAL EVENT LIABILITX PROGRAM <br />Driver Alliant Insurance Services <br />P. O. Box 28323 <br />Santa Ana, CA 92799-8323 <br />(949)660-8163 <br />C.%ty ab Santa Ana <br />20 C~,v.ic Centuc Pkaza, M-28 <br />Santa. Ana, CA 92701 <br />Bhau.C<:o Mendez ~.I-%,ua{-rc.z. <br />2313 S. Rene Dai,ve N- a,c~oH-ie~-ol <br />Santa Ana, CA 92704 <br />TYPE: Alrr,t,ir <br />DATE(S): ~c~3/ns _ 19/~/os <br />LOCATION: >=Y cnP. t{ „ r°"reh <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 contractor other document with respect to which this <br />certificate maybe 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: OSSEP1000001 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2005 EXPIRATION: JANUARY 1, 2006 <br />COMMERCIAL GENERAL LIAHILrTY <br /> <br />Gaenl Aggregate Limit OCCURREN(~ FORM <br />000 DEDUCT03LE: NONE <br />S 2,000 <br />Products .@ Completed Operations , <br />1.000 <br />000 <br />Personal & Advertsing Injury , <br />1.000 <br />000 <br />Each Oaurrena Limit , <br />1 <br />000 <br />000 <br />Fire Darrrege (Any One Firc) . <br />, <br />50 <br />000 <br />Medial Payments (Any One Person) . <br />5,000 <br />------ -..•, --w_wv ~. ~..:.. ovon[ meurm by this polity as if a separate policy of insurance has ban issued for drat event. <br />°Who is insured" is amtnded to include, es an insured, the person or orguiiutltar shown in [his schedule, but on with <br />ownersh~ main b respect to liability arising nut of the <br />rP, terunce or use of the premises used by the named insured (evert holder). This insurance does not apply b: Any "occunsna" which takes plea <br />after the evert holder cases to'be a tenant in thaz arerniew.c <br />AS TO <br />1~ <br />Laura Stitt eedy <br />Assts[ant City' Attornc~ <br />CnNCELLnT10N~ Should the above described policy [o arrcelled before the expiration date thereof, the issuing company will mail 30 days written notice to the <br />certifiatc holder and additional insureds listed. <br />AUTHORIZED REPRESENTATIVE: ~~ <br />DATE ISSUED: Febhucucy 23, 2005 <br />