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<br />02/15/2005 17:14 <br /> <br />7142458148 <br /> <br />SANTA ANA JAIL BKNGK <br /> <br />PAGE 05 <br /> <br />EVANSTON INSURANCE COMPANY <br />CERTlFlCATE NO.: <br /> <br />CERTJFlCATI: OF INSURANCE , <br />EXCI.UDES COVERAGE:roll NOMINEE EVENTS. SEE SEPARATE Al'J'LICA.TIONS FOR NOMINEE EVENTS. <br />SPECIAL EVENT UABIl.ITY PROGRAM <br /> <br />, PRODUCER: PUBUC l!NTrtY (ADnmONAL INSURED) <br /> Driver Alliant IDsutance Scrvic:cs CUI/ C f, San..t4 AIta <br /> P.O.llox 28323 20 Civic Ce/l.tVt Puza., /0/-28 <br /> Suta AlIa, CA 92799-8323 StULta. AlId, CA 92101 <br /> (949) 660-8163 <br /> LicellIe No: OC 36861 <br /> NAMED INSURED (EVENT HOlDER): , BVlNT INFOnrn~ nal elf, <br /> rV- 9-.00'-1-/33 TYPE' 114 0 ' ' - S I mplLOvenrent <br /> DATE(S): IllIblll) - IZ/~IIII> <br /> Let.i.Wt QuiIto z LOCATION: S.I\. Ja.,u <br /> Thio is 10 catify dJat 1bc policieo of iIIIlnaceJiJted below have ~ isIaed II) tile iDsuNd IINIIed abcr<e fer 1bc poljcy period <br /> iIIdicaIiod. NllIWill-. .1:.-& JDJ' '.---01>0, .... cw <:oIIcIiIiGaI of JDJ' _ or otbot do-. -'Ill 'll'itb Il:IIpllCt 10 TIIlich tbiI <br /> corti1ieote, may be iasuecI <Ie .,........ ... iuutucc afrozded by'" )IOIicieI described hcRiD is IlIbjcct to aU 1bc termo, <br /> exclusions IJId coadllioaa of such poIicia. Lituilo Ibowa may Jave beCII nU:ed by paid c--. <br /> INSURANCE CARRIER: B_m.u.-:e ~y <br /> MAS'I'ER POUCY NUMBER: OSSEl'IOOOOOI <br /> MASTER POUCY DATES: IJI'FECTJVE: JANUARY t. 2005 J:XPIRATlON: JANUARY t, 2006 <br /> COMNI!RClAL GEIlERALlJABtUlY llCCI.WIENl:1I FORM llEllOCTIllLlS: NONl! <br /> GoIoonI... i.m.ic $2.OlIO,lJIlO <br /> Proolucls A " ..lh.J()plaIiaaI IAOOAOO . <br /> '--lAAd... . . _19"'7 I,llOOAOO <br /> _t' ._ UmiI I,llOOAOO <br /> I'Ve 0.... (Ally O,din) 5O,/lOO <br /> NeclieoIPa".". (AnY One_) SAOO <br /> 1hclinillol___r. ---........,.... policy. iI"_poIicyor_..._ inuooI for.......... <br /> "WIlo" -- Is_ loillcltJdr, ".irDuroII,..._ or ~~ . 11.11....... .....-.lIutanJjrwillJ _ Ioliollili\y """OUlor.. <br /> -....__or'*'or...................,..._ ........(__~ 11110 ---110I",,1)'10: ~.... .--" -tIId"',- <br /> -"''''''hoI<Ior_Jtibea_in_--. <br /> OTHER ADDmONAL lNSUUDS <br /> , <br /> t:A"""I ........"'. _lire - -- JlOIie1Io CIIIllOl1alI>eltn tlrt.............. """"'t tile iJsQu., """"""'" will moilJOd'I)S _ DOlico lolll< <br /> _hoI<Iorllnd____ <br /> <br />AUTJfORlZED REPRESENTAllVB: <br /> <br />~~~ <br /> <br />."~ { ': <br /> <br />'r <br /> <br />OATBJsSUED: <br /> <br />]MU/Vt!/ 6. 2005 <br /> <br />'I/I"!.(A/ <br />',', '\.f' <br />