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. EVANSTON INSURANCE COMPANY CERTIFICATE NO.: CERTIFICATE OF INSURANCE . EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. SPECIAL EVENT LIABILITY PROGRAM PRODUCER: PUBLIC ENTITY (ADDITIONAL INSURED) Driver Alliap.t Insurance Services P. O. Box 28323 Santa Ana, CA 92799-8323 (949) 660-8163 License No: OC 36861 NAMED INSURED (EVENT HOLDER): Ka.t:hle.e.n NWon I CUI} 06 San:ta Ana I, zo C.i.v.i.c- Ce.n.teJ1. P!aza, M-U San.ta Ana, CA 9Z701 EVENT lNFORMA TION: TYPE: 1/'l.6.twctionlLf-Se..t6 DATE(S): 1/ Ubi U~ - I Z I j 1/ U~ LOCATION: S.A. JlUt ImpftOv e.me.n.t This is to certify that the policies of insurance. listed below bave been issued to the insured named above for the policy period indicated. Notwithstanding any requirements, terms or conditions of any contract or other document with respeer to which this certificate may be issued or may pertain, the insurance afforded by the policies descnbed herein is subject to all the tenm, exclusions and conditions of such policies. Limits shown may bave been reduced by paid claims. INSURANCE CARRIER: Evanston Insurance Company MASTER POLICY NUMBER: 05SEPlOOOOOl MASTER POLICY DATES: EFFECTIVE: JANUARY I, 2005 EXPIRATION: JANUARY 1,2006 COMMERCIAL GENERAL LlABIUTY General Aggregate Umit Producls & Completed OperatiOlls Personal & Advertising Injury Each Occurrence Umit Fir<: Damage (Any One Fino) Medical Payments (Any One Person) OCCURRENCE FORM DEDUCTffiLE: NONE $ 2,000,000 J .000,000 1,000.000 1,000,000 50,000 5,000 The limits of insurance apply separately to each event insured by this pOlicy as if a sepan.te policy of insurance has been issued for that event "Who is insured" is amended to include, as IltI insured, the person or organization shown in this schedule. but only with respect to liability arising out of the ownership. maintenance Of use of the premises used by the named insured (event holdet'). This insurance does ~ot apply to: Any "occurrence" which takes place after the event holder ceases to'be a tenant in that premises. OTHER ADDITIONAL INSUREDS fl' J I',\ll t,:! "-- \/"-iv' . , . ii / ~((-</.. .' .,,, ,-..-. - '~ , CANCELLA nON: Should the above described policy to cancelled before the expiration date thereof. the issuing company will mail 30 days written notice to \he certificate holder and additional insureds listed. AUTHORIZED REPRESENTATIVE: u;Z~ DATE ISSUED: JaYUlaJLl} 6, Z005