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<br />EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: <br /> <br />CERTIFICATE OF INSURANCE , <br />EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. <br />SPECIAL EVENT LIABILITY PROGRAM <br /> <br />PRODUCER: PUBUC ENTITY (ADDITIONAL INSURED) <br />Driver Allilljlt Insurance Services City On Santa A~a <br />P. O. Box 28323 20 Civi~ Cent~ Plaza, M-28 <br />Santa Ana, CA 92799-8323 Santa Ana, CA 92701 <br />(949) 660-8163 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: <br />PiLthway.6 ;to Adventwt(!. TYPE: Fi.6fU~Q & Campi~Q-In.6~ue;tionai <br /> DATE(S): 2/07 /05 - 6/30/05 <br /> LOCATION: VatUOU.6 <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: 05SEPIOOOOOl <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1,2005 EXPIRATION: JANUARY 1,2006 <br />COMMERCIAL GENERAL UABIUTY OCCURRENCE FORM DEDUCTIBlE: NONE <br />General A_Ie Umit 52,000.000 <br />Products & Completed Operations 1,000,000 <br />Personal &: Advertising; Injury 1.000,000 <br />Each Occum:nce Umit 1,000.000 <br />Fin: Damage (AnyOne Fino) 50,000 <br />Medical Payments (Any One Penoo) 5,000 <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 iI1slm=d.1he person or OIpIlization shown in this scheduJe. but only with respect to liability arising out of the <br />ownership, maintenance or use ofdlc premises used by the named insured (event holder). This insurance does not apply to: Any "occurrence" which takes place <br />after the event holder ceases to'be a tenant in that premises, . <br /> OTHER ADDITIONAL INSUREDS <br /> Al't'ROV"Sb AS 1'0 FORM , <br /> *~f. --- <br /> ---~_.' '~-:--~'--'~'-,,-' '-',-- <br /> ,lll!!l ,lLl\ ). ~ ..Uj <br /> "",~,,1'I' '~.d:1 Allunl~Y <br />CANCELLATION- Should the above described policy to cancelled befa-e the expiration date thereof. the issuing company will mail 30 days written notice to the <br />certificate holder and additional insureds listed. <br /> <br />AUTHORIZED REPRESENT A TJVE: <br /> <br />u;z- ~ <br /> <br />DATE ISSUED: <br /> <br />2/07/05 <br />