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<br />EV ANSTON INSURANCE CO:vIPANY <br />CERTIFICATE 1\0" <br /> <br />CERTIFICA TR OF TNSlTRA~CF. <br />~:XCLlJUJo:S COVJo:RAGE FORXOMINEE f:Vf:NTS, Sf:f: Sf:PARATE APPI.ICATlONS FOR XOMINEf: EVENTS, <br />SPECIAL EVf:NT LIARILITY PROGRAM <br /> <br />PRODU:ER: PUBLIC ENTITY (ADDlTIONAL INSURED) <br /> City of Santa Ana <br />Driver Alliant Insurance Services in conjunction with 20 Civic Center Plaza, ]\'I~28 <br />Apex Insurance Services Santa Ana, CA 92701 <br />P. o. flox 28:)23 <br />Santa Ana, CA 92799-8323 <br />(949) 1ifi0-R I 63 <br />License No: OC 36R61 <br />NAMED NSURED (EVENT HOLIJLR)' EVENT TNFORMA TION: <br />Tony Delgado ,v- :200S- " I TYPE: I nstructionallSelf-T morovement <br /> DATE(S): .January t - December 31. 2006 <br /> LOCATION: Santa Ana .Jail <br />This is to certify that the policies ofinsuram:e listed beluv\" have been issued to the insured named above tor the policy period <br />indicated. Notwithstanding any requirements, terms or conditions orany contract or other document \vith respect to which this <br />certificate may be issued or may pertain, the insurance afforded by lhe pulicies 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 />I1\TSl:RA:\'CE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: 04SEP 100000 I <br />MASTER POLiCY DATES: EFFECTiVE: JA"UARY I, 2006 EXPIRATION, JANUARY I, 2007 <br />CO,vIMU{C1AL GE:-.IER/\L 1.1..\BII.lTY OCCURRENCE FORM DEDUCTlBlr:: J\ONE <br />General Aggregate Limit $ 2,000,000 <br />Plodu(ts&Colllpltll:dOpnatioIlS I,O()(),OOO <br />Personal & Advertising Injury 1.OOO,ODD <br />Each OeeuITcnec Limit 1,000,000 <br />Fire Damage (Any One Fire) 50,000 <br />Medical Paymellls (Any One Pcrson) 5,000 <br />Thc limits of insurance apply separately to eael1 event insured by this policy ag if a separate policy of insurance has been issued t'or that eVl;nt <br />"\Vho is insured" is amended to inclmk, as un insured, Ihe person or organization ShO\~11 in this schedule, hut only with n.:spect to liability arising out 01' tIll: <br />ll\\ll~rship, maintcnuncc or use of the premises used by the named insured (even! holder)_ This insurance does not apply to: Any '.ol'cllTTem:e"wliicli lakes place <br />altcrlhc event holder ceases 10 bcalenant in that premises <br /> OTHER ADDITIONAL INSUREDS <br />C.'\:--JCELI ATIO\; Sll0uld thi.: llbuveJt'si.:ribnl floli"y In Glllcelled hdilTC the expiration date thcreuf, the issuing company will mail J() days \\Titten nutii.:e to the <br />cenii'il.:akllulderillllJadditional illsllrcl1slislcd <br /> <br />~;Z~ <br /> <br />AUTllORlZED R EPR ESENT A TIVE, <br /> <br />DATE ISSUED, <br /> <br />Januarv 20. 2006 <br /> <br />';13' <br />,-V\.{/:>.e;/ <br />/ <br /> <br />" <br /> <br />v <br />