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<br />. <br /> <br />EV ANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: <br /> <br />CERTIFICATE OF INSI"RANCE <br />EXCLllUES COVERAGE FOR :\"OMINEE EVENTS. SEE SRPARATE APPLICATIONS FOR NOMINEE EVFl\"TS. <br />SPECIAL EVENT LIABILITY PROGRAM <br /> <br />PIWD1X~ER: PUBLIC ENTITY (ADDITIONAL lNSI"RED) <br /> City of Santa Ana <br />Driver Alliant Insurance Services in cunjunction with 20 Civic Center Plaza, 1\'1-28 <br />Apex Immrance Services Santa Ana, CA 92701 <br />P. O. Em: 2R323 <br />Santa Ana, C:A 92799-8323 <br />(949) 660-RI63 <br />License No: OC 36861 <br /> - <br />NAMED TNSUl{l'D (EVENT HOLDER): EVENT INFORMATIO": <br />Daniel Achatz #_~OO? -(Y(lI'-6Z TYl'E: InstructionallSelf-ImnTovement <br /> DA TE(S): Januarv 1 - December 31. 2006 <br /> LOCA no:\": Santa Ana Jail <br />This is to certify that the policies of insurance listed below have bt:eu issued to the insured named above for the policy periud <br />indicated. Notwith~tanding 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 i~ subject to all the terms, <br />exclusions and eondilions of such policies_ T .imits shown may have been n::duced by paid claims. <br />INSURANCE CARRIER Evanston Insurance Company <br />MASTER POLICY :\"U'\1BER U4SEP 1000001 <br />MASTER POLICY DATES: EFFECTIVE: JA:-IUARY 1,2006 EXPIRATION- JA,\;l:ARY 1,2007 <br />CUMMERC[AL GENERAl. L1AB[L1TY OCCL'RRENCH FORM DEDUCTIBLE: NO:\E <br />(lcneral Aggregate Limit S 2,000,000 <br />Prouucts & Complekd Operations 1,000,000 <br />Personal & Advcrtisillf, Injury 1,000,000 <br />EachOceurrene;c Limit [,000,000 <br />fir.;; Damage (AnyOne fire) 50.000 <br />Ml'dical Payments (Any One Person) 'i,OOO <br />~I:m]ts of in~urunce apply separatdy lo l'ach ~Vl:l1t insured hy this policy as if a separate polil:)i ur illslll~lll~e has been issucd tor that l'\'cnt. <br />"\'l/ho is in~lIrcd" lS omended lu include, as an illsured, th~ person ur orguni/.otion 5110\\11 in this schedule, but OIl[Y with respect tv liabihty arising out of the <br />O\\11crshlp, muinlt.'naIK'e or ust.' orthe pr~lIlises lIst:d by th;c named insured (event holder), This insurallce does nnt apply to: Any "OcCllITI.'I1Ce" which takes place <br />aner (he event holder ceases 10 bca t~lIallt inlhatprt:miscs <br /> OTHER AnmnONAL INSUREDS <br />~~ANCELLATlON: Should the ahove described policy to caneellCll beforc lh~ npirilliun date thereof, the issuing company will m:lil 30 d:JYs written notice to tht.' <br />ecrlifil'atehnldcruml<ldditlOl1a[insuredslislcd. <br /> <br />;/::/;/ ~4 <br /> <br />~-. <br />I <br />" . ......-<---:' "'--y <br /> <br />AUTllORTZED REPRESENTA TlVE: <br /> <br />DATE ISSUED: ~uarv 20,2006 <br /> <br />'- <br />