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<br />EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 2007-18 <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: <br /> <br />PUBLIC ENTITY (ADDITIONAL INSURED) <br />City of Santa Ana <br /> <br />Alliant Insurance Services, Inc. in conjunction with <br />Apex [nsurance Services <br />P. O. Box 6450 <br />Newport Beach. CA 92658 <br />(949) 660-8163 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />Virginia 1\Iaj'ne <br />1601 E. Avalon Ave. <br />Santa Ana, CA 92705 <br /> <br />20 Civic Center Plaza, M-28 <br />Santa Ana, CA 92701 <br /> <br />EVENT INFORMATION: <br />TYPE: Self-Improvement <br />DA TE(S): 4/5/07 - 12/31107 <br />LOCATION: SA Work Ccnter <br />"Liquor Liability after 2am 0 <br /> <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 reqUlrements, 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 /> <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: 04SEP 1 00000 1 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1,2007 EXPIRATION: JANUARY 1. 2008 <br />COMMERCIAL GENERAL LIABILITY OCCURRENCE FOR.I\.f IJEDUCTIBI.E. NO~E <br />General Aggregate Limit $ 2.000.000 <br />Products & Completed Operations 1,000.000 <br />Personal & Advertising Injury 1.000.000 <br />Each Occurrence Limit 1,000,000 <br />Fire Damage (Any One Fire) 50.000 <br />Medical Payments (Any One Person) 5.000 <br />The limits of insurance apply separately to each event insured by this policy as if a separate polic}" of in:;urancc has been issued for {hat cve;:nt <br />'Who is insured" is amended to include, as all insured, the person or organization shown in this schedule, but only with res peel to liahility arising out of the <br />Jwnership, maintenance or use of the premises used by the named insured (event holder). This insurance does not apply to: Any "occurrence" which takes place <br />Ifter the event holder ceases to be a tenant in that premises <br /> OTHER ADDITIONAL INSUREDS <br />:.A.NCELLATION: Should the above described policy to cancelled be/ore the expiration date thereof: the issuing company will mail 3D days written notice to the <br />~crtificate holder and additional insureds listed. <br /> <br />U:7~ <br /> <br />\UTHORIZED REPRESENT A TIVE: <br /> <br />JA TE ISSUED: April 5. 2007 <br /> <br />]enerated by Risk Management Division by: <br /> <br />~ -/ilu~~A <br />