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V'1NSTON INSURANCE COMPANY <br />ERTIFICATE NO.: 2007 -07 <br />CERTIFICATE OF INSURANCE <br />EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. <br />SPECIAL EVENT LIABILITY PROGRAM <br />PRUDLICGR. <br />PUBLIC ENTITY (ADDITIONAL INSURED) <br />I <br />City of Santa Ana <br />!I :Nllianl Insurance Set vices, Inc, in conjunction with <br />20 Civic Center Plaza, M -28 <br />Npex Insurance Services <br />Santa Ana, CA 92701 <br />P (t Boa 6450 <br />\cwport Beach. CA 92618 <br />li 11149) 660 -8163 <br />I. icense No: OC 36861 <br />NAMFD INSURED i F.VLNI HOLDER): <br />EVENT INFORMATION: <br />Luis Martinez N, 8006 _ /d j <br />TYPE. Self - Improvement <br />1' 1681 Cameo Drive <br />DATF.(S): 01/01/07- 12/31/07 <br />.manta Ana, CA 92705 <br />LOCATION: Santa Ana Jail <br />"Li uor Liabilit after tam ❑ <br />ii <br />4 I hi; is 6r cernly that the policies of insurance listed below have been issued to the insured named above for the policy period <br />�I indicated Notwithstanding any requirements, terms or conditions ofany contract or other document with respect to which this <br />icertificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, <br />e\Clmions and conditions of such policies. Limits shown may have been reduced by paid claims. <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: O4SEP1O00001 <br />MASTER POLICY DATES: EFFECTIVE: JANIJARY 1, 2007 EXPIRATION: JANUARY 1, 2008 <br />( OMMPRI'IAt 61:NLRAL I IANILI "rY <br />OCCI IRRENCE FORM <br />DEDUCTIBLE. NONE <br />t rneml Aggregate limit S 2,000r0p) <br />Products Xt Completed Opemnnn,' 1,000,000 <br />Personal ,f Advertising Injury 1.000,000 <br />I neh Occunenee Limn 1,000,OOU <br />I ire I7amv_c IAuy One Fire) 50.000 <br />Nl ulrcal Pmrznenl, lAm One Persanl S OIN) <br />he hnnts of .......lice apply separately to each event insured by this policy as if a separate policy of insurance has been issued for that event. <br />'who,, m,tiad' is sneadcd to include, as:m insured, the person or organization shown in this schedule, but only with respect to liability arising out attic <br />..umr.hT maimcnaoc,, ur use at the premises used by the named insured (went holder). Thin insurance does not apply in Any "occurrence" which lakes place <br />All till eccnt holden lenses !u be a tens l in that premises. <br />OTHER ADDITIONAL INSUREDS <br />I <br />_A V.C1 L_I ATIUN- Should the above described policy to cancelled before the expiration date dinned[ the issuing company will mad 30 days wril0.tn notice m the <br />milicwt, holder and additional insureds listed. <br />AUTIIURILED RLPRE.SEN I I I VE —_. <br />DATE ISSUED _ January Ol 2007 <br />rlieruied hr Risk Management Division by <br />