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EVANSTON INSURANCE COMPANY �2 - 1,l'2- ,,J <br />CERTIFICATE NO.: 2007-05 �' <br />CERTIFIC <br />TE OF INSURANCE <br />EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. <br />SPECIAL EVENT LIABILITY PROGRAM <br />4liant <br />City of Santa Ana �✓� <br />Insurance Services, Inc. in conjunction with <br />Apex Insurance Services <br />20 Civic Center Plaza, M-28 <br />P. 0. Box 6450 N- oZ00 -03 <br />Santa Ana, CA 92701 <br />Newport Beach, CA 92658 <br />(949)660-8163 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />Felice nkcagla <br />EVENT INFORMATION: <br />3436 S. Taurus Lane <br />TYPE: Self-Im rovement <br />Santa Ana, CA 92704 <br />DATE(S): O1 01/07 -12/31/07 <br />LOCATION: _ - Santiae0 Lawn Bowling Center <br />Tins is to certify that the policies of insurance listed below have been issued to the insured named above for the policy <br />indrtxted. Notwithstanding any requirements, terms or conditions of any contract or other document with respect to which this <br />cerhfsion may be issued may pertain, the i <br />exclusions and conditions of <br />afforded by the policies described herein is subject to all the terms, <br />of such policies. Limits shown may have been reduced by paid claims. <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: 04SEP i 000001 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2007 EXPIRATION: JANUARY 1, 2008 <br />COMMERCIAL GENERAL- LIABILITY <br />General AOCCURRENCE FORM <br />b@�e Limit $ Z DEDUCTIBLE: NONE <br />Products & Completed Operations 1,000,000 <br />Pam ai & Advertising Injury 1,000,000 <br />Each a Limit 1000,000 <br />Fire Dauug, <br />e (Any One Fire) ,000 <br />50 <br />Medical Payments (Any One Person) 0,000 <br />----- +ry �.r••aK,y w taco even[ insured by this policy as if a s orate Ire <br />"who is irraand" is eP W � Y of insurance has been issued for that even[. <br />amended to include, as an insured, the person or organization shown in this schedule, but only with <br />ownerespect to liability arising out of the <br />rship, mainterunce or use of the premises used by the named insured (even[ holder). This insurance does not <br />after the event holder ceases to be a tenant in that oremisec apply to: Any "occurrence- which take place <br />AN r aP10N* Should the above described policy to cancelled before the expiration date thereof, the issuing company will mail 30 days written notice to the <br />:ttificate holder and additional insureds listed. <br />x�':;g- <br />UTHORIZED REPRESENTATIVE: <br />ATE ISSUED: <br />Inerated by Risk Management Division by: <br />