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EY ANSTON INSURANCE COMPANY CERTIFICATE NO.: 2007 -03 A-ZOj) If -/4-3 /I- ~ ~()() & - (/1.;2 -():1. 7 A -;;.00 5 - )t-fL.> CERTIFICATE OF INSURA,'iCE I<:XCLUDES COVERAGE FOR NOMINEE EVENTS. SEI<: SEPARATE APPLICATIONS FOR NOMINEE EVENTS. SPECIAL EVENT LIABILITY PROGRAM: II PRODUCER, PUBLIC ENTITY (ADDITIONAL INSURED) City of Santa Ana I AllIant Insurance Services, Inc. in conjunction with 20 Civic Center Plaza, :\1-28 Apex Insurance Services Santa Ana, CA 92701 I P. O. Box 6450 Newport Beach, CA 92658 (949) 660-8163 LIcense No, OC 36861 NAMED INSURED (EVENT HOLDER), EVENT INFORMATION, National Heritage Foundation TYPE: Ballet Class Academy of International Dance DATE(S): Jan. I. 07 - Det:. 31. 07 Sonia Miskulin LOCATION: Sale:ado Center and Memorial Park 220 E. 4th Street, Suile 202, Santa Ana, CA 92701 "Liquor Liabilitv after 2am 0 This is to certify that the policies of insurance listed below have been issued to the insured named above for the policy period indicated. ~otwithstanding any requirements, terms or conditions of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies. Limits shown may have been reduced by paid claims. , INSURANCE CARRIER: Evanston Insurance Company MASTER POLICY NUMBER: 04SEPlOOOOOI MASTER POLICY DATES: EFFECTIVE: JAl'.'UARY 1.2007 EXPIRATION: JANUARY 1.2008 COMMEI{ClAL GENERAL LJAHILlTY OCCURRENCE FORM DEDUCTIBLE: NONE General Aggregate Limit S 2,000,000 Products & Completed Operations 1,000,000 Personal & Advertising mjury 1,000,000 Each Occurrence Limit 1,000.000 I Fire Damage (Any One Fire) 50,000 I Medical Payments (Any One Person) 5,000 , The limits of insurance apply separately to each event insured by this policy as if a separate policy of insurance has bcen issued for that event. I "Who is insured" is amended to include. as an insun:d, the person or organization shown in this schedule, but only with respect to liability arising out ofthl: I ollonen.hip, maintenance or use of the premises used by the named insured (event holder). This insurance does not apply 10: Any "occurrence" which takes place I after the event holder ceases to be a tenant in that premises I OTHER ADDITIONAL INSUREDS - @~@W\! , :1 G",~ m, ,,-" ~-" -- ",,,. .,..."". ~ .,",., - "-", """"~' ." "., '"'~ 00'''"""'' ~ certificate holder and addltlonal msureds hsted. ~;7~ AUTHORIZED REPRESENTATIVE D\TE ISSUED: Januarv 4. 2007 Generated by Risk Management Division by: f:-.. I i7f~ ~/l/I.q /J j tA....-