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<br />EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 2007-11 <br /> <br />CERTIFICATE OF INSURANCE <br />EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEP ARA TE APPLICATIONS FOR NOMINEE EVENTS. <br />SPECIAL EVENT LIABILITY PROGRAM <br /> <br />PRODUCER: PUBLIC ENTITY (ADDITIONAL INSURED) <br /> City of Santa Ana <br />AHiant Insurance Services, Inc. in conjunction with 20 Civic Center Plaza, M-28 <br />Apex Insurance Services Santa Ana, CA 92701 <br />P. O. Box 6450 <br />Newport Beach, CA 92658 <br />(949) 660-8163 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: <br />Suzanna Bond TYPE: Arts and Crafts <br />21570 Dunrobin Way DATE(S): 211107 - 12131/07 <br />Y orba Linda, CA 92887 LOCATION: Santia!!o Lawn Bowlin!! Center <br /> **Liouor Liabilitv after 2am 0 <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 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 is subject to all the terms, <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 I <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1,2007 EXPIRATION: JANUARY 1,2008 <br />COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE <br />aon.ra1 Aggregate Limit $ 2,000.000 <br />Products & Completed Operations 1,000,000 <br />Personal & Advmising Injwy 1,000.000 <br />Each Occurrence Limit 1,000,000 <br />Fin: Damage (Any On. Fire) 50,000 <br />Medical Payments (Any One Person) 5,000 <br />The limits of insurance apply separately to each event inswed by this policy as if a separate policy of insurance has been issued for that event. <br />"Who is insured" is amended to include, as an insured, the person or organization shown in this schedule, but only with respect to liability arising out of the <br />ownership, 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 />after the event holder ceases to be a tenant in that premises. <br /> OTHER ADDITIONAL INSUREDS <br />CANCELLATION. Should the above described policy to cancelled before the expiration date thereof. the issuing companv'. -- f1.ays written notice to the <br /> -'~\~,{ <br />certificate holder and additional insureds listed. I r ru f ( ,\ \ <br /> ~-'" <br /> <br />~;z~ <br /> <br />Tn r.'-),~ "",,1 <br /> <br />AUTHORIZED REPRESENTATIVE: <br /> <br />~ <br /> <br />DATE ISSUED: February 01. 2007 <br />.. Generated by Risk Management Division by: 6;"Y'"'" .'7?2~f a ,~L- <br />