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FAX NO. :7145509285 May. 17 2007 04:53PM P1 <br />SFNTA A14A RISK MGMT. Fax:7i4-647-5311 NIay 16 2007 16:59 P.O, <br />S tJ1 : tiSURA�CE COMPANY <br />-ATE 110: 2W-0 <br />CERTIFICATE OF INSURANCE <br />EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS BOIL NOMINEE I VENTS. <br />UECIAL EVENT LIABILITY PROGI AM <br />PRODUCER: <br />PUBLIC ENTITY (ADDITIONAL INSLRHDi <br />City of Santa Ana <br />Alliant Insurance Services, Inc, in conjuactioa with <br />20 Civic Center Plaza, M-28 <br />Apex lasutaoce Services <br />Santa Ana, CA 91.701 <br />!� P.O. Box 6430 <br />NC>w�oR 13cach, CA 92658 A-.2005-146-01 <br />(?,a J ,550$163 <br />License No: OC 36861 <br />d NA sW INSURED (EVENT HOLDER): <br />EVENT TNFORNfATION: <br />II CAP fbo ACADEMY OF Mill, DANCE <br />TYPY Ballet Class <br />220 E. 4TY3 $T, UNIT #202 <br />DATE($); San, 1.07 - Dec. 31, 07 <br />SANTA ANA, CA 92701 <br />LOCATION: . sthoigg fgater k <br />•"Li uor Liability alter 2ain <br />ris is to certify bat the policies of insurance lined below have been issued to the lasnxad named above for the peticy per od <br />iudicated.: Tornithstanding any requitaments, terms or conditions of any coanraet or other document wirh respect to whicb this <br />cemlicate may be issaad or tray pertain, the inswance afforded by the policies desenbed herent is subject to all the taims, <br />cx:': eons and conditions of such policies_ Lir drs shown may have been Ndticed by paid claims, <br />*'ti5'71? 4 NCE CARRIER; Eranstm Insurance Company <br />N'A1TS:*+.POT,ICYNUmBER- 04SEP1000007 <br />` MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2007 EXPIRAT : ANUARY 1, ZOOS <br />CONVMCM OlniMI1AL UAJ31 " <br />OCCl1BRb^ICF F'O;Ni <br />�:: DEDUCIMLE: NONC <br />Gesbral Airgm ate Lirrlt S2Ao0,000 <br />Products & Complewd Oporetions I OOO,oW <br />PAfBOgBi Bc Adverti.irra ltryory },opQ,(1p9 <br />'i�i. <br />ExhOcauttn:c li¢ti' 1,OOo,Doo <br />� <br />Foe Damyo(Any One Fire) so,stro <br />Iii <br />J�;viedieal F0111011115 (Art One Poroon) <br />q <br />�! <br />i'i 71v 1)rlrlh Of )rr51,r9Y.'tapply soqaztdto asd1 event imureAl: oY ea4 pOnCV aA if i espaeare jM:KY Of im <br />bee¢ utued tb, 4,. ClWt <br />-WLo is i:ssrsl is amended to include, as u i nwed, the person of o(SWI eRiM ilho m in ibis Aehedulo <br />, ' with tespoct to liability wising ort oft g <br />I� owb rshipl ruiptertiam or use oA Ute premises used by ran Rained roster+ aven(Lolder). This irAURa <br />m Apply so: Any "occurru�,oe' whioA aka place <br />- -� �elsa eves ro W a tenant in d7er pramiws <br />0 rHER ADDITIONAL LNSL <br />I <br />4 <br />..'�n):(`�r1:dTillN'CR,viAfY.a ahnw_Aehhv7�l Mil..v of euvellu3 LCfO,e dlEeX01[aa0n dew iLlssa'diol <br />I <br />G�earlY Arn matl3o dans miens ivsg tptbe <br />ddilionel tdsmeds Iliad. 1 <br />-.a�TAIi0R17.ED REPRESENTATIVE: <br />DATE ISSUBD; May 16 2007 <br />";^Generpred by Risk Managemem Division by <br />TO FORM <br />A tin�t.1 IL i t.}' ;�,LiOCiCV <br />