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cv'uv~nnv I,~~ultH:vlt•~'VMYANY <br />l ER'I'IFiCATE NO.: 2007-U7 <br />CERTIFICATE OF INSURANCE. <br />EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. <br />SPECIAL EVENT LIABILITY PROGRAM <br />r PRUD~C'GR. PUBLIC ENTITY (ADDITIONAL INSURED) <br />II City of Santa Ana <br />~ :1llimu lnswance Set vices, Inc, in conjunction with 20 Civic Ceater Plaza, M-28 <br />` ~prx Insurance Services Saata Ana, CA 92701 <br />P t . Ro>: 6450 <br />\owixtrt Reach. CA 92618 <br />s ri4q) 660-816 <br />I iccnse Nu: OC 3686! <br />[v~V1FU [NSURF:D I F.VLN C HOLDER): <br />$ EVENT INFORMATION: <br />~~Q(p _ /~ <br />Luis Martinez TYPE. Self•Imorovement <br />N <br />1681 Cameo Drive ~ DATE(S): 01/01/07 - 12/31/07 <br />i ~;tote Ana, CA 927175 /)/~ aQa(- /~'~~ LOCATION' Santa Ana Jail <br />I; **Li uorl.iabilit after2am ^ <br />_, _._ <br />I hi; is to cenily that the policies of insurance listed below have been issued to the instued named above for the policy period <br />'I ^Idtcated Notwithstanding any requirements, terms or conditions of any conAact or other document with respect to which this <br />cdrlifcate may be tssued ur may pertain, the insurance afforded ]yy the policies described herein is subject to all the terms, <br />~~ escEu,iuns and conditions of such policies. Limits shown may have been reduced by paid claims. <br />[NSU1tANCE CARRIER: Evanston Insurance Company <br />M1tASI'Ek PULICY NUMBER: 04SEP1000001 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2007 EXPIRATION: JANUARY 1, 2008 <br />L- <br />! t a tMMPltI'IA1. liliNEltAL I [AHILI'fY U[:CIIRRENCE FURM DEDIiCT[66E. NONE <br />~ I~nu•nd Aggregate limit 52.OUg0170 <br />I Products A Completed Upernuans 1 400,000 <br />1'ersonul dt Advertising Injury 1.DOQ,OOU <br />I nch ikcurtrna Limit I,000.WU <br />I he I7mnagr IAu7 lhlr Pod SU,WII <br />hlnhud Pacnrcnls IAm Vne Prrsanl 5I1M1 <br />.l <br /> <br />pp y parately u+r:mh event insured by the ohc u it'a. ohc of insurance has been iswed for that event. <br />i he luaus ur nna,ancc :+ I xr P Y ~P~rP 5 _. <br />ls'hu ~. msured' s amended lu include, as an ,nsuted, the person nr arganirntion shown m Zhu schedule, but duly wish respect iu Eiability artsmg out oFthe <br />~~+tner.hip nminlrnuucr ur use ul [nr prrnuses used by the named msured Icvrnt hntdeq. This insurwtae does not apply w'. Any "occurrence" which takes plnce <br />{ <br />n., IiK ccun hnldn erases m be a lenaln in that premises. <br />OTHER ADll!'1'[UNAL INSUREDS <br />I~ <br />` <br />I <br />I -- -- <br />j jt VCI`L_I SuN' Should tlw ahnvo dCSefitfed pOhey to wncxllcd hcforc the cxpiratkat date theredl; the,ssuiag company will toed 30 tlltY$ writu.n notice m the <br />I <br />I <br />cnidcare tnddrl and additional msttrals lislcd. _ _ <br />~~ ~ ~~ <br />1tPT1IURILED RLPRF.SF.NIA~fIVL: <br />);LTE ISSUED Jany[~ry 01 .x,007 -. - <br />~rnrrurud hr Rlsk :Llunuge»tcnt Drveslnn by ~Y ~,W a~~~G.~ <br />