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EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 2008-02 CERTIFICATE OF INSURANCE EXCLUDES COVERAGE FOR NOMINEE EV E`NTTSS. SSE SEPARATE TE APPLICATIONS FOR NOMINEE EVENTS. PROGRAM SPEC Alliant Insurance Services, Inc. Apex Insurance Services P. O. Box 6450 Newport Beach, CA 92659 (949)660-8135 Salomon Rivera 709 S. Parton Street Santa Ana, CA 92701 TYPE: Dance Class - Salsa DATE(S): Jan. 2008 —December 2008 LOCATION: Southwest Senior Center *Liquor Liability Yes ❑ No **T .' .. r ial,ility after 12 am ends before 2 ar ❑ This is to certify that the policies of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirements, terms or conditions of any contract or other document with respect to which this certificate tray 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: 04SEP 1000001.4 MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2008 EXPIRATION: IANUARY 1, 2009 OCCURRENCEFORM DEDUCTIBLE: NONE COMMERCIAL GENERAL LIABILITYS Z 000 000 General Aggregate Limit 1,000,000 Products & Coumleud Operations1000A00 Personal &Advertising Injury 1000p00 Each OccurrenceLimit 50,000 Fire Damage (Any One Fire) 5 ,000 Medical Paymerts(Any One Person) 1000000 Liquor Liability (If purchased) .-;--A t,., Ahia n EM as if a SCnaratepolicy of insurance 1!!Ib= issued ftm that event the hrtrirs otmsurance appy scpmcwr .+. �-.."_. _... "Who is insured" is amended to include, as an insured, the person a Organisation shown m this schedule, but only with respect to liability arising out of the ownership, maintenance or use of the premises used by the named insured (even tholder)- This vuuraoce dow not apply to: Any "Occurrence" which takes place CANCEL LATION� Should the above described policy to cancelled before the expiration date thereof, the issuing company will mail 30 days written notice to the certificate holder and additional insureds listed. lal AUTHORIZED REPRESENTATIVE: DATE ISSUED: